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Prognostic value of sarcopenia in patients with colorectal liver metastases undergoing hepatic resection. Sci Rep 2020; 10:6459. [PMID: 32296122 PMCID: PMC7160152 DOI: 10.1038/s41598-020-63644-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 04/03/2020] [Indexed: 02/06/2023] Open
Abstract
The prognostic significance of sarcopenia has been widely studied in different cancer patients. This study aimed to analyze the influence of sarcopenia on long-term survival in patients with colorectal liver metastasis (CRLM) undergoing hepatic resection. A retrospective analysis of 182 patients undergoing hepatic resection for CRLM was performed. Sarcopenia was determinedusing the Hounsfield unit average calculation (HUAC), a measure of muscle quality-muscledensity at preoperative abdominal computed tomography scans. Sarcopenia was defined as an HUAC score of less than 22 HU calculated using receiver operating characteristic analysis. The prognostic relevance of clinical variables and overall survival (OS) and recurrence-free survival (RFS) was evaluated. Patients with sarcopenia were older (p < 0.001) and had higher prevalence of diabetics (p = 0.004), higher body mass index (BMI) (p < 0.001) and neutrophil-to-lymphocyte ratio (p = 0.026) compared to those without. Sarcopenia was not significantly associated with OS and RFS. Multivariate Cox’s regression analysis showed that multinodularity (>3) (hazard ratio (HR) 2.736; 95% confidence interval (CI), 1.631–4.589; p < 0.001), high CEA level (≥20 ng/ml) (HR 1.793; 95% CI, 1.092–2.945; p = 0.021) and blood loss (≥300 cc) (HR1.793; 95% CI, 1.084–2.964; p = 0.023) were independent factors associated with OS. In subgroup analyses, sarcopenia was a significant factor of poor OS in the patients with multinodularity by univariate (p = 0.002) and multivariate analyses(HR 3.571; 95% CI, 1.508–8.403; p = 0.004). Multinodularity (>3) (HR 1.750; 95% CI, 1.066–2.872; p = 0.027), high aspartate aminotransferase level (HR 1.024; 95% CI, 1.003–1.046; p = 0.025) and male gender (HR 1.688; 95% CI, 1.036–2.748; p = 0.035) were independent factors of RFS. In conclusion, despite no significance in whole cohort, sarcopenia was predictive of worse OS in patients with multiple CRLM after partial hepatectomy.
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152
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Bian A, Ma Y, Zhou X, Guo Y, Wang W, Zhang Y, Wang X. Association between sarcopenia and levels of growth hormone and insulin-like growth factor-1 in the elderly. BMC Musculoskelet Disord 2020; 21:214. [PMID: 32264885 PMCID: PMC7140321 DOI: 10.1186/s12891-020-03236-y] [Citation(s) in RCA: 121] [Impact Index Per Article: 24.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 03/25/2020] [Indexed: 12/14/2022] Open
Abstract
Background Age-related sarcopenia is a serious global health issue in elderly individuals and for the community as it induces disability and significant economic burden. The purpose of the study is to understand the factors associated with sarcopenia and the role of growth hormone (GH) and insulin-like growth factor (IGF-1) in the occurrence of sarcopenia. Methods Elderly patients (n = 3276) were included in this cross-sectional study. Survey and measurement of body composition (bioelectrical impedance), grip strength, and step speed were performed according to the Asian Working Group on Sarcopenia (AWGS) diagnostic criteria. Hematological and hormonal indicators were compared between patients with and without sarcopenia in order to identify the associated factors. Results There were significant differences in the demographic parameters between the sarcopenia and non-sarcopenia groups (all P < 0.05). There were significant differences between the two groups regarding the blood levels of GH, IGF-1, testosterone (T), and mechanical growth factor (MGF) (all P < 0.001). Correlation analyses showed that the appendicular skeletal muscle mass (ASMI) was positively associated with gender and BMI, and with GH, T, IGF-1, MGF, BUN, Cr, and Hb levels, but negatively associated with HDL-C (all P < 0.05). Logistic multivariable regression analysis showed that IGF-1, MGF, BMI, and gender were independently associated with appendicular skeletal muscle mass (ASMI) (all P < 0.05). Conclusions GH and IGF-1 are associated with sarcopenia in the elderly. IGF-1 and MGF are independently associated with the reduction of skeletal muscle mass, along with BMI and gender.
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Affiliation(s)
- Ailin Bian
- Geriatrics Department, Tianjin First Central Hospital, No. 24, Fukang Road, Nankai District, Tianjin, 300192, China.
| | - Yue Ma
- Geriatrics Department, Tianjin First Central Hospital, No. 24, Fukang Road, Nankai District, Tianjin, 300192, China
| | - Xinzi Zhou
- Geriatrics Department, Tianjin First Central Hospital, No. 24, Fukang Road, Nankai District, Tianjin, 300192, China
| | - Ying Guo
- Geriatrics Department, Tianjin First Central Hospital, No. 24, Fukang Road, Nankai District, Tianjin, 300192, China
| | - Wenyi Wang
- Geriatrics Department, Tianjin First Central Hospital, No. 24, Fukang Road, Nankai District, Tianjin, 300192, China
| | - Yiran Zhang
- Geriatrics Department, Tianjin First Central Hospital, No. 24, Fukang Road, Nankai District, Tianjin, 300192, China
| | - Xiaofei Wang
- Geriatrics Department, Tianjin First Central Hospital, No. 24, Fukang Road, Nankai District, Tianjin, 300192, China.
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153
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Vergara-Fernandez O, Trejo-Avila M, Salgado-Nesme N. Sarcopenia in patients with colorectal cancer: A comprehensive review. World J Clin Cases 2020; 8:1188-1202. [PMID: 32337193 PMCID: PMC7176615 DOI: 10.12998/wjcc.v8.i7.1188] [Citation(s) in RCA: 87] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 03/06/2020] [Accepted: 03/14/2020] [Indexed: 02/05/2023] Open
Abstract
Colorectal cancer (CRC) is the third most commonly diagnosed cancer globally and the second cancer in terms of mortality. The prevalence of sarcopenia in patients with CRC ranges between 12%-60%. Sarcopenia comes from the Greek "sarx" for flesh, and "penia" for loss. Sarcopenia is considered a phenomenon of the aging process and precedes the onset of frailty (primary sarcopenia), but sarcopenia may also result from pathogenic mechanisms and that disorder is termed secondary sarcopenia. Sarcopenia diagnosis is confirmed by the presence of low muscle quantity or quality. Three parameters need to be measured: muscle strength, muscle quantity and physical performance. The standard method to evaluate muscle mass is by analyzing the tomographic total cross-sectional area of all muscle groups at the level of lumbar 3rd vertebra. Sarcopenia may negatively impact on the postoperative outcomes of patients with colorectal cancer undergoing surgical resection. It has been described an association between sarcopenia and numerous poor short-term CRC outcomes like increased perioperative mortality, postoperative sepsis, prolonged length of stay, increased cost of care and physical disability. Sarcopenia may also negatively impact on overall survival, disease-free survival, recurrence-free survival, and cancer-specific survival in patients with non-metastatic and metastatic colorectal cancer. Furthermore, patients with sarcopenia seem prone to toxic effects during chemotherapy, requiring dose deescalations or treatment delays, which seems to reduce treatment efficacy. A multimodal approach including nutritional support (dietary intake, high energy, high protein, and omega-3 fatty acids), exercise programs and anabolic-orexigenic agents (ghrelin, anamorelin), could contribute to muscle mass preservation. Addition of sarcopenia screening to the established clinical-pathological scores for patients undergoing oncological treatment (chemotherapy, radiotherapy or surgery) seems to be the next step for the best of care of CRC patients.
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Affiliation(s)
- Omar Vergara-Fernandez
- Department of Colorectal Surgery, Instituto Nacional de Ciencias Medicas y Nutrición “Salvador Zubirán”, Mexico 14080, Mexico
| | - Mario Trejo-Avila
- Department of Colorectal Surgery, Instituto Nacional de Ciencias Medicas y Nutrición “Salvador Zubirán”, Mexico 14080, Mexico
| | - Noel Salgado-Nesme
- Department of Colorectal Surgery, Instituto Nacional de Ciencias Medicas y Nutrición “Salvador Zubirán”, Mexico 14080, Mexico
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Sharpe M, Okoye E, Antoniou GA. Prognostic review and time-to-event data meta-analysis of low skeletal muscle mass in patients with peripheral arterial disease of the lower limbs undergoing revascularization. INT ANGIOL 2020; 39:50-59. [DOI: 10.23736/s0392-9590.19.04248-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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155
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Alalwan TA. Phenotypes of Sarcopenic Obesity: Exploring the Effects on Peri-Muscular Fat, the Obesity Paradox, Hormone-Related Responses and the Clinical Implications. Geriatrics (Basel) 2020; 5:geriatrics5010008. [PMID: 32075166 PMCID: PMC7151126 DOI: 10.3390/geriatrics5010008] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 02/03/2020] [Accepted: 02/06/2020] [Indexed: 12/11/2022] Open
Abstract
Sarcopenic obesity combines the words sarcopenia and obesity. This definition of obesity should be better differentiated between visceral and subcutaneous fat phenotypes. For this reason, this review lays the foundation for defining the subcutaneous and the visceral fat into the context of sarcopenia. Thus, the review aims to explore the missing links on pathogenesis of visceral fat and its relationship on age: defining the peri-muscular fat as a new entity and the subcutaneous fat as a first factor that leads to the obesity paradox. Last but not least, this review underlines and motivates the mechanisms of the hormonal responses and anti-inflammatory adipokines responsible for the clinical implications of sarcopenic visceral obesity, describing factor by factor the multiple axis between the visceral fat-sarcopenia and all mortality outcomes linked to cancer, diabetes, cardiovascular diseases, cirrhosis, polycystic ovary, disability and postoperative complications.
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Affiliation(s)
- Tariq A Alalwan
- Department of Biology, College of Science, University of Bahrain, Sakhir P.O. Box 32038, Bahrain
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156
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Examining Bone, Muscle and Fat in Middle-Aged Long-Term Endurance Runners: A Cross-Sectional Study. J Clin Med 2020; 9:jcm9020522. [PMID: 32075157 PMCID: PMC7073848 DOI: 10.3390/jcm9020522] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Revised: 02/10/2020] [Accepted: 02/13/2020] [Indexed: 11/18/2022] Open
Abstract
Aerobic exercise training has many known cardiovascular benefits that may promote healthy aging. It is not known if long-term aerobic exercise training is also associated with structural benefits (e.g., lower fat mass, higher areal bone mineral density (BMD) and greater muscle mass). We evaluated these parameters in middle-aged long-term endurance runners compared to sex-, age-, height-, and weight-matched non-running controls. Total and regional lean and fat mass and areal BMD were assessed by dual-energy X-ray absorptiometry. Sagittal magnetic resonance images captured the cross-sectional area and thickness of the lumbar multifidus. Runners (n = 10; all male) had a mean (standard deviation; SD) age of 49 (4) years, height of 178.9 (4.9) cm, weight of 67.8 (5.8) kg, body mass index (BMI) of 21.4 (1.4) kg/m2 and had been running 82.6 (27.9) km/week for 23 (13) years. Controls (n = 9) had a mean (SD) age of 51 (5) years, height of 176.0 (5.1) cm, weight of 72.8 (7.1) kg, and BMI of 23.7 (2.1) kg/m2. BMI was greater in controls (p = 0.010). When compared to controls on average, runners had a 10 percentage-point greater total body lean mass than controls (p = 0.001) and 14% greater trunk lean mass (p = 0.010), as well as less total body (8.6 kg; p < 0.001), arm (58%; p = 0.002), leg (52%; p < 0.001), trunk (73%; p < 0.001), android (91%; p < 0.001), and gynoid fat mass (64%; p < 0.001). No differences were observed between groups for BMD outcomes or multifidus size. These results underscore the benefits of endurance running to body composition that carry over to middle-age.
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157
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Thomas R, Shinagare AB, Rosenthal MH, Lee B, Jacene HA, Johnston MA, Overmoyer BA. Computed tomographic assessment of lean body mass in patients on selective androgen receptor modulator. Clin Imaging 2020; 59:100-103. [DOI: 10.1016/j.clinimag.2019.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Revised: 07/30/2019] [Accepted: 08/15/2019] [Indexed: 11/28/2022]
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158
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Centonze L, Di Sandro S, Lauterio A, De Carlis R, Botta F, Mariani A, Bagnardi V, De Carlis L. The Impact of Sarcopenia on Postoperative Course following Pancreatoduodenectomy: Single-Center Experience of 110 Consecutive Cases. Dig Surg 2020; 37:312-320. [PMID: 31958796 DOI: 10.1159/000504703] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 11/10/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND Despite that mortality following pancreatoduodenectomy (PD) has gradually dropped during the past few decades, the incidence of postoperative complications remains high, ranging from 30-60%. Many studies have been focused on identification of perioperative risk factors for morbidity, and in recent years, sarcopenia has been pointed out as a valid predictor of postoperative complication. MATERIALS AND METHODS Perioperative data from 110 consecutive patients who underwent PD were retrieved, and the presence of sarcopenia was assessed by the measurement of Hounsfield unit average calculation on preoperative CT scans. Postoperative complications were graded according to Clavien-Dindo classification, and the morbidity burden was assessed by comprehensive complication index (CCI) calculation. RESULTS Sarcopenia was associated with advanced age (72 vs. 66 years; p = 0.014) and lower preoperative albumin levels (3.5 vs. 3.7 g/dL; p = 0.010); it represented an independent risk factor for clinically relevant complications (relative risk: 1.71; p = 0.015) and was related to a higher rate of Grade C postoperative pancreatic fistula (50.0 vs. 11.4%; p = 0.005) and a higher CCI (47.6 vs. 29.6; p = 0.001). CONCLUSIONS Sarcopenia represents a valid indicator of increased morbidity risk and may play a central role in preoperative risk stratification, allowing the selection of patients who may benefit from prehabilitation programs.
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Affiliation(s)
- Leonardo Centonze
- Department of General Surgery and Transplantation, Niguarda Ca' Granda Hospital, Milan, Italy,
| | - Stefano Di Sandro
- Department of General Surgery and Transplantation, Niguarda Ca' Granda Hospital, Milan, Italy
| | - Andrea Lauterio
- Department of General Surgery and Transplantation, Niguarda Ca' Granda Hospital, Milan, Italy
| | - Riccardo De Carlis
- Department of General Surgery and Transplantation, Niguarda Ca' Granda Hospital, Milan, Italy
- Department of Surgical Sciences, University of Pavia, Pavia, Italy
| | - Francesca Botta
- Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Milan, Italy
| | - Anna Mariani
- Department of General Surgery and Transplantation, Niguarda Ca' Granda Hospital, Milan, Italy
| | - Vincenzo Bagnardi
- Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Milan, Italy
| | - Luciano De Carlis
- Department of General Surgery and Transplantation, Niguarda Ca' Granda Hospital, Milan, Italy
- School of Medicine, University of Milan-Bicocca, Milan, Italy
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159
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Veronese N. Frailty as Cardiovascular Risk Factor (and Vice Versa). ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1216:51-54. [DOI: 10.1007/978-3-030-33330-0_6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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160
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Shou J, Chen PJ, Xiao WH. Mechanism of increased risk of insulin resistance in aging skeletal muscle. Diabetol Metab Syndr 2020; 12:14. [PMID: 32082422 PMCID: PMC7014712 DOI: 10.1186/s13098-020-0523-x] [Citation(s) in RCA: 160] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Accepted: 02/04/2020] [Indexed: 12/17/2022] Open
Abstract
As age increases, the risk of developing type 2 diabetes increases, which is associated with senile skeletal muscle dysfunction. During skeletal muscle aging, mitochondrial dysfunction, intramyocellular lipid accumulation, increased inflammation, oxidative stress, modified activity of insulin sensitivity regulatory enzymes, endoplasmic reticulum stress, decreased autophagy, sarcopenia and over-activated renin-angiotensin system may occur. These changes can impair skeletal muscle insulin sensitivity and increase the risk of insulin resistance and type 2 diabetes during skeletal muscle aging. This review of the mechanism of the increased risk of insulin resistance during skeletal muscle aging will provide a more comprehensive explanation for the increased incidence of type 2 diabetes in elderly individuals, and will also provide a more comprehensive perspective for the prevention and treatment of type 2 diabetes in elderly populations.
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Affiliation(s)
- Jian Shou
- School of Kinesiology, Shanghai University of Sport, 200 Hengren Road, Yangpu District, Shanghai, 200438 China
| | - Pei-Jie Chen
- School of Kinesiology, Shanghai University of Sport, 200 Hengren Road, Yangpu District, Shanghai, 200438 China
| | - Wei-Hua Xiao
- School of Kinesiology, Shanghai University of Sport, 200 Hengren Road, Yangpu District, Shanghai, 200438 China
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161
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Koliaki C, Liatis S, Dalamaga M, Kokkinos A. Sarcopenic Obesity: Epidemiologic Evidence, Pathophysiology, and Therapeutic Perspectives. Curr Obes Rep 2019; 8:458-471. [PMID: 31654335 DOI: 10.1007/s13679-019-00359-9] [Citation(s) in RCA: 102] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE OF REVIEW This review provides a comprehensive update on the definition, assessment, epidemiology, pathophysiology, clinical implications, and therapeutic approach of sarcopenic obesity (SO) and highlights the challenges, limitations, and knowledge gaps in SO research. RECENT FINDINGS The confluence of a rapidly aging population with rising obesity rates has led to the phenotype of SO, defined as the concurrent presence of sarcopenia and obesity. Despite efforts, a standardized definition of SO is still lacking. Its prevalence varies widely between studies, depending on population characteristics and different definitions. The major pathogenetic mechanisms include age-related changes in body composition and hormonal milieu, positive energy balance, pro-inflammatory pathways, and insulin resistance. Lifestyle interventions, including caloric restriction and physical activity, are the cornerstones of SO treatment. SO is a multifaceted syndrome with serious clinical implications. The development and implementation of effective prevention and treatment strategies is a top priority based on its dramatically increasing health impact.
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Affiliation(s)
- Chrysi Koliaki
- First Department of Propaedeutic Internal Medicine and Diabetes Center, School of Medicine, National & Kapodistrian University of Athens, Laiko General Hospital, 17 Agiou Thoma St, 11527, Athens, Greece
| | - Stavros Liatis
- First Department of Propaedeutic Internal Medicine and Diabetes Center, School of Medicine, National & Kapodistrian University of Athens, Laiko General Hospital, 17 Agiou Thoma St, 11527, Athens, Greece
| | - Maria Dalamaga
- Department of Biological Chemistry, Medical School, National & Kapodistrian University of Athens, Athens, Greece
| | - Alexander Kokkinos
- First Department of Propaedeutic Internal Medicine and Diabetes Center, School of Medicine, National & Kapodistrian University of Athens, Laiko General Hospital, 17 Agiou Thoma St, 11527, Athens, Greece.
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162
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Kim BJ, Lee SH, Koh JM. Clinical insights into the kynurenine pathway in age-related diseases. Exp Gerontol 2019; 130:110793. [PMID: 31765740 DOI: 10.1016/j.exger.2019.110793] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 11/18/2019] [Accepted: 11/21/2019] [Indexed: 01/02/2023]
Abstract
Accumulating evidence from diverse experiments, including heterochronic parabiosis-the surgical joining of two animals of different ages-has highlighted the importance of systemic factors in the progressive functional decline of various organs and tissues during aging. The major metabolic pathway of tryptophan, an essential amino acid in humans, is the kynurenine pathway (KP) in which indoleamine 2,3-dioxygenase (IDO) and tryptophan 2,3-dioxygenase (TDO) catalyze the conversion of tryptophan into kynurenine. Importantly, circulating kynurenine produced by this enzymatic breakdown, as a primary driver of the aging process, has been linked to higher mortality in humans. This review discusses the potential roles of tryptophan derivatives as biomarkers for the risk of frailty in the elderly, based on human observational studies as well as the KP as a therapeutic target for age-related diseases.
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Affiliation(s)
- Beom-Jun Kim
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
| | - Seung Hun Lee
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jung-Min Koh
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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163
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Hernández-Álvarez D, Mena-Montes B, Toledo-Pérez R, Pedraza-Vázquez G, López-Cervantes SP, Morales-Salazar A, Hernández-Cruz E, Lazzarini-Lechuga R, Vázquez-Cárdenas RR, Vilchis-DeLaRosa S, Posadas-Rodríguez P, Santín-Márquez R, Rosas-Carrasco O, Ibañez-Contreras A, Alarcón-Aguilar A, López-Díazguerrero NE, Luna-López A, Königsberg M. Long-Term Moderate Exercise Combined with Metformin Treatment Induces an Hormetic Response That Prevents Strength and Muscle Mass Loss in Old Female Wistar Rats. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2019; 2019:3428543. [PMID: 31814870 PMCID: PMC6877950 DOI: 10.1155/2019/3428543] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 09/18/2019] [Indexed: 12/18/2022]
Abstract
Sarcopenia is a syndrome characterized by a progressive and generalized skeletal muscle mass and strength loss, as well as a poor physical performance, which as strongly been associated with aging. Sedentary lifestyle in the elderly contributes to this condition; however, physical activity improves health, reducing morbidity and mortality. Recent studies have shown that metformin (MTF) can also prevent muscle damage promoting muscular performance. To date, there is great controversy if MTF treatment combined with exercise training improves or nullifies the benefits provided by physical activity. This study is aimed at evaluating the effect of long-term moderate exercise combined with MTF treatment on body composition, strength, redox state, and survival rate during the life of female Wistar rats. In this study, rats performed moderate exercise during 20 of their 24 months of life and were treated with MTF for one year or for 6 months, i.e., from 12 to 24 months old and 18 to 24 months old. The body composition (percentage of fat, bone, and lean mass) was determined using a dual-energy X-ray absorption scanner (DXA), and grip strength was determined using a dynamometer. Likewise, medial and tibial nerve somatosensory evoked potentials were evaluated and the redox state was measured by HPLC, calculating the GSH/GSSG ratio in the gastrocnemius muscle. Our results suggest- that the MTF administration, both in the sedentary and the exercise groups, might activate a mechanism that is directly related to the induction of the hormetic response through the redox state modulation. MTF treatment does not eliminate the beneficial effects of exercise throughout life, and although MTF does not increase muscle mass, it increases longevity.
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Affiliation(s)
- David Hernández-Álvarez
- Departamento de Ciencias de la Salud, Universidad Autónoma Metropolitana-Iztapalapa, Ciudad de México 09340, Mexico
- Posgrado en Ciencias Biológicas, Universidad Autónoma Metropolitana, Ciudad de México 09340, Mexico
| | - Beatriz Mena-Montes
- Departamento de Ciencias de la Salud, Universidad Autónoma Metropolitana-Iztapalapa, Ciudad de México 09340, Mexico
- Instituto Nacional de Geriatría, SSA, Ciudad de México 10200, Mexico
- Posgrado en Biología Experimental, Universidad Autónoma Metropolitana-Iztapalapa, Ciudad de México 09340, Mexico
| | - Rafael Toledo-Pérez
- Departamento de Ciencias de la Salud, Universidad Autónoma Metropolitana-Iztapalapa, Ciudad de México 09340, Mexico
- Posgrado en Biología Experimental, Universidad Autónoma Metropolitana-Iztapalapa, Ciudad de México 09340, Mexico
| | - Gibrán Pedraza-Vázquez
- Departamento de Ciencias de la Salud, Universidad Autónoma Metropolitana-Iztapalapa, Ciudad de México 09340, Mexico
- Posgrado en Biología Experimental, Universidad Autónoma Metropolitana-Iztapalapa, Ciudad de México 09340, Mexico
| | - Stefanie Paola López-Cervantes
- Departamento de Ciencias de la Salud, Universidad Autónoma Metropolitana-Iztapalapa, Ciudad de México 09340, Mexico
- Posgrado en Biología Experimental, Universidad Autónoma Metropolitana-Iztapalapa, Ciudad de México 09340, Mexico
| | - Alfredo Morales-Salazar
- Departamento de Ciencias de la Salud, Universidad Autónoma Metropolitana-Iztapalapa, Ciudad de México 09340, Mexico
| | - Edith Hernández-Cruz
- Departamento de Ciencias de la Salud, Universidad Autónoma Metropolitana-Iztapalapa, Ciudad de México 09340, Mexico
| | - Roberto Lazzarini-Lechuga
- Departamento de Biología de la Reproducción, Universidad Autónoma Metropolitana-Iztapalapa, Ciudad de México 09340, Mexico
| | - Roman Royer Vázquez-Cárdenas
- Departamento de Ciencias de la Salud, Universidad Autónoma Metropolitana-Iztapalapa, Ciudad de México 09340, Mexico
| | - Silvia Vilchis-DeLaRosa
- Departamento de Ciencias de la Salud, Universidad Autónoma Metropolitana-Iztapalapa, Ciudad de México 09340, Mexico
| | - Pedro Posadas-Rodríguez
- Departamento de Ciencias de la Salud, Universidad Autónoma Metropolitana-Iztapalapa, Ciudad de México 09340, Mexico
- Posgrado en Biología Experimental, Universidad Autónoma Metropolitana-Iztapalapa, Ciudad de México 09340, Mexico
| | - Roberto Santín-Márquez
- Departamento de Ciencias de la Salud, Universidad Autónoma Metropolitana-Iztapalapa, Ciudad de México 09340, Mexico
- Posgrado en Biología Experimental, Universidad Autónoma Metropolitana-Iztapalapa, Ciudad de México 09340, Mexico
| | | | | | - Adriana Alarcón-Aguilar
- Departamento de Ciencias de la Salud, Universidad Autónoma Metropolitana-Iztapalapa, Ciudad de México 09340, Mexico
| | | | | | - Mina Königsberg
- Departamento de Ciencias de la Salud, Universidad Autónoma Metropolitana-Iztapalapa, Ciudad de México 09340, Mexico
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164
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Chiang PL, Chen YS, Lin AWC. Altered Body Composition of Psoas and Thigh Muscles in Relation to Frailty and Severity of Parkinson's Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16193667. [PMID: 31569569 PMCID: PMC6801975 DOI: 10.3390/ijerph16193667] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 09/23/2019] [Accepted: 09/27/2019] [Indexed: 12/19/2022]
Abstract
Background: To investigate the relationship between fat content and the cross-sectional area of psoas and thigh muscles, and clinical severity in patients with Parkinson’s disease. Materials and Methods: Twenty-five patients and 20 age- and sex-matched normal controls were recruited. All subjects underwent MRI study to determine the fat content of the bilateral psoas and thigh muscles. Muscle quality was measured by grasp, walking speed, and cross-sectional area. All patients underwent clinical surveys to evaluate disease severity and frailty, and analyses of the correlations between muscle quality and disease severity were performed. Results: Compared with the controls, patients exhibited higher fatty content in the measured muscles. The higher fat infiltration of measured muscles was significantly correlated with increased disease severity and frailty in patients. The fat fraction of the bilateral medial compartment of the thigh was correlated with the Unified Parkinson Disease Rating Scale-I results and the fat fraction of the bilateral anterior compartment of the thigh was correlated with weakness and exhaustion in patients. Conclusions: Decreased quality in psoas and thigh muscles is prominent in Parkinson’s disease which is further associated with disease severity and frailty. Awareness of the risk of sarcopenia and associated sequelae might improve patient care and outcomes.
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Affiliation(s)
- Pi-Ling Chiang
- Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta-Pei Road, Niao-Sung, Kaohsiung 83305, Taiwan
| | - Yueh-Sheng Chen
- Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta-Pei Road, Niao-Sung, Kaohsiung 83305, Taiwan
| | - And Wei-Che Lin
- Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta-Pei Road, Niao-Sung, Kaohsiung 83305, Taiwan.
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165
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Yumioka T, Honda M, Nishikawa R, Teraoka S, Kimura Y, Iwamoto H, Morizane S, Hikita K, Takenaka A. Sarcopenia as a significant predictive factor of neutropenia and overall survival in urothelial carcinoma patients underwent gemcitabine and cisplatin or carboplatin. Int J Clin Oncol 2019; 25:158-164. [DOI: 10.1007/s10147-019-01544-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 09/03/2019] [Indexed: 10/26/2022]
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166
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Chan AH, D'Souza RF, Beals JW, Zeng N, Prodhan U, Fanning AC, Poppitt SD, Li Z, Burd NA, Cameron-Smith D, Mitchell CJ. The Degree of Aminoacidemia after Dairy Protein Ingestion Does Not Modulate the Postexercise Anabolic Response in Young Men: A Randomized Controlled Trial. J Nutr 2019; 149:1511-1522. [PMID: 31152658 PMCID: PMC7443755 DOI: 10.1093/jn/nxz099] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 01/04/2019] [Accepted: 04/16/2019] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Resistance exercise and dietary protein stimulate muscle protein synthesis (MPS). The rate at which proteins are digested and absorbed into circulation alters peak plasma amino acid concentrations and may modulate postexercise MPS. A novel mineral modified milk protein concentrate (mMPC), with identical amino acid composition to standard milk protein concentrate (MPC), was formulated to induce rapid aminoacidemia. OBJECTIVES The aim of this study was to determine whether rapid aminoacidemia and greater peak essential amino acid (EAA) concentrations induced by mMPC would stimulate greater postresistance exercise MPS, anabolic signaling, and ribosome biogenesis compared to standard dairy proteins, which induce a small but sustained plasma essential aminoacidemia. METHODS Thirty healthy young men (22.5 ± 3.0 y; BMI 23.8 ± 2.7 kg/m2) received primed constant infusions of l-[ring-13C6]-phenylalanine and completed 3 sets of leg presses and leg extensions at 80% of 1 repetition. Afterwards, participants were randomly assigned in a double-blind fashion to consume 25 g mMPC, MPC, or calcium caseinate (CAS). Vastus lateralis biopsies were collected at rest, and 2 and 4 h post exercise. RESULTS Plasma EAA concentrations, including leucine, were 19.2-26.6% greater in the mMPC group 45-90 min post ingestion than in MPC and CAS groups (P < 0.001). Myofibrillar fractional synthetic rate from baseline to 4 h was increased by 82.6 ± 64.8%, 137.8 ± 72.1%, and 140.6 ± 52.4% in the MPC, mMPC, and CAS groups, respectively, with no difference between groups (P = 0.548). Phosphorylation of anabolic signaling targets (P70S6KThr389, P70S6KThr421/Ser424, RPS6Ser235/236, RPS6Ser240/244, P90RSKSer380, 4EBP1) were elevated by <3-fold at both 2 and 4 h post exercise in all groups (P < 0.05). CONCLUSIONS The amplitude of plasma leucine and EAA concentrations does not modulate the anabolic response to resistance exercise after ingestion of 25 g dairy protein in young men. This trial was registered at http://www.anzctr.org.au/ as ACTRN12617000393358.
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Affiliation(s)
| | | | | | | | | | - Aaron C Fanning
- Fonterra Research and Development Centre, Palmerston North, New Zealand
| | - Sally D Poppitt
- School of Biological Sciences, University of Auckland, Auckland, New Zealand,Riddet Institute, Centre of Research Excellence (CoRE), Palmerston North, New Zealand
| | - Zhong Li
- Roy J. Carver Biotechnology Center
| | - Nicholas A Burd
- Division of Nutritional Sciences,Department of Kinesiology and Community Health, University of Illinois, Urbana, IL
| | - David Cameron-Smith
- Liggins Institute,Riddet Institute, Centre of Research Excellence (CoRE), Palmerston North, New Zealand,Food & Bio-based Products Group, AgResearch, Palmerston North, New Zealand
| | - Cameron J Mitchell
- Liggins Institute,School of Kinesiology, Faculty of Education, University of British Columbia, Vancouver, Canada,Address correspondence to CJM (E-mail: )
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167
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Shintakuya R, Sasaki M, Nakamitsu A, Kohyama M, Tazaki T, Sugiyama Y, Hirano T, Kaiki Y. Sarcopenia is an independent predictor of delayed gastric emptying following pancreaticoduodenectomy: a retrospective study. ANZ J Surg 2019; 89:E433-E437. [DOI: 10.1111/ans.15379] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 06/26/2019] [Accepted: 06/27/2019] [Indexed: 12/15/2022]
Affiliation(s)
- Ryuta Shintakuya
- Department of SurgeryJA Hiroshima General Hospital Hatsukaichi Hiroshima Japan
| | - Masaru Sasaki
- Department of SurgeryJA Hiroshima General Hospital Hatsukaichi Hiroshima Japan
| | - Atsushi Nakamitsu
- Department of SurgeryJA Hiroshima General Hospital Hatsukaichi Hiroshima Japan
| | - Mohei Kohyama
- Department of SurgeryJA Hiroshima General Hospital Hatsukaichi Hiroshima Japan
| | - Tatsuya Tazaki
- Department of SurgeryJA Hiroshima General Hospital Hatsukaichi Hiroshima Japan
| | - Yoichi Sugiyama
- Department of SurgeryJA Hiroshima General Hospital Hatsukaichi Hiroshima Japan
| | - Toshinori Hirano
- Department of SurgeryJA Hiroshima General Hospital Hatsukaichi Hiroshima Japan
| | - Yuki Kaiki
- Department of SurgeryJA Hiroshima General Hospital Hatsukaichi Hiroshima Japan
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168
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Balan E, Schwalm C, Naslain D, Nielens H, Francaux M, Deldicque L. Regular Endurance Exercise Promotes Fission, Mitophagy, and Oxidative Phosphorylation in Human Skeletal Muscle Independently of Age. Front Physiol 2019; 10:1088. [PMID: 31507451 PMCID: PMC6713923 DOI: 10.3389/fphys.2019.01088] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 08/07/2019] [Indexed: 12/12/2022] Open
Abstract
This study investigated whether regular endurance exercise maintains basal mitophagy and mitochondrial function during aging. Mitochondrial proteins and total mRNA were isolated from vastus lateralis biopsies (n = 33) of young sedentary (YS), old sedentary (OS), young active (YA), and old active (OA) men. Markers for mitophagy, fission, fusion, mitogenesis, and mitochondrial metabolism were assessed using qRT-PCR, Western blot, and immunofluorescence staining. Independently of age, fission protein Fis1 was higher in active vs. sedentary subjects (+80%; P < 0.05). Mitophagy protein PARKIN was more elevated in OA than in OS (+145%; P = 0.0026). mRNA expression of Beclin1 and Gabarap, involved in autophagosomes synthesis, were lower in OS compared to YS and OA (P < 0.05). Fusion and oxidative phosphorylation proteins were globally more elevated in the active groups (P < 0.05), while COx activity was only higher in OA than in OS (P = 0.032). Transcriptional regulation of mitogenesis did not vary with age or exercise. In conclusion, physically active lifestyle seems to participate in the maintenance of lifelong mitochondrial quality control by increasing fission and mitophagy.
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Affiliation(s)
- Estelle Balan
- Institute of Neuroscience, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Céline Schwalm
- Institute of Neuroscience, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Damien Naslain
- Institute of Neuroscience, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Henri Nielens
- Saint-Luc University Hospital, Université catholique de Louvain, Brussels, Belgium
| | - Marc Francaux
- Institute of Neuroscience, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Louise Deldicque
- Institute of Neuroscience, Université catholique de Louvain, Louvain-la-Neuve, Belgium
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169
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Lee SY, Tung HH, Peng LN, Chen LK, Hsu CI, Huang YL. Resilience among older cardiovascular disease patients with probable sarcopenia. Arch Gerontol Geriatr 2019; 86:103939. [PMID: 31525556 DOI: 10.1016/j.archger.2019.103939] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 08/18/2019] [Accepted: 08/18/2019] [Indexed: 12/25/2022]
Abstract
AIM AND OBJECTIVES The purpose of this study was to investigate the factors associated with resilience among probable sarcopenia older adults with cardiovascular disease. INTRODUCTION Resilience has been reported to be positively correlated with the mental health and physical functioning of older adults. Previous research has found that the development of resilience constitutes a form of compensation for loss of physical health. It is important for older adults, especially those with other underlying conditions, such as cardiovascular disease and sarcopenia, to have the ability to overcome adversity during the aging process. Thus, resilience becomes a critical characteristic in achieving a better life. METHODS A cross-sectional study design was used. A demographic questionnaire and the Chinese version of the Resilience Scale (CRS) were used to collect data. Multiple logistic regression was used to evaluate the predictors of low resilience. RESULTS A total of 267 participants were recruited, including 126 females and 141 males. Of the participants, 56% of their scores indicated low resilience. Income, education level, exercise time, primary caregiver, and having hypertension were the predictors of resilience. CONCLUSION The population with sarcopenia is increasing worldwide. Understanding resilience levels among older adults with probable sarcopenia is essential for promoting their mental health. Clinicians can use the results of this study to identify populations at high risk for low resilience and design specific interventions to promote better health outcomes.
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Affiliation(s)
- Szu-Ying Lee
- Department of Nursing, Mackay Medical College, No.46, Sec. 3, Zhongzheng Rd., Sanzhi Dist., New Taipei City, 252, Taiwan, ROC.
| | - Heng-Hsin Tung
- School of Nursing, National Yang-Ming University, No.155, Sec.2, Linong Street, Taipei, 112, Taiwan, ROC; Tungs' Taichung MetroHarbor Hospital, No.155, Sec.2, Linong Street, Taipei, 112, Taiwan, ROC.
| | - Li-Ning Peng
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shi-Pai Road, Taipei City, 11217, Taiwan, ROC.
| | - Liang-Kung Chen
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shi-Pai Road, Taipei City, 11217, Taiwan, ROC.
| | - Ching-I Hsu
- Nursing Department, Heart Center of Chen-Hsin Hospital, 45 Cheng-Hsin St, PeiTou, Taipei, 112, Taiwan, ROC.
| | - Yen-Ling Huang
- Nursing Department, Heart Center of Chen-Hsin Hospital, 45 Cheng-Hsin St, PeiTou, Taipei, 112, Taiwan, ROC.
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170
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Gensous N, Bacalini MG, Franceschi C, Meskers CGM, Maier AB, Garagnani P. Age-Related DNA Methylation Changes: Potential Impact on Skeletal Muscle Aging in Humans. Front Physiol 2019; 10:996. [PMID: 31427991 PMCID: PMC6688482 DOI: 10.3389/fphys.2019.00996] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 07/18/2019] [Indexed: 12/27/2022] Open
Abstract
Human aging is accompanied by a decline in muscle mass and muscle function, which is commonly referred to as sarcopenia. Sarcopenia is associated with detrimental clinical outcomes, such as a reduced quality of life, frailty, an increased risk of falls, fractures, hospitalization, and mortality. The exact underlying mechanisms of sarcopenia are poorly delineated and the molecular mechanisms driving the development and progression of this disorder remain to be uncovered. Previous studies have described age-related differences in gene expression, with one study identifying an age-specific expression signature of sarcopenia, but little is known about the influence of epigenetics, and specially of DNA methylation, in its pathogenesis. In this review, we will focus on the available knowledge in literature on the characterization of DNA methylation profiles during skeletal muscle aging and the possible impact of physical activity and nutrition. We will consider the possible use of the recently developed DNA methylation-based biomarkers of aging called epigenetic clocks in the assessment of physical performance in older individuals. Finally, we will discuss limitations and future directions of this field.
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Affiliation(s)
- Noémie Gensous
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | | | - Claudio Franceschi
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.,Lobachevsky State University of Nizhny Novgorod, Nizhny Novgorod, Russia
| | - Carel G M Meskers
- Amsterdam UMC, Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Andrea B Maier
- Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, VIC, Australia
| | - Paolo Garagnani
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.,Clinical Chemistry, Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.,Applied Biomedical Research Center (CRBA), Policlinico S.Orsola-Malpighi Polyclinic, Bologna, Italy.,CNR Institute of Molecular Genetics, Unit of Bologna, Bologna, Italy
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171
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Graffy PM, Liu J, Pickhardt PJ, Burns JE, Yao J, Summers RM. Deep learning-based muscle segmentation and quantification at abdominal CT: application to a longitudinal adult screening cohort for sarcopenia assessment. Br J Radiol 2019; 92:20190327. [PMID: 31199670 DOI: 10.1259/bjr.20190327] [Citation(s) in RCA: 100] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE To investigate a fully automated abdominal CT-based muscle tool in a large adult screening population. METHODS A fully automated validated muscle segmentation algorithm was applied to 9310 non-contrast CT scans, including a primary screening cohort of 8037 consecutive asymptomatic adults (mean age, 57.1±7.8 years; 3555M/4482F). Sequential follow-up scans were available in a subset of 1171 individuals (mean interval, 5.1 years). Muscle tissue cross-sectional area and attenuation (Hounsfield unit, HU) at the L3 level were assessed, including change over time. RESULTS Mean values were significantly higher in males for both muscle area (190.6±33.6 vs 133.3±24.1 cm2, p<0.001) and density (34.3±11.1 HU vs 27.3±11.7 HU, p<0.001). Age-related losses were observed, with mean muscle area reduction of -1.5 cm2/year and attenuation reduction of -1.5 HU/year. Overall age-related muscle density (attenuation) loss was steeper than for muscle area for both sexes up to the age of 70 years. Between ages 50 and 70, relative muscle attenuation decreased significantly more in females (-30.6% vs -18.0%, p<0.001), whereas relative rates of muscle area loss were similar (-8%). Between ages 70 and 90, males lost more density (-22.4% vs -7.5%) and area (-13.4% vs -6.9%, p<0.001). Of the 1171 patients with longitudinal follow-up, 1013 (86.5%) showed a decrease in muscle attenuation, 739 (63.1%) showed a decrease in area, and 1119 (95.6%) showed a decrease in at least one of these measures. CONCLUSION This fully automated CT muscle tool allows for both individualized and population-based assessment. Such data could be automatically derived at abdominal CT regardless of study indication, allowing for opportunistic sarcopenia detection. ADVANCES IN KNOWLEDGE This fully automated tool can be applied to routine abdominal CT scans for prospective or retrospective opportunistic sarcopenia assessment, regardless of the original clinical indication. Mean values were significantly higher in males for both muscle area and muscle density. Overall age-related muscle density (attenuation) loss was steeper than for muscle area for both sexes, and therefore may be a more valuable predictor of adverse outcomes.
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Affiliation(s)
- Peter M Graffy
- 1 University of Wisconsin School of Medicine and Public Health 600 Highland Avenue, Madison, WI 53705
| | - Jiamin Liu
- 2 Radiology and Imaging Sciences, National Institutes of Health Clinical Center, 10 Center Drive, Bethesda, MD 20892-1182
| | - Perry J Pickhardt
- 1 University of Wisconsin School of Medicine and Public Health 600 Highland Avenue, Madison, WI 53705
| | - Joseph E Burns
- 3 Department of Radiological Sciences, University of California-Irvine, Orange, CA
| | - Jianhua Yao
- 2 Radiology and Imaging Sciences, National Institutes of Health Clinical Center, 10 Center Drive, Bethesda, MD 20892-1182
| | - Ronald M Summers
- 2 Radiology and Imaging Sciences, National Institutes of Health Clinical Center, 10 Center Drive, Bethesda, MD 20892-1182
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172
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Yeung SSY, Reijnierse EM, Pham VK, Trappenburg MC, Lim WK, Meskers CGM, Maier AB. Sarcopenia and its association with falls and fractures in older adults: A systematic review and meta-analysis. J Cachexia Sarcopenia Muscle 2019; 10:485-500. [PMID: 30993881 PMCID: PMC6596401 DOI: 10.1002/jcsm.12411] [Citation(s) in RCA: 605] [Impact Index Per Article: 100.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Accepted: 01/27/2019] [Indexed: 12/23/2022] Open
Abstract
Sarcopenia is a potentially modifiable risk factor for falls and fractures in older adults, but the strength of the association between sarcopenia, falls, and fractures is unclear. This study aims to systematically assess the literature and perform a meta-analysis of the association between sarcopenia with falls and fractures among older adults. A literature search was performed using MEDLINE, EMBASE, Cochrane, and CINAHL from inception to May 2018. Inclusion criteria were the following: published in English, mean/median age ≥ 65 years, sarcopenia diagnosis (based on definitions used by the original studies' authors), falls and/or fractures outcomes, and any study population. Pooled analyses were conducted of the associations of sarcopenia with falls and fractures, expressed in odds ratios (OR) and 95% confidence intervals (CIs). Subgroup analyses were performed by study design, population, sex, sarcopenia definition, continent, and study quality. Heterogeneity was assessed using the I2 statistics. The search identified 2771 studies. Thirty-six studies (52 838 individuals, 48.8% females, and mean age of the study populations ranging from 65.0 to 86.7 years) were included in the systematic review. Four studies reported on both falls and fractures. Ten out of 22 studies reported a significantly higher risk of falls in sarcopenic compared with non-sarcopenic individuals; 11 out of 19 studies showed a significant positive association with fractures. Thirty-three studies (45 926 individuals) were included in the meta-analysis. Sarcopenic individuals had a significant higher risk of falls (cross-sectional studies: OR 1.60; 95% CI 1.37-1.86, P < 0.001, I2 = 34%; prospective studies: OR 1.89; 95% CI 1.33-2.68, P < 0.001, I2 = 37%) and fractures (cross-sectional studies: OR 1.84; 95% CI 1.30-2.62, P = 0.001, I2 = 91%; prospective studies: OR 1.71; 95% CI 1.44-2.03, P = 0.011, I2 = 0%) compared with non-sarcopenic individuals. This was independent of study design, population, sex, sarcopenia definition, continent, and study quality. The positive association between sarcopenia with falls and fractures in older adults strengthens the need to invest in sarcopenia prevention and interventions to evaluate its effect on falls and fractures.
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Affiliation(s)
- Suey S Y Yeung
- Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit, Amsterdam, The Netherlands.,Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia
| | - Esmee M Reijnierse
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia
| | - Vivien K Pham
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia
| | - Marijke C Trappenburg
- Department of Internal Medicine, Section of Gerontology and Geriatrics, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands.,Department of Internal Medicine, Amstelland Hospital, Amstelveen, The Netherlands
| | - Wen Kwang Lim
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia
| | - Carel G M Meskers
- Department of Rehabilitation Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Andrea B Maier
- Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit, Amsterdam, The Netherlands.,Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia
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173
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Gonçalves SEAB, Ribeiro AAF, Hirose EY, Santos FPDS, Ferreira FM, Koch LDOM, Tanaka M, de Souza MS, Souza PMR, Gonçalves TJM, Pereira AZ. Brazilian Nutritional Consensus in Hematopoietic Stem Cell Transplantation: Elderly. EINSTEIN-SAO PAULO 2019; 17:eAE4340. [PMID: 31116236 PMCID: PMC6533077 DOI: 10.31744/einstein_journal/2019ae4340] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 09/05/2018] [Indexed: 12/20/2022] Open
Abstract
The Brazilian Nutritional Consensus in Hematopoietic Stem Cell Transplantation: Elderly was elaborated by nutritionists, nutrologists and hematologists physicians from 15 Brazilians reference centers in hematopoietic stem cell transplantation, in order to emphasize the importancy of nutritional status and the body composition during the treatment, as well as the main characteristics related to patient's nutritional assessment. Establishing the consensus, we intended to improve and standardize the nutritional therapy during the hematopoietic stem cell transplantation. The Consensus was approved by the Brazilian Society of Bone Marrow Transplantation.
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Affiliation(s)
| | - Andreza Alice Feitosa Ribeiro
- Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
- Centro de Transplante de Medula Óssea, Rio de Janeiro, RJ, Brazil
| | | | | | | | | | - Márcia Tanaka
- Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
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174
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Cancer-related fatigue and biochemical parameters among cancer patients with different stages of sarcopenia. Support Care Cancer 2019; 28:581-588. [DOI: 10.1007/s00520-019-04717-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 02/25/2019] [Indexed: 02/07/2023]
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175
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Potes Y, Pérez-Martinez Z, Bermejo-Millo JC, Rubio-Gonzalez A, Fernandez-Fernández M, Bermudez M, Arche JM, Solano JJ, Boga JA, Oliván M, Caballero B, Vega-Naredo I, Coto-Montes A. Overweight in the Elderly Induces a Switch in Energy Metabolism that Undermines Muscle Integrity. Aging Dis 2019; 10:217-230. [PMID: 31011474 PMCID: PMC6457058 DOI: 10.14336/ad.2018.0430] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 04/30/2018] [Indexed: 12/19/2022] Open
Abstract
Aging is characterized by a progressive loss of skeletal muscle mass and function (sarcopenia). Obesity exacerbates age-related decline and lead to frailty. Skeletal muscle fat infiltration increases with aging and seems to be crucial for the progression of sarcopenia. Additionally, skeletal muscle plasticity modulates metabolic adaptation to different pathophysiological situations. Thus, cellular bioenergetics and mitochondrial profile were studied in the skeletal muscle of overweight aged people without reaching obesity to prevent this extreme situation. Overweight aged muscle lacked ATP production, as indicated by defects in the phosphagen system, glycolysis and especially mostly by oxidative phosphorylation metabolic pathway. Overweight subjects exhibited an inhibition of mitophagy that was linked to an increase in mitochondrial biogenesis that underlies the accumulation of dysfunctional mitochondria and encourages the onset of sarcopenia. As a strategy to maintain cellular homeostasis, overweight subjects experienced a metabolic switch from oxidative to lactic acid fermentation metabolism, which allows continued ATP production under mitochondrial dysfunction, but without reaching physiological aged basal levels. This ATP depletion induced early signs of impaired contractile function and a decline in skeletal muscle structural integrity, evidenced by lower levels of filamin C. Our findings reveal the main effector pathways at an early stage of obesity and highlight the importance of mitochondrial metabolism in overweight and obese individuals. Exploiting mitochondrial profiles for therapeutic purposes in humans is an ambitious strategy for treating muscle impairment diseases.
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Affiliation(s)
- Yaiza Potes
- 1Department of Morphology and Cell Biology, Faculty of Medicine, University of Oviedo, Asturias, Spain.,2Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Spain
| | | | - Juan C Bermejo-Millo
- 1Department of Morphology and Cell Biology, Faculty of Medicine, University of Oviedo, Asturias, Spain.,2Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Spain
| | - Adrian Rubio-Gonzalez
- 1Department of Morphology and Cell Biology, Faculty of Medicine, University of Oviedo, Asturias, Spain
| | | | | | - Jose M Arche
- 4Geriatric Service, Monte Naranco Hospital, Asturias, Spain
| | - Juan J Solano
- 2Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Spain.,4Geriatric Service, Monte Naranco Hospital, Asturias, Spain
| | - Jose A Boga
- 3Microbiology Service, Central University Hospital of Asturias, Asturias, Spain
| | - Mamen Oliván
- 2Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Spain.,5Servicio Regional de Investigación y Desarrollo Agroalimentario (SERIDA), Asturias, Spain
| | - Beatriz Caballero
- 1Department of Morphology and Cell Biology, Faculty of Medicine, University of Oviedo, Asturias, Spain.,2Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Spain
| | - Ignacio Vega-Naredo
- 1Department of Morphology and Cell Biology, Faculty of Medicine, University of Oviedo, Asturias, Spain.,2Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Spain
| | - Ana Coto-Montes
- 1Department of Morphology and Cell Biology, Faculty of Medicine, University of Oviedo, Asturias, Spain.,2Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Spain
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176
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Brightwell CR, Markofski MM, Moro T, Fry CS, Porter C, Volpi E, Rasmussen BB. Moderate-intensity aerobic exercise improves skeletal muscle quality in older adults. TRANSLATIONAL SPORTS MEDICINE 2019; 2:109-119. [PMID: 31123725 PMCID: PMC6518946 DOI: 10.1002/tsm2.70] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 01/16/2019] [Accepted: 01/22/2019] [Indexed: 12/12/2022]
Abstract
Sarcopenia, age-associated involuntary loss of muscle and strength, can progress to clinically relevant functional decline. Resistance exercise attenuates muscle and strength loss but may not be feasible for some older adults. Aerobic exercise training (AET) improves cardiopulmonary health; however, effects on protein turnover, muscle mass, and strength are less clear. We aimed to determine whether AET improves basal myofibrillar protein synthesis (MPS) and capillarization, promoting hypertrophy and strength. We hypothesized that AET improves strength with increased MPS and capillarization. Older adults were randomized to non-exercise (NON; n = 11, 71.4 ± 4.18 years) or exercise (EX; n = 12, 73.7 ± 4.05 years). EX completed 24 weeks of AET (walking 3×/week, 45 minutes, 70% heart rate reserve); NON remained sedentary. A stable isotope tracer was infused. MPS and capillarization were analyzed from vastus lateralis muscle biopsies. Strength was measured via isokinetic dynamometry. Lean mass was determined with dual-energy X-ray absorptiometry. Basal MPS increased in EX (+50.7%, P = 0.01) along with capillary density (+66.4%, P = 0.03), peak oxygen consumption (+15.8%, P = 0.01), quadriceps strength (+15.1%, P = 0.01), and muscle quality (peak torque divided by leg lean mass, +15.5%, P = 0.01). Lean mass did not change (P > 0.05). AET increases muscle protein turnover and capillarization in older adults, improving muscle quality.
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Affiliation(s)
- Camille R. Brightwell
- Department of Nutrition and MetabolismUniversity of Texas Medical BranchGalvestonTexas
- Division of Neuroscience, Cell Biology and AnatomyUniversity of Texas Medical BranchGalvestonTexas
| | | | - Tatiana Moro
- Department of Nutrition and MetabolismUniversity of Texas Medical BranchGalvestonTexas
- Sealy Center on AgingUniversity of Texas Medical BranchGalvestonTexas
- Center for RecoveryPhysical Activity, and NutritionUniversity of Texas Medical BranchGalvestonTexas
| | - Christopher S. Fry
- Department of Nutrition and MetabolismUniversity of Texas Medical BranchGalvestonTexas
- Center for RecoveryPhysical Activity, and NutritionUniversity of Texas Medical BranchGalvestonTexas
| | - Craig Porter
- Center for RecoveryPhysical Activity, and NutritionUniversity of Texas Medical BranchGalvestonTexas
- Metabolism UnitShriners Hospitals for ChildrenGalvestonTexas
| | - Elena Volpi
- Sealy Center on AgingUniversity of Texas Medical BranchGalvestonTexas
- Center for RecoveryPhysical Activity, and NutritionUniversity of Texas Medical BranchGalvestonTexas
| | - Blake B. Rasmussen
- Department of Nutrition and MetabolismUniversity of Texas Medical BranchGalvestonTexas
- Sealy Center on AgingUniversity of Texas Medical BranchGalvestonTexas
- Center for RecoveryPhysical Activity, and NutritionUniversity of Texas Medical BranchGalvestonTexas
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177
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Metabolic and Molecular Basis of Sarcopenia: Implications in the Management of Urothelial Carcinoma. Int J Mol Sci 2019; 20:ijms20030760. [PMID: 30754663 PMCID: PMC6387186 DOI: 10.3390/ijms20030760] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 02/05/2019] [Accepted: 02/09/2019] [Indexed: 12/11/2022] Open
Abstract
Sarcopenia, which represents the degenerative and systemic loss of skeletal muscle mass, is a multifactorial syndrome caused by various clinical conditions. Sarcopenia reflects not only frailty and poor general health status, but also the possible presence of advanced or progressive cancer or cancer cachexia. Therefore, sarcopenia affects the management of cancer-bearing patients, including those with urothelial carcinoma. Recently, growing evidence has shown that sarcopenia is significantly associated with higher rates of treatment-related complications and worse prognosis in patients with urothelial carcinoma, including muscle-invasive bladder cancer, upper tract urothelial carcinoma, and advanced urothelial carcinoma. Moreover, several studies reported that a post-therapeutic increase in skeletal muscle mass predicts favorable prognosis in urothelial carcinoma patients. To further explore the role of sarcopenia in the management of urothelial carcinoma patients, comprehensive understanding of its pathophysiology is vital. In this article, we reviewed the metabolic and molecular basis of cancer cachexia and sarcopenia. From this viewpoint, we discussed the possible mechanism of changes in skeletal muscle mass during the course of treatment.
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178
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Rubio-Ruiz ME, Guarner-Lans V, Pérez-Torres I, Soto ME. Mechanisms Underlying Metabolic Syndrome-Related Sarcopenia and Possible Therapeutic Measures. Int J Mol Sci 2019; 20:ijms20030647. [PMID: 30717377 PMCID: PMC6387003 DOI: 10.3390/ijms20030647] [Citation(s) in RCA: 111] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Revised: 01/30/2019] [Accepted: 01/30/2019] [Indexed: 12/15/2022] Open
Abstract
Although there are several reviews that report the interrelationship between sarcopenia and obesity and insulin resistance, the relation between sarcopenia and the other signs that compose the metabolic syndrome (MetS) has not been extensively revised. Here, we review the mechanisms underlying MetS-related sarcopenia and discuss the possible therapeutic measures proposed. A vicious cycle between the loss of muscle and the accumulation of intramuscular fat might be associated with MetS via a complex interplay of factors including nutritional intake, physical activity, body fat, oxidative stress, proinflammatory cytokines, insulin resistance, hormonal changes, and mitochondrial dysfunction. The enormous differences in lipid storage capacities between the two genders and elevated amounts of endogenous fat having lipotoxic effects that lead to the loss of muscle mass are discussed. The important repercussions of MetS-related sarcopenia on other illnesses that lead to increased disability, morbidity, and mortality are also addressed. Additional research is needed to better understand the pathophysiology of MetS-related sarcopenia and its consequences. Although there is currently no consensus on the treatment, lifestyle changes including diet and power exercise seem to be the best options.
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Affiliation(s)
- María Esther Rubio-Ruiz
- Department of Physiology, Instituto Nacional de Cardiología "Ignacio Chávez", Juan Badiano 1, Sección XVI, Tlalpan, Mexico City 14080, Mexico.
| | - Verónica Guarner-Lans
- Department of Physiology, Instituto Nacional de Cardiología "Ignacio Chávez", Juan Badiano 1, Sección XVI, Tlalpan, Mexico City 14080, Mexico.
| | - Israel Pérez-Torres
- Department of Pathology, Instituto Nacional de Cardiología "Ignacio Chávez", Juan Badiano 1, Sección XVI, Tlalpan, Mexico City 14080, Mexico.
| | - María Elena Soto
- Department of Immunology, Instituto Nacional de Cardiología "Ignacio Chávez", Juan Badiano 1, Sección XVI, Tlalpan, Mexico City 14080, Mexico.
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179
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Epidemiology of Sarcopenia and Factors Associated With It Among Community-Dwelling Older Adults in Taiwan. Am J Med Sci 2019; 357:124-133. [DOI: 10.1016/j.amjms.2018.11.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 11/13/2018] [Accepted: 11/16/2018] [Indexed: 12/15/2022]
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180
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Leduc-Gaudet JP, Reynaud O, Hussain SN, Gouspillou G. Parkin overexpression protects from ageing-related loss of muscle mass and strength. J Physiol 2019; 597:1975-1991. [PMID: 30614532 DOI: 10.1113/jp277157] [Citation(s) in RCA: 87] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 12/21/2018] [Indexed: 12/13/2022] Open
Abstract
KEY POINTS Recent evidence suggests that impaired mitophagy, a process in charge of removing damaged/dysfunctional mitochondria and in part regulated by Parkin, could contribute to the ageing-related loss of muscle mass and function. In the present study, we show that Parkin overexpression attenuates ageing-related loss of muscle mass and strength and unexpectedly causes hypertrophy in adult skeletal muscles. We also show that Parkin overexpression leads to increases in mitochondrial content and enzymatic activities. Finally, our results show that Parkin overexpression protects from ageing-related increases in markers of oxidative stress, fibrosis and apoptosis. Our findings place Parkin as a potential therapeutic target to attenuate sarcopenia and improve skeletal muscle health and performance. ABSTRACT The ageing-related loss of muscle mass and strength, a process called sarcopenia, is one of the most deleterious hallmarks of ageing. Solid experimental evidence indicates that mitochondrial dysfunctions accumulate with ageing and are critical in the sarcopenic process. Recent findings suggest that mitophagy, the process in charge of the removal of damaged/dysfunctional mitochondria, is altered in aged muscle. Impaired mitophagy represents an attractive mechanism that could contribute to the accumulation of mitochondrial dysfunctions and sarcopenia. To test this hypothesis, we investigated the impact of Parkin overexpression in skeletal muscles of young and old mice. Parkin was overexpressed for 4 months in muscles of young (3 months) and late middle-aged (18 months) mice using i.m. injections of adeno-associated viruses. We show that Parkin overexpression increased muscle mass, fibre size and mitochondrial enzyme activities in both young and old muscles. In old mice, Parkin overexpression increased muscle strength, peroxisome proliferator‐activated receptor gamma coactivator 1‐alpha (PGC‐1α) and mitochondrial density. Parkin overexpression also attenuated the ageing-related increase in 4-hydroxynonenal content (a marker of oxidative stress) and type I collagen content (a marker of fibrosis), as well as the number of terminal deoxynucleotidyl transferase dUTP nick-end labelling-positive myonuclei (a marker of apoptosis). Overall, our results indicate that Parkin overexpression attenuates sarcopenia and unexpectedly causes hypertrophy in adult muscles. They also show that Parkin overexpression leads to increases in mitochondrial content and enzymatic activities. Finally, our results show that Parkin overexpression protects against oxidative stress, fibrosis and apoptosis. These findings highlight that Parkin may be an attractive therapeutic target with respect to attenuating sarcopenia and improving skeletal muscle health and performance.
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Affiliation(s)
- Jean-Philippe Leduc-Gaudet
- Département des sciences de l'activité physique, Faculté des sciences, Université du Québec à Montréal, Montréal, QC, Canada.,Groupe de recherche en activité physique adaptée, Université du Québec à Montréal, Montréal, QC, Canada.,Department of Critical Care, McGill University Health Centre and Meakins-Christie Laboratories, Department of Medicine, McGill University, Montréal, QC, Canada
| | - Olivier Reynaud
- Département des sciences de l'activité physique, Faculté des sciences, Université du Québec à Montréal, Montréal, QC, Canada.,Groupe de recherche en activité physique adaptée, Université du Québec à Montréal, Montréal, QC, Canada
| | - Sabah N Hussain
- Department of Critical Care, McGill University Health Centre and Meakins-Christie Laboratories, Department of Medicine, McGill University, Montréal, QC, Canada
| | - Gilles Gouspillou
- Département des sciences de l'activité physique, Faculté des sciences, Université du Québec à Montréal, Montréal, QC, Canada.,Groupe de recherche en activité physique adaptée, Université du Québec à Montréal, Montréal, QC, Canada.,Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada
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181
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Changes in Redox Signaling in the Skeletal Muscle with Aging. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2019; 2019:4617801. [PMID: 30800208 PMCID: PMC6360032 DOI: 10.1155/2019/4617801] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 11/05/2018] [Accepted: 11/22/2018] [Indexed: 01/01/2023]
Abstract
Reduction in muscle strength with aging is due to both loss of muscle mass (quantity) and intrinsic force production (quality). Along with decreased functional capacity of the muscle, age-related muscle loss is associated with corresponding comorbidities and healthcare costs. Mitochondrial dysfunction and increased oxidative stress are the central driving forces for age-related skeletal muscle abnormalities. The increased oxidative stress in the aged muscle can lead to altered excitation-contraction coupling and calcium homeostasis. Furthermore, apoptosis-mediated fiber loss, atrophy of the remaining fibers, dysfunction of the satellite cells (muscle stem cells), and concomitant impaired muscle regeneration are also the consequences of increased oxidative stress, leading to a decrease in muscle mass, strength, and function of the aged muscle. Here we summarize the possible effects of oxidative stress in the aged muscle and the benefits of physical activity and antioxidant therapy.
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182
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Dionyssiotis Y, Skarantavos G, Petropoulou K, Galanos A, Rapidi CA, Lyritis GP. Application of current sarcopenia definitions in spinal cord injury. JOURNAL OF MUSCULOSKELETAL & NEURONAL INTERACTIONS 2019; 19:21-29. [PMID: 30839300 PMCID: PMC6454250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Little is known about how appropriate the working definitions of sarcopenia are in subjects with spinal cord injury (SCI). This study aimed to evaluate the application of current sarcopenia definitions in SCI. METHODS We compared 31 complete SCI men with 33 able-bodied age matched subjects. All were examined by whole body DXA (Norland XR 36, USA) regarding muscle and fat mass and by peripheral quantitative computed tomography (pQCT XCT-3000, Germany) in 66% of tibia's length (muscle cross sectional area, (CSA) in mm2). Low muscle mass was defined by skeletal muscle index, (SMI= appendicular lean mass (aLM)/height2 in Kg/m2) and by the residual method: relative aLM, 20th percentile of the distribution of residuals as the cutoff point, (RASM), respectively. CSA is a surrogate for force. RESULTS We found lower values on RASM (p<0.001), and SMI (p<0.001) compared to controls in SCI and difference in the rate of sarcopenia according to sarcopenia definitions. CSA was significantly decreased in SCI (p<0.001) and correlation with duration of paralysis was weak. CONCLUSION Current functional definitions of sarcopenia classify different individuals as sarcopenic. Sarcopenia was more prevalent in SCI. The sensitivity and specificity of using these measurements in SCI remain unclear.
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Affiliation(s)
- Yannis Dionyssiotis
- Physical Medicine and Rehabilitation Department, University Hospital of Ioannina, Ioannina, Greece,Laboratory for Research of the Musculoskeletal System, KAT Hospital, Kifissia, Greece,Hellenic Osteoporosis Foundation, Kifissia, Greece,Corresponding author: Yannis Dionyssiotis, MD, MSc., PhD, s. FEBPRM, Physical Medicine & Rehabilitation Department, University Hospital of Ioannina, Leoforos Stavrou Niarchou, 45500, Ioannina, Greece E-mail:
| | - Grigorios Skarantavos
- Rheumatology and Bone unit Department, 1st Orthopedic Department, General University Hospital ATTIKON, Athens, Greece
| | - Konstantina Petropoulou
- 2nd Physical Medicine and Rehabilitation Department, National Rehabilitation Center, Athens, Greece
| | - Antonios Galanos
- Laboratory for Research of the Musculoskeletal System, KAT Hospital, Kifissia, Greece
| | | | - George P. Lyritis
- Laboratory for Research of the Musculoskeletal System, KAT Hospital, Kifissia, Greece,Hellenic Osteoporosis Foundation, Kifissia, Greece
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183
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Hanai T, Shiraki M, Miwa T, Watanabe S, Imai K, Suetsugu A, Takai K, Moriwaki H, Shimizu M. Effect of loop diuretics on skeletal muscle depletion in patients with liver cirrhosis. Hepatol Res 2019; 49:82-95. [PMID: 30156741 DOI: 10.1111/hepr.13244] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 08/16/2018] [Accepted: 08/23/2018] [Indexed: 12/13/2022]
Abstract
AIM Sarcopenia, the loss of skeletal muscle mass, impairs prognosis of patients with liver cirrhosis. The aim of this study was to investigate the effect of loop diuretics, which are frequently used to treat hepatic edema/ascites, on skeletal muscle depletion and the prognosis in patients with liver cirrhosis. METHODS This retrospective study evaluated 226 patients with liver cirrhosis. The skeletal muscle cross-sectional area at the level of the third lumbar vertebra was measured using computed tomography. The relative change in skeletal muscle area per year (ΔSMA) was calculated, and the association between ΔSMA and therapeutic dosage of loop diuretics was examined. RESULTS The therapeutic dosage of loop diuretics was inversely correlated with ΔSMA by simple (r = -0.27, P < 0.0001) and multiple regression analyses (t = -3.07, P = 0.002). During a median follow-up period of 49 months, 82 patients died. Overall survival rates were lower in patients treated with loop diuretics at >20 mg than in those who received ≤20 mg (median, 66 vs. 97 months; P = 0.002). Multivariate analysis revealed that loop diuretics of >20 mg (hazard ratio [HR], 1.86; 95% confidence interval [CI], 1.03-3.24; P = 0.039) and ΔSMA of ≤-3.1% (HR, 3.87; 95% CI, 2.32-6.60; P < 0.0001) were independently associated with mortality. CONCLUSIONS A higher dose of loop diuretic use was associated with more rapid skeletal muscle depletion and poor survival in patients with liver cirrhosis, independent of the severity of liver disease.
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Affiliation(s)
- Tatsunori Hanai
- Department of Gastroenterology/Internal Medicine, Gifu University Graduate School of Medicine, Gifu, Japan.,Division for Regional Cancer Control, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Makoto Shiraki
- Department of Gastroenterology/Internal Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Takao Miwa
- Department of Gastroenterology/Internal Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Satoshi Watanabe
- Department of Gastroenterology/Internal Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Kenji Imai
- Department of Gastroenterology/Internal Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Atsushi Suetsugu
- Department of Gastroenterology/Internal Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Koji Takai
- Department of Gastroenterology/Internal Medicine, Gifu University Graduate School of Medicine, Gifu, Japan.,Division for Regional Cancer Control, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Hisataka Moriwaki
- Department of Gastroenterology/Internal Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Masahito Shimizu
- Department of Gastroenterology/Internal Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
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184
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Ono S, Yoshida N, Maekawa D, Kitakaze T, Kobayashi Y, Kitano T, Fujita T, Okuwa‐Hayashi H, Harada N, Nakano Y, Yamaji R. 5-Hydroxy-7-methoxyflavone derivatives from Kaempferia parviflora induce skeletal muscle hypertrophy. Food Sci Nutr 2019; 7:312-321. [PMID: 30680186 PMCID: PMC6341173 DOI: 10.1002/fsn3.891] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 10/29/2018] [Accepted: 11/03/2018] [Indexed: 12/24/2022] Open
Abstract
Skeletal muscle plays a critical role in locomotion and energy metabolism. Maintenance or enhancement of skeletal muscle mass contributes to the improvement of mobility and prevents the development of metabolic diseases. The extracts from Kaempferia parviflora rhizomes contain at least ten methoxyflavone derivatives that exhibit enhancing effects on ATP production and glucose uptake in skeletal muscle cells. In the present study, we investigated the effects of ten K. parviflora-derived methoxyflavone derivatives (six 5,7-dimethoxyflavone (DMF) derivatives and four 5-hydroxy-7-methoxyflavone (HMF) derivatives) on skeletal muscle hypertrophy. Murine C2C12 myotubes and senescence-accelerated mouse-prone 1 (SAMP1) mice treated with methoxyflavones were used as experimental models to determine the effects of HMF derivatives on myotube diameter and size and muscle mass. The four HMF derivatives, but not the six DMF derivatives, increased myotube diameter. The 5-hydroxyflavone, 7-methoxyflavone, and 5,7-dihydroxyflavone had no influence on myotube size, a result that differed from HMF. Dietary administration of the mixture composed of the four HMF derivatives resulted in increase in the soleus muscle size and mass in SAMP1 mice. HMF derivatives also promoted protein synthesis in myotubes, and treatment with the intracellular Ca2+ chelator BAPTA-AM, which depletes intracellular Ca2+ levels, inhibited this promotion. Furthermore, BAPTA-AM inhibited HMF-promoted protein synthesis even when myotubes were incubated in Ca2+-free medium. These results indicate that HMF derivatives induce myotube hypertrophy and that both the 5-hydroxyl group and the 7-methoxy group in the flavones are necessary for myotube hypertrophy. Furthermore, these results suggest that HMF-induced protein synthesis requires intracellular Ca2+, but not extracellular Ca2+.
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Affiliation(s)
- Shintaro Ono
- Division of Applied Life SciencesGraduate School of Life and Environmental SciencesOsaka Prefecture UniversitySakaiOsakaJapan
| | - Naoki Yoshida
- Division of Applied Life SciencesGraduate School of Life and Environmental SciencesOsaka Prefecture UniversitySakaiOsakaJapan
| | - Daisuke Maekawa
- Division of Applied Life SciencesGraduate School of Life and Environmental SciencesOsaka Prefecture UniversitySakaiOsakaJapan
| | - Tomoya Kitakaze
- Division of Applied Life SciencesGraduate School of Life and Environmental SciencesOsaka Prefecture UniversitySakaiOsakaJapan
| | - Yasuyuki Kobayashi
- Division of Applied Life SciencesGraduate School of Life and Environmental SciencesOsaka Prefecture UniversitySakaiOsakaJapan
| | - Takehiro Kitano
- Division of Applied Life SciencesGraduate School of Life and Environmental SciencesOsaka Prefecture UniversitySakaiOsakaJapan
| | | | - Hirotaka Okuwa‐Hayashi
- Japan Tablet CorporationUjiKyotoJapan
- Center for Research and Development of BioresourcesOsaka Prefecture UniversitySakaiOsakaJapan
| | - Naoki Harada
- Division of Applied Life SciencesGraduate School of Life and Environmental SciencesOsaka Prefecture UniversitySakaiOsakaJapan
| | - Yoshihisa Nakano
- Center for Research and Development of BioresourcesOsaka Prefecture UniversitySakaiOsakaJapan
| | - Ryoichi Yamaji
- Division of Applied Life SciencesGraduate School of Life and Environmental SciencesOsaka Prefecture UniversitySakaiOsakaJapan
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Jang TY, Yeh ML, Huang CI, Lin ZY, Chen SC, Hsieh MH, Dai CY, Huang JF, Huang CF, Chuang WL, Yu ML. Association of hyperuricemia with disease severity in chronic hepatitis C patients. PLoS One 2018; 13:e0207043. [PMID: 30395654 PMCID: PMC6218088 DOI: 10.1371/journal.pone.0207043] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Accepted: 10/23/2018] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND/AIMS Hepatitis C virus (HCV) infection is associated with extrahepatic manifestations such as metabolic abnormalities. The association between chronic hepatitis C (CHC) and uric acid levels has rarely been investigated. We aimed to evaluate the levels of serum uric acid in CHC patients. METHODS Three hundred and seventy-three histologically confirmed CHC patients who were scheduled to receive antiviral therapy were consecutively enrolled, and 746 age- and sex-matched uninfected controls were included for comparison. Hyperuricemia was defined as a uric acid level > 7 mg/dL in men and > 6.0 mg/dL in women. RESULTS Hyperuricemia was identified in 15.8% of the CHC patients. The uric acid levels did not differ between the CHC patients and the controls (5.54 ± 1.20 mg/dL vs. 5.45 ± 1.45 mg/dL, P = 0.3). Among the 373 CHC patients, the factors associated with hyperuricemia included body mass index (BMI) (OR/CI: 1.13/1.04-1.21, P = 0.003) and estimated glomerular filtration rate (eGFR) (OR/CI: 0.98/0.97-1.00, P = 0.02). Logistic regression analysis revealed that the factors associated with hyperuricemia in male patients included BMI (OR/CI: 1.12/1.05-1.30, P = 0.006) and advanced fibrosis (F3-4) (OR/CI: 0.27/0.09-0.83, P = 0.02), whereas the factors associated with hyperuricemia in female patients included eGFR (OR/CI: 0.97/0.95-0.99, P = 0.02) and diabetes (OR/CI: 3.03/1.11-8.25, P = 0.03). There was a significant decreasing trend of serum uric acid levels with the progression of fibrotic stages among male patients (6.21 ± 1.03 mg/dL 5.82 ± 1.16 mg/dL and 5.44 ± 1.28 mg/dL in stages F0-2, F3, and F4, respectively, trend P = 0.01). CONCLUSIONS Hyperuricemia was inversely associated with liver disease severity in CHC male patients.
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Affiliation(s)
- Tyng-Yuan Jang
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ming-Lun Yeh
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Faculty of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ching-I Huang
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Zu-Yau Lin
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Faculty of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shinn-Cherng Chen
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Faculty of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Meng-Hsuan Hsieh
- Department of Occupational Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Preventive Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chia-Yen Dai
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Faculty of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Occupational Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Preventive Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jee-Fu Huang
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Faculty of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chung-Feng Huang
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Faculty of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Occupational Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wan-Long Chuang
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Faculty of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ming-Lung Yu
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Faculty of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Institute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan
- College of Biological Science and Technology, National Chiao Tung University, Hsin-Chu, Taiwan
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186
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Shergill R, Syed W, Rizvi SA, Singh I. Nutritional support in chronic liver disease and cirrhotics. World J Hepatol 2018; 10:685-694. [PMID: 30386461 PMCID: PMC6206154 DOI: 10.4254/wjh.v10.i10.685] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 08/04/2018] [Accepted: 08/06/2018] [Indexed: 02/06/2023] Open
Abstract
The liver is a major organ and an essential component in maintaining an appropriate nutritional status in healthy individuals through metabolism of protein, carbohydrates, and fat. In individuals with chronic liver disease (CLD), along with a number of other essential functions that the liver serves, its role in nutrition maintenance is severely impaired. Common causes of CLD include hepatitis C, alcoholic liver disease, and non-alcoholic liver disease. Amongst this population, the most common manifestation of impaired nutritional maintenance is protein-calorie malnutrition. Aside from inherent abnormalities in metabolism, such as malabsorption and maldigestion, CLD can be associated with anorexia as well as increased metabolic requirements, all of which contribute to a state of malnutrition. Given the systemic implications and impact on prognosis of malnutrition, proper nutritional assessment is essential and can be achieved through a thorough history and physical, as well as biochemical investigations and anthropometry as needed. Following an appropriate assessment of a patient’s nutritional status, an approach to management can be decided upon and is based on the extent of malnutrition which directly reflects the severity of disease. Management options can be grossly separated into enteral and parenteral nutrition. The former is usually sufficient in the form of oral supplements in less severe cases of malnutrition, but as the CLD worsens, parenteral nutrition becomes necessary. With appropriate assessment and early intervention, many of the complications of CLD can be avoided, and ultimately better outcomes can be achieved.
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Affiliation(s)
- Ravi Shergill
- Radiology Department, McMaster University, Hamilton, ON L8S4L8, Canada
| | - Wajahat Syed
- Undergraduate Medicine, McMaster University, Hamilton, ON L8S4L8, Canada
| | - Syed Ali Rizvi
- Undergraduate Medicine, McMaster University, Hamilton, ON L8S4L8, Canada
| | - Ikjot Singh
- Undergraduate Medicine, McMaster University, Hamilton, ON L8S4L8, Canada
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187
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Alexandrov NV, Eelderink C, Singh-Povel CM, Navis GJ, Bakker SJL, Corpeleijn E. Dietary Protein Sources and Muscle Mass over the Life Course: The Lifelines Cohort Study. Nutrients 2018; 10:nu10101471. [PMID: 30308987 PMCID: PMC6212815 DOI: 10.3390/nu10101471] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 09/30/2018] [Accepted: 10/02/2018] [Indexed: 12/28/2022] Open
Abstract
The influence of dietary protein intake on muscle mass in adults remains unclear. Our objective was to investigate the association between protein intake and muscle mass in 31,278 men and 45,355 women from the Lifelines Cohort. Protein intake was estimated by food frequency questionnaire and muscle mass was estimated from 24 h urinary creatinine excretion. The age range was 18⁻91 years and mean total protein intake was 1.0 ± 0.3 g/kg/day. Across increasing quartiles of total protein intake, animal protein intake, and fish/meat/egg protein intake, creatinine excretion significantly increased in both men (+4% for total and +6% for fish/meat/egg protein intake, p < 0.001) and women (+3% for total and +6% for fish/meat/egg protein intake, p < 0.001). The associations were not systematically stronger or weaker with increasing age, but associations were strongest for young men (26⁻45 years) and older women (>75 years). The association between total protein intake and muscle mass was dependent on physical activity in women (p interaction < 0.001). This study suggests that total protein intake, animal protein intake, and in particular fish/meat/egg protein intake may be important for building and preserving muscle mass. Dietary protein sources should be further studied for their potential to build and preserve muscle mass.
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Affiliation(s)
- Nikita V Alexandrov
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, 9713GZ Groningen, The Netherlands.
| | - Coby Eelderink
- Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, 9713GZ Groningen, The Netherlands.
| | | | - Gerjan J Navis
- Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, 9713GZ Groningen, The Netherlands.
| | - Stephan J L Bakker
- Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, 9713GZ Groningen, The Netherlands.
| | - Eva Corpeleijn
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, 9713GZ Groningen, The Netherlands.
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188
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Fukushima H, Takemura K, Suzuki H, Koga F. Impact of Sarcopenia as a Prognostic Biomarker of Bladder Cancer. Int J Mol Sci 2018; 19:ijms19102999. [PMID: 30275370 PMCID: PMC6213561 DOI: 10.3390/ijms19102999] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2018] [Revised: 09/29/2018] [Accepted: 09/29/2018] [Indexed: 12/25/2022] Open
Abstract
Sarcopenia, the degenerative and systemic loss of skeletal muscle mass, indicates patient frailty and impaired physical function. Sarcopenia can be caused by multiple factors, including advanced age, lack of exercise, poor nutritional status, inflammatory diseases, endocrine diseases, and malignancies. In patients with cancer cachexia, anorexia, poor nutrition and systemic inflammation make the metabolic state more catabolic, resulting in sarcopenia. Thus, sarcopenia is considered as one of manifestations of cancer cachexia. Recently, growing evidence has indicated the importance of sarcopenia in the management of patients with various cancers. Sarcopenia is associated with not only higher rates of treatment-related complications but also worse prognosis in cancer-bearing patients. In this article, we summarized metabolic backgrounds of cancer cachexia and sarcopenia and definitions of sarcopenia based on computed tomography (CT) images. We conducted a systematic literature review regarding the significance of sarcopenia as a prognostic biomarker of bladder cancer. We also reviewed recent studies focusing on the prognostic role of changes in skeletal muscle mass during the course of treatment in bladder cancer patients. Lastly, we discussed the impact of nutritional support, medication, and exercise on sarcopenia in cancer-bearing patients.
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Affiliation(s)
- Hiroshi Fukushima
- Department of Urology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo 113-8677, Japan.
| | - Kosuke Takemura
- Department of Urology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo 113-8677, Japan.
| | - Hiroaki Suzuki
- Department of Urology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo 113-8677, Japan.
| | - Fumitaka Koga
- Department of Urology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo 113-8677, Japan.
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189
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Seo MH, Kim YH, Han K, Lee WY, Yoo SJ. Prevalence of Obesity and Incidence of Obesity-Related Comorbidities in Koreans Based on National Health Insurance Service Health Checkup Data 2006-2015 (J Obes Metab Syndr 2018;27:46-52). J Obes Metab Syndr 2018; 27:198-199. [PMID: 31089563 PMCID: PMC6504200 DOI: 10.7570/jomes.2018.27.3.198] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 09/19/2018] [Accepted: 09/21/2018] [Indexed: 12/19/2022] Open
Affiliation(s)
- Mi Hae Seo
- Division of Endocrinology, Department of Internal Medicine, Soonchunhyang University Gumi Hospital, Soonchunhyang University School of Medicine, Gumi,
Korea
| | - Yang-Hyun Kim
- Department of Family Medicine, Korea University College of Medicine, Seoul,
Korea
| | - Kyungdo Han
- Department of Biostatistics, The Catholic University of Korea, Seoul,
Korea
| | - Won-Young Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul,
Korea
| | - Soon Jib Yoo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Bucheon,
Korea
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190
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Agostini D, Zeppa Donati S, Lucertini F, Annibalini G, Gervasi M, Ferri Marini C, Piccoli G, Stocchi V, Barbieri E, Sestili P. Muscle and Bone Health in Postmenopausal Women: Role of Protein and Vitamin D Supplementation Combined with Exercise Training. Nutrients 2018; 10:nu10081103. [PMID: 30115856 PMCID: PMC6116194 DOI: 10.3390/nu10081103] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 08/11/2018] [Accepted: 08/13/2018] [Indexed: 12/25/2022] Open
Abstract
Menopause is an age-dependent physiological condition associated with a natural decline in oestrogen levels, which causes a progressive decrease of muscle mass and strength and bone density. Sarcopenia and osteoporosis often coexist in elderly people, with a prevalence of the latter in elderly women. The profound interaction between muscle and bone induces a negative resonance between the two tissues affected by these disorders worsening the quality of life in the postmenopausal period. It has been estimated that at least 1 in 3 women over age 50 will experience osteoporotic fractures, often requiring hospitalisation and long-term care, causing a large financial burden to health insurance systems. Hormonal replacement therapy is effective in osteoporosis prevention, but concerns have been raised with regard to its safety. On the whole, the increase in life expectancy for postmenopausal women along with the need to improve their quality of life makes it necessary to develop specific and safe therapeutic strategies, alternative to hormonal replacement therapy, targeting both sarcopenia and osteoporosis progression. This review will examine the rationale and the effects of dietary protein, vitamin D and calcium supplementation combined with a specifically-designed exercise training prescription as a strategy to counteract these postmenopausal-associated disorders.
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Affiliation(s)
- Deborah Agostini
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino 61029 (PU), Italy.
| | - Sabrina Zeppa Donati
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino 61029 (PU), Italy.
| | - Francesco Lucertini
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino 61029 (PU), Italy.
| | - Giosuè Annibalini
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino 61029 (PU), Italy.
| | - Marco Gervasi
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino 61029 (PU), Italy.
| | - Carlo Ferri Marini
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino 61029 (PU), Italy.
| | - Giovanni Piccoli
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino 61029 (PU), Italy.
| | - Vilberto Stocchi
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino 61029 (PU), Italy.
| | - Elena Barbieri
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino 61029 (PU), Italy.
- Interuniversity Institute of Myology (IIM), University of Urbino Carlo Bo, Urbino 61029 (PU), Italy.
| | - Piero Sestili
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino 61029 (PU), Italy.
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191
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Dos Santos EM, de Moraes R, Tibiriça EV, Huguenin GVB, Moreira ASB, De Lorenzo AR. Whey protein supplementation for the preservation of mass and muscular strength of patients with heart failure: study protocol for a randomized controlled trial. Trials 2018; 19:431. [PMID: 30089525 PMCID: PMC6083622 DOI: 10.1186/s13063-018-2811-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Accepted: 07/17/2018] [Indexed: 02/06/2023] Open
Abstract
Background Heart failure (HF) is an important public health problem, considered a new epidemic with high morbidity and mortality. The progression of HF often determines weight reduction, muscle mass loss, and reduced physical ability. Whey protein supplementation may increase the effects of exercise on strength and muscle mass, in addition to promoting improved endothelial function, body composition and quality of life. However, studies are needed to evaluate its benefits in patients with HF. Methods/design This is a double-blind, randomized, placebo-controlled clinical trial in which patients with HF will be randomly allocated to two groups to receive supplementation with whey protein or placebo, associated with supervised exercise, for 12 weeks. The frequency of exercise will be three times a week. The study variables will be evaluated at baseline and 12 weeks. The main outcome will be maintenance of muscle mass and strength. Microvascular reactivity, quality of life, and inflammatory parameters will be evaluated as secondary outcomes. Discussion HF is associated with severe loss of muscle mass and strength, directly contributing to exercise intolerance and inability to maintain daily life activities, becoming a strong predictor of reduced quality of life and mortality. The results of this study will add to the evidence base for providing new dietary recommendations. Trial registration ClinicalTrials.gov, ID: NCT03142399. Registered on 29 May 2016. Effect of Whey Protein’ Supplementation and Exercise in Patients with Heart Failure (PROT-HF). Electronic supplementary material The online version of this article (10.1186/s13063-018-2811-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Elisa Maia Dos Santos
- Institute of the Heart Edson Saad, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil. .,Department of Clinical Research, National Institute of Cardiology (INC), Rua das Laranjeiras, 374, 5o andar - Laranjeiras, Rio de Janeiro, RJ, CEP: 22240-006, Brazil.
| | | | - Eduardo Vera Tibiriça
- Laboratory of Cardiovascular Investigation, Oswaldo Cruz Institute (IOC), Rio de Janeiro, RJ, Brazil
| | - Grazielle Vilas Bôas Huguenin
- Universidade Federal Fluminense (UFF), Niterói, Brazil.,National Institute of Cardiology (INC), Rio de Janeiro, RJ, Brazil
| | - Annie Seixas Belo Moreira
- State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.,Department of Clinical Research, National Institute of Cardiology (INC), Rua das Laranjeiras, 374, 5o andar - Laranjeiras, Rio de Janeiro, RJ, CEP: 22240-006, Brazil
| | - Andrea Rocha De Lorenzo
- Institute of the Heart Edson Saad, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil.,Department of Clinical Research, National Institute of Cardiology (INC), Rua das Laranjeiras, 374, 5o andar - Laranjeiras, Rio de Janeiro, RJ, CEP: 22240-006, Brazil
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192
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You JY, Kim YJ, Shin WY, Kim NY, Cho SH, Kim JH. Heritability of muscle mass in Korean parent-offspring pairs in the Fifth Korean National Health and Nutrition Examination Survey (KNHANES V). Maturitas 2018; 114:67-72. [PMID: 29907249 DOI: 10.1016/j.maturitas.2018.06.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 03/26/2018] [Accepted: 06/03/2018] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Decreased muscle mass is known to be associated with several serious medical conditions. We analyzed the Fifth Korean National Health and Nutrition Examination Survey (KNHANES V, 2010-2011) to estimate the heritability of muscle mass in Korean parent-offspring pairs. STUDY DESIGN Cross-sectional. MAIN OUTCOME MEASURES A total of 1233 parents (average age 57.67 ± 8.50 years) and 917 offspring (average age 29.10 ± 7.57 years) from 743 families were included in the analysis. Muscle mass was estimated based on three different indices: appendicular skeletal muscle mass (ASM) measured with a dual-energy X-ray absorptiometry (DXA), weight-adjusted ASM (SMI), and height-adjusted ASM (RASM). The heritability was estimated by employing the maximum-likelihood variance components implemented in Sequential Oligogenic Linkage Analysis Routines (SOLAR). The best-fitting model was determined out of four polygenic models. Pearson's partial correlation coefficient was also calculated using the muscle mass indices to further study the association between father or mother and son or daughter pairs. RESULTS The heritability estimates of the muscle mass indices ranged from 55% to 80% (all p < 0.01). The correlation coefficient of father and offspring ranged from 0.11 to 0.40, while that of mother and offspring ranged from 0.23 to 0.43 (all p < 0.01). CONCLUSIONS The heritability estimates of muscle mass in Koreans are large and significant, suggesting that parental muscle mass is an important predictor of the offspring's muscle mass. The result implies that there may be a genetic factor partly determining muscle mass.
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Affiliation(s)
- Ju-Young You
- Department of Family Medicine, Chung-Ang University Medical Center, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Yun-Jee Kim
- Department of Family Medicine, Chung-Ang University Medical Center, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Woo-Young Shin
- Department of Family Medicine, Chung-Ang University Medical Center, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Na-Yeon Kim
- Department of Family Medicine, Chung-Ang University Medical Center, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Soo Hyun Cho
- Department of Family Medicine, Chung-Ang University Medical Center, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Jung-Ha Kim
- Department of Family Medicine, Chung-Ang University Medical Center, Chung-Ang University College of Medicine, Seoul, Republic of Korea.
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193
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Varban OA. Concise Commentary: Visceral Obesity, Sarcopenia, and Cancer Surgery-Increasing Fitness Decreases Risk. Dig Dis Sci 2018; 63:1631-1632. [PMID: 29663263 DOI: 10.1007/s10620-018-5061-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Affiliation(s)
- Oliver A Varban
- Department of Surgery, Michigan Medicine, 2926 Taubman Center, 1500 E Medical Center Drive, SPC 5343, Ann Arbor, MI, 48109-5343, USA.
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194
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Fabrication of Micromolded Gelatin Hydrogels for Long-Term Culture of Aligned Skeletal Myotubes. Methods Mol Biol 2018; 1668:147-163. [PMID: 28842908 DOI: 10.1007/978-1-4939-7283-8_11] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
Abstract
Cultured skeletal myotubes are a powerful in vitro system for identifying mechanisms of skeletal muscle development and disease. However, skeletal myotubes routinely delaminate from conventional culture substrates after approximately 1 week, which significantly hampers their utility for in vitro disease modeling and drug screening. To address this problem, we fabricated micromolded gelatin hydrogels as culture substrates that are more biomimetic than conventional substrates. On micromolded gelatin hydrogels, C2C12 skeletal myoblasts align and differentiate into skeletal myotubes that are stable in culture for multiple weeks. With this protocol, we detail three key steps: (1) Fabrication of micromolded gelatin hydrogels; (2) Culture of mouse C2C12 myoblasts and differentiation into myotubes; and (3) Quantification of myotube morphology. These substrates have many applications for skeletal muscle disease modeling and drug screening over longer time scales.
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195
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Liguori I, Russo G, Aran L, Bulli G, Curcio F, Della-Morte D, Gargiulo G, Testa G, Cacciatore F, Bonaduce D, Abete P. Sarcopenia: assessment of disease burden and strategies to improve outcomes. Clin Interv Aging 2018; 13:913-927. [PMID: 29785098 PMCID: PMC5957062 DOI: 10.2147/cia.s149232] [Citation(s) in RCA: 192] [Impact Index Per Article: 27.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Life expectancy is increasing worldwide, with a resultant increase in the elderly population. Aging is characterized by the progressive loss of skeletal muscle mass and strength - a phenomenon called sarcopenia. Sarcopenia has a complex multifactorial pathogenesis, which involves not only age-related changes in neuromuscular function, muscle protein turnover, and hormone levels and sensitivity, but also a chronic pro-inflammatory state, oxidative stress, and behavioral factors - in particular, nutritional status and degree of physical activity. According to the operational definition by the European Working Group on Sarcopenia in Older People (EWGSOP), the diagnosis of sarcopenia requires the presence of both low muscle mass and low muscle function, which can be defined by low muscle strength or low physical performance. Moreover, biomarkers of sarcopenia have been identified for its early detection and for a detailed identification of the main pathophysiological mechanisms involved in its development. Because sarcopenia is associated with important adverse health outcomes, such as frailty, hospitalization, and mortality, several therapeutic strategies have been identified that involve exercise training, nutritional supplementation, hormonal therapies, and novel strategies and are still under investigation. At the present time, only physical exercise has showed a positive effect in managing and preventing sarcopenia and its adverse health outcomes. Thus, further well-designed and well-conducted studies on sarcopenia are needed.
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Affiliation(s)
- Ilaria Liguori
- Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy
| | - Gennaro Russo
- Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy
| | - Luisa Aran
- Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy
| | - Giulia Bulli
- Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy
| | - Francesco Curcio
- Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy
| | - David Della-Morte
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.,Department of Human Sciences and Quality of Life Promotion, San Raffaele Roma Open University, Rome, Italy
| | - Gaetano Gargiulo
- Division of Internal Medicine, AOU San Giovanni di Dio e Ruggi di Aragona, Salerno, Italy
| | - Gianluca Testa
- Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy.,Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy
| | - Francesco Cacciatore
- Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy.,Azienda Ospedaliera dei Colli, Monaldi Hospital, Heart Transplantation Unit, Naples, Italy
| | - Domenico Bonaduce
- Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy
| | - Pasquale Abete
- Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy
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196
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Chung HS, Hwang SY, Choi JH, Lee HJ, Yoo HJ, Seo JA, Kim SG, Kim NH, Choi DS, Baik SH, Choi KM. Effects of Low Muscle Mass on Albuminuria and Chronic Kidney Disease in Patients With Type 2 Diabetes: The Korean Sarcopenic Obesity Study (KSOS). J Gerontol A Biol Sci Med Sci 2018; 73:386-392. [PMID: 28407041 PMCID: PMC5861907 DOI: 10.1093/gerona/glx055] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 03/16/2017] [Indexed: 12/22/2022] Open
Abstract
Background Previous studies have shown that chronic kidney disease (CKD) is associated with accelerated loss of skeletal muscle in patients on dialysis. However, the relationships of sarcopenia with albuminuria and early-stage CKD in patients with type 2 diabetes have not been examined. Methods We analyzed diabetic subgroup data from 409 patients with type 2 diabetes from the Korean Sarcopenic Obesity Study (KSOS). Sarcopenia was defined as a skeletal muscle mass index (SMI; SMI [%] = total skeletal muscle mass [kg]/weight [kg] × 100) less than 2 SD below the sex-specific mean for a younger reference group. The estimated glomerular filtration rates and urinary albumin-to-creatinine ratios were used to assess renal function and albuminuria. Results The prevalence of sarcopenia was significantly increased in the albuminuria group compared with the normo-albuminuria group (26.7% vs 12.6%, p = .001), as well as in CKD 3 group compared with the CKD 1-2 group (46.7% vs 15.1%, p = .005). After adjusting for age, SMI was negatively correlated with urinary albumin-to-creatinine ratios and positively correlated with aspartate aminotransferase, alanine aminotransferase, total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol levels. Multiple logistic regression analysis revealed that the odds ratio for albuminuria association was 3.02 (95% CI 1.37-6.67) in the lowest tertile of SMI compared with the highest tertile after adjusting for various confounding factors. Conclusions Sarcopenia is more prevalent in individuals with albuminuria than in those without albuminuria. Furthermore, increased albuminuria is independently associated with low muscle mass in patients with type 2 diabetes.
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Affiliation(s)
- Hye Soo Chung
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul
| | - Soon Young Hwang
- Department of Biostatistics, College of Medicine, Korea University, Seoul
| | - Ju Hee Choi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul
| | - Hyun Jung Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul
| | - Hye Jin Yoo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul
| | - Ji-A Seo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul
| | - Sin Gon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul
| | - Nan Hee Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul
| | - Dong Seop Choi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul
| | - Sei Hyun Baik
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul
| | - Kyung Mook Choi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul
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197
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Kemmochi Y, Ohta T, Motohashi Y, Kaneshige A, Katsumi S, Kakimoto K, Yasui Y, Anagawa-Nakamura A, Toyoda K, Taniai-Riya E, Takahashi A, Shoda T, Yamada T. Pathophysiological analyses of skeletal muscle in obese type 2 diabetes SDT fatty rats. J Toxicol Pathol 2018; 31:113-123. [PMID: 29750000 PMCID: PMC5938212 DOI: 10.1293/tox.2017-0064] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Accepted: 12/30/2017] [Indexed: 12/25/2022] Open
Abstract
Sarcopenia is the age-related decrease of muscle mass and function. Diabetes and obesity
are known to be risk factors that exacerbate sarcopenia, but the underlying mechanism of
diabetes-related sarcopenia is still unknown. Obese type 2 diabetes SDT fatty rats show
early onset of severe diabetes and there have been no reports on the characteristics of
their skeletal muscle. Therefore, pathophysiological analyses were performed for the
skeletal muscle in these rats. Diabetic male SDT fatty rats were sacrificed at 8, 16, 24,
32 and 40 weeks of age. Age-matched Sprague Dawley (SD) rats were used as the normal
control. In addition to biological blood parameters, the soleus and the extensor digitorum
longus muscles were examined for muscle weight, histopathology, and protein synthesis and
degradation. Muscle grip strength was also examined. These results revealed that the
muscle weights of the SDT fatty rats were significantly decreased from 16 weeks of age.
The mean cross-sectional area of muscle fibers in the SDT fatty rats decreased from 24
weeks of age. Increased intramyocellular lipid accumulation, identified by
immunohistochemistry for adipophilin and TEM, was observed in the SDT fatty rats from 8
weeks of age. Plasma insulin-like growth factor (IGF)-1 levels and muscle strength in the
SDT fatty rats decreased at 24 weeks of age and thereafter. These pathophysiological
findings have been reported both in sarcopenia in aged humans and in patients with
diabetes. In conclusion, the SDT fatty rat was considered to be a useful model for
analysis of diabetes-related sarcopenia.
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Affiliation(s)
- Yusuke Kemmochi
- Toxicology Research Laboratories, Central Pharmaceutical Research Institute, Japan Tobacco Inc., 23 Naganuki, Hadano, Kanagawa 257-0024, Japan
| | - Takeshi Ohta
- Biology and Research Laboratories, Central Pharmaceutical Research Institute, Japan Tobacco Inc., 1-1 Murasaki-cho, Takatsuki, Osaka 569-1125, Japan
| | - Yu Motohashi
- Biology and Research Laboratories, Central Pharmaceutical Research Institute, Japan Tobacco Inc., 1-1 Murasaki-cho, Takatsuki, Osaka 569-1125, Japan
| | - Akihiro Kaneshige
- Biology and Research Laboratories, Central Pharmaceutical Research Institute, Japan Tobacco Inc., 1-1 Murasaki-cho, Takatsuki, Osaka 569-1125, Japan
| | - Sohei Katsumi
- Biology and Research Laboratories, Central Pharmaceutical Research Institute, Japan Tobacco Inc., 1-1 Murasaki-cho, Takatsuki, Osaka 569-1125, Japan
| | - Kochi Kakimoto
- Toxicology Research Laboratories, Central Pharmaceutical Research Institute, Japan Tobacco Inc., 23 Naganuki, Hadano, Kanagawa 257-0024, Japan
| | - Yuzo Yasui
- Toxicology Research Laboratories, Central Pharmaceutical Research Institute, Japan Tobacco Inc., 23 Naganuki, Hadano, Kanagawa 257-0024, Japan
| | - Akiko Anagawa-Nakamura
- Toxicology Research Laboratories, Central Pharmaceutical Research Institute, Japan Tobacco Inc., 23 Naganuki, Hadano, Kanagawa 257-0024, Japan
| | - Kaoru Toyoda
- Toxicology Research Laboratories, Central Pharmaceutical Research Institute, Japan Tobacco Inc., 23 Naganuki, Hadano, Kanagawa 257-0024, Japan
| | - Eriko Taniai-Riya
- Toxicology Research Laboratories, Central Pharmaceutical Research Institute, Japan Tobacco Inc., 23 Naganuki, Hadano, Kanagawa 257-0024, Japan
| | - Akemi Takahashi
- Toxicology Research Laboratories, Central Pharmaceutical Research Institute, Japan Tobacco Inc., 23 Naganuki, Hadano, Kanagawa 257-0024, Japan
| | - Toshiyuki Shoda
- Toxicology Research Laboratories, Central Pharmaceutical Research Institute, Japan Tobacco Inc., 23 Naganuki, Hadano, Kanagawa 257-0024, Japan
| | - Takahisa Yamada
- Department of Agrobiology, Faculty of Agriculture, Niigata University, 2-8050 Igarashi, Nishiku, Niigata, Niigata 950-2181, Japan
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198
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Mislang AR, Di Donato S, Hubbard J, Krishna L, Mottino G, Bozzetti F, Biganzoli L. Nutritional management of older adults with gastrointestinal cancers: An International Society of Geriatric Oncology (SIOG) review paper. J Geriatr Oncol 2018; 9:382-392. [PMID: 29396234 DOI: 10.1016/j.jgo.2018.01.003] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2017] [Revised: 11/28/2017] [Accepted: 01/08/2018] [Indexed: 12/15/2022]
Abstract
Malnutrition is one of the most common physical manifestations of gastrointestinal (GI) cancers and is often under-diagnosed and under-treated. Like cancers, malnutrition occurs more commonly in older adults, with potential negative consequences to quality of life, functional status, tolerance to treatment, and prognosis. Nutritional assessment and management require a proactive and systematic, multi-disciplinary approach. Early assessment, detection, and prompt intervention of cancer-associated malnutrition and cachexia are equally essential to achieve better quality nutritional care for older oncology patients. This article aims to provide an overview of the evidence associated with poor nutrition and outcomes in older adults with GI cancers, and recommends a management approach from a geriatric oncologist's perspective.
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Affiliation(s)
- Anna Rachelle Mislang
- Medical Oncology Department, Nuovo Ospedale-Santo Stefano, Instituto Toscano Tumori, 59100 Prato, Italy; Cancer Clinical Trials Unit, Department of Medical Oncology, Royal Adelaide Hospital, 1 Port Road, Thebarton, South Australia 5000, Australia
| | - Samantha Di Donato
- Medical Oncology Department, Nuovo Ospedale-Santo Stefano, Instituto Toscano Tumori, 59100 Prato, Italy
| | - Joleen Hubbard
- Mayo Clinic Medical Oncology, 200 First St. SW, Rochester, MN 55905, United States
| | - Lalit Krishna
- Duke-NUS Graduate Medical School, Singapore; National Cancer Centre Singapore, Singapore; Centre of Biomedical Ethics at National University Singapore, Singapore
| | - Giuseppe Mottino
- Geriatric Medicine, Nuovo Ospedale-Santo Stefano, 59100 Prato, Italy
| | - Federico Bozzetti
- Faculty of Medicine, University of Milan, Via Festa del Perdono, 7, 20122 Milan, Italy
| | - Laura Biganzoli
- Medical Oncology Department, Nuovo Ospedale-Santo Stefano, Instituto Toscano Tumori, 59100 Prato, Italy.
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199
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Trierweiler H, Kisielewicz G, Hoffmann Jonasson T, Rasmussen Petterle R, Aguiar Moreira C, Zeghbi Cochenski Borba V. Sarcopenia: a chronic complication of type 2 diabetes mellitus. Diabetol Metab Syndr 2018; 10:25. [PMID: 29632617 PMCID: PMC5883537 DOI: 10.1186/s13098-018-0326-5] [Citation(s) in RCA: 99] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Accepted: 03/20/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Diabetics are at increased risk for impaired mobility and strength, frequently related to the disease control. Sarcopenia is the reduction of muscle mass associated with the decrease in muscle strength and/or performance, resulting in worse morbidity in chronic diseases. METHODS The objectives of this paper was to assess the prevalence of sarcopenia in patients with type 2 diabetes mellitus (T2DM) and determine its association with diabetes characteristics, progression, and complications, as well as changes in bone mineral density. The sample consisted of patients with T2DM followed at the outpatient clinics of the Serviço de Endocrinologia e Metabologia do Hospital de Clínicas da Universidade Federal do Paraná, from March to August 2016. Participants were men and women above 18 years with T2DM diagnosed at least 1 year earlier. Individuals with chronic diseases, users of any drug that modifies body composition, patients with body mass index (BMI) > 35 or < 18 kg/m2, and users of illicit drugs or hormonal or nutritional supplementation were excluded. The selected patients answered questionnaires about demographics, eating habits, and disease characteristics, and performed a bone densitometry exam in a dual energy absorptiometry (total body; spine and femur (total and neck)), a handgrip test by manual dynamometer, and an evaluation of the abdominal circumference (AC). The medical records were reviewed seeking diabetes data and laboratory test results. Patients were matched for sex, age, and race with healthy controls [Control Group (CG)]. The diagnosis of sarcopenia was conducted according to the criteria of the Foundation for National Institute of Health. RESULTS The final sample consisted of 83 patients in the DG and 83 in the CG. The DG had higher BMI, WC, past history of fractures and lower calcium and healthy diet intake (p < 0.005), compared to the CG. The DG presented a higher frequency of abnormal BMD (osteopenia in 45 (53%), and osteoporosis in 14 (19%)) and comorbidities than the CG (p < 0.005). Pre-sarcopenia was not different between groups, but muscle weakness was present in 25 diabetics (18 women) and only in 5 controls (4 men) (p = 0.00036). Sarcopenia was diagnosed in 13 (16.2%) patients in the DG and 2 (2.4%) in the CG (p = 0.01168). Pre-sarcopenia and sarcopenia were associated with altered BMD (p < 0.005), with no association with diabetes duration or control. Body mass index and osteoporosis increased the likelihood to have sarcopenia, but hypertension and healthy diet decreased it. CONCLUSION The DG had altered BMD associated with worse glycemic control, and a higher prevalence of sarcopenia, suggesting the need to look for their presence in diabetics.
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Affiliation(s)
| | | | | | | | - Carolina Aguiar Moreira
- Endocrine Division, Hospital de Clínicas da Universidade Federal do Paraná (SEMPR), Avenida Agostinho Leão Júnior, 285, Alto da Glória, Curitiba, PR 80030-110 Brazil
| | - Victória Zeghbi Cochenski Borba
- Endocrine Division, Hospital de Clínicas da Universidade Federal do Paraná (SEMPR), Avenida Agostinho Leão Júnior, 285, Alto da Glória, Curitiba, PR 80030-110 Brazil
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200
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Brooks JM, Titus AJ, Bruce ML, Orzechowski NM, Mackenzie TA, Bartels SJ, Batsis JA. Depression and Handgrip Strength Among U.S. Adults Aged 60 Years and Older from NHANES 2011-2014. J Nutr Health Aging 2018; 22:938-943. [PMID: 30272097 PMCID: PMC6168750 DOI: 10.1007/s12603-018-1041-5] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Sarcopenia is a gradual loss of muscle mass and strength that occurs with aging. This muscle deterioration is linked to increased morbidity, disability, and other adverse outcomes. Although reduced handgrip strength can be considered a marker of sarcopenia and other aging-related decline in the elderly, there is limited research on this physical health problem in at-risk groups with common biopsychosocial conditions such as depression. Our primary objective was to ascertain level of combined handgrip strength and its relationship with depression among adults aged 60 years and older. DESIGN Unadjusted and adjusted linear regression models were conducted with a cross-sectional survey dataset. SETTING Secondary dataset from the 2011-2014 National Health and Nutrition Examination Survey (NHANES). PARTICIPANTS Community-dwelling, non-institutionalized adults ≥60 years old (n=3,421). MEASUREMENTS The predictor variables included a positive screen for clinically relevant depression (referent=PHQ-9 score <10). The criterion variable of combined handgrip strength (kg) was determined using a dynamometer. RESULTS Mean age and BMI were 69.9 years (51.5% female) and 28.8 kg/m2, respectively. Mean combined handgrip strength in the overall cohort was 73.5 and 46.6 kg in males and females, respectively. Three hundred thirty-six (9.8%) reported symptoms of depression. In unadjusted and fully adjusted models, depression was significantly associated with reduced handgrip strength (B = -0.26±0.79 and B = -0.19±0.08, respectively; p<0.001). CONCLUSION Our findings demonstrate handgrip strength has a significant inverse association with depression. Future longitudinal studies should investigate the causal processes and potential moderators and mediators of the relationships between depression and reduced handgrip strength. This information may further encourage the use of depression and handgrip strength assessments and aid in the monitoring and implementation of health care services that address both physical and mental health limitations among older adult populations.
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Affiliation(s)
- J M Brooks
- Jessica M. Brooks, Postdoctoral Fellow, Department of Psychiatry, 46, Centerra Parkway, Lebanon, NH. USA 03766 E-mail: , Phone number: (603) 653-3436
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