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Zhang RD, Jiang SQ, Yan FJ, Ruan L, Zhang CT, Quan XQ. The association of prealbumin, transferrin, and albumin with immunosenescence among elderly males. Aging Male 2024; 27:2310308. [PMID: 38317318 DOI: 10.1080/13685538.2024.2310308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 01/20/2024] [Indexed: 02/07/2024] Open
Abstract
OBJECTIVE As people get older, the innate and acquired immunity of the elderly are affected, resulting in immunosenescence. Prealbumin (PAB), transferrin (TRF), and albumin (ALB) are commonly used markers to monitor protein energy malnutrition (PEM). However, their relationship with the immune system has not been fully explored. METHODS In our study, a total of 93 subjects (≥65 years) were recruited from Tongji Hospital between January 2015 and February 2017. According to the serum levels of these proteins (PAB, TRF, and ALB), we divided the patients into the high serum protein group and the low serum protein group. Then, we compared the percent expression of lymphocyte subsets between two groups. RESULTS All the low serum protein groups (PAB, TRF, and ALB) had significant decreases in the percentage of CD4+ cells, CD3+CD28+ cells, CD4+CD28+ cells and significant increases in the percentage of CD8+ cells, CD8+CD28- cells. PAB, TRF, and ALB levels revealed positive correlations with CD4/CD8 ratio, proportions of CD4+ cells, CD3+CD28+ cells, CD4+CD28+ cells, and negative correlation with proportions of CD8+ cells, CD8+CD28- cells. CONCLUSIONS This study suggested PAB, TRF, and ALB could be used as immunosenescence indicators. PEM might accelerate the process of immunosenescence in elderly males.
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Affiliation(s)
- Ren-Dan Zhang
- Department of Geriatrics, Shenzhen Longhua District Central Hospital, Shenzhen, PR China
| | - Shi-Qin Jiang
- Department of Clinical Pharmacy, Shenzhen Hospital of Integrated Traditional Chinese and Western Medicine, Shenzhen, PR China
| | - Feng-Juan Yan
- Department of Geriatrics, Shenzhen Longhua District Central Hospital, Shenzhen, PR China
| | - Lei Ruan
- Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
| | - Cun-Tai Zhang
- Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
| | - Xiao-Qing Quan
- Department of Geriatrics, Shenzhen Longhua District Central Hospital, Shenzhen, PR China
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2
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Li Q, Cheng H, Cen W, Yang T, Tao S. Development and validation of a predictive model for the risk of sarcopenia in the older adults in China. Eur J Med Res 2024; 29:278. [PMID: 38725036 PMCID: PMC11084063 DOI: 10.1186/s40001-024-01873-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 04/26/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Sarcopenia is a progressive age-related disease that can cause a range of adverse health outcomes in older adults, and older adults with severe sarcopenia are also at increased short-term mortality risk. The aim of this study was to construct and validate a risk prediction model for sarcopenia in Chinese older adults. METHODS This study used data from the 2015 China Health and Retirement Longitudinal Study (CHARLS), a high-quality micro-level data representative of households and individuals aged 45 years and older adults in China. The study analyzed 65 indicators, including sociodemographic indicators, health-related indicators, and biochemical indicators. RESULTS 3454 older adults enrolled in the CHARLS database in 2015 were included in the final analysis. A total of 997 (28.8%) had phenotypes of sarcopenia. Multivariate logistic regression analysis showed that sex, Body Mass Index (BMI), Mean Systolic Blood Pressure (MSBP), Mean Diastolic Blood Pressure (MDBP) and pain were predictive factors for sarcopenia in older adults. These factors were used to construct a nomogram model, which showed good consistency and accuracy. The AUC value of the prediction model in the training set was 0.77 (95% CI = 0.75-0.79); the AUC value in the validation set was 0.76 (95% CI = 0.73-0.79). Hosmer-Lemeshow test values were P = 0.5041 and P = 0.2668 (both P > 0.05). Calibration curves showed significant agreement between the nomogram model and actual observations. ROC and DCA showed that the nomograms had good predictive properties. CONCLUSIONS The constructed sarcopenia risk prediction model, incorporating factors such as sex, BMI, MSBP, MDBP, and pain, demonstrates promising predictive capabilities. This model offers valuable insights for clinical practitioners, aiding in early screening and targeted interventions for sarcopenia in Chinese older adults.
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Affiliation(s)
- Qiugui Li
- School of Nursing, Jinan University, Guangzhou, Guangdong, China
| | - Hongtao Cheng
- School of Nursing, Jinan University, Guangzhou, Guangdong, China
| | - Wenjiao Cen
- School of Nursing, Jinan University, Guangzhou, Guangdong, China
| | - Tao Yang
- Department of Neurosurgery, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
| | - Shengru Tao
- Department of Healthcare-Associated Infection Management, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China.
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3
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Pedauyé-Rueda B, García-Fernández P, Maicas-Pérez L, Maté-Muñoz JL, Hernández-Lougedo J. Different Diagnostic Criteria for Determining the Prevalence of Sarcopenia in Older Adults: A Systematic Review. J Clin Med 2024; 13:2520. [PMID: 38731050 PMCID: PMC11084913 DOI: 10.3390/jcm13092520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 04/19/2024] [Accepted: 04/23/2024] [Indexed: 05/13/2024] Open
Abstract
Background: Sarcopenia is defined as a loss of muscle mass, strength, and physical function associated with aging. It is due to a combination of genetic, environmental, and physiological factors. It is also associated with an increased risk of health problems. Since there are many different researchers in the field, with their own algorithms and cut-off points, there is no single criterion for diagnosis. This review aims to compare the prevalence of sarcopenia according to these different diagnostic criteria in older adult populations by age group and sex. Methods: Different databases were searched: Web of Science, Pubmed, Dialnet, Scopus, and Cochrane. The keywords used were "sarcopenia", "diagnosis", "prevalence", "assessment", "aged", "aging" and "older". Studies conducted in a population aged ≥65 assessing the prevalence of sarcopenia were selected. Results: Nineteen articles met the inclusion criteria, with a total of 33,515 subjects, 38.08% female and 61.42% male, at a mean age of 74.52. The diagnostic algorithms used were 52.63% AWGS2, 21.05% EWGSOP2, 10.53% AWGS1 and EWGS1, and 5.26% FNIH. Prevalence ranged from 1.7% to 37.47%, but was higher in males and increased with age. Conclusions: The prevalence of sarcopenia varies depending on the diagnostic algorithm used, but it increases with age and is higher in men. The EWGSOP2 and AWGS2 are the most used diagnostic criteria and measure the same variables but have different cut-off points. Of these two diagnostic algorithms, the one with the highest prevalence of sarcopenia and severe sarcopenia is the AWGS2. These differences may be due to the use of different tools and cut-off points. Therefore, a universal diagnostic criterion should be developed to allow early diagnosis of sarcopenia.
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Affiliation(s)
- Blanca Pedauyé-Rueda
- HM Faculty of Health Sciences, Camilo José Cela University, 28692 Madrid, Spain; (B.P.-R.); (J.H.-L.)
| | - Pablo García-Fernández
- Department of Radiology, Rehabilitation and Physiotherapy, Complutense University of Madrid, 28040 Madrid, Spain;
| | - Luis Maicas-Pérez
- Atlético de Madrid Foundation, 28004 Madrid, Spain;
- Faculty of Health Sciences, Universidad Internacional de la Rioja, 26006 Logroño, Spain
| | - José Luis Maté-Muñoz
- Department of Radiology, Rehabilitation and Physiotherapy, Complutense University of Madrid, 28040 Madrid, Spain;
| | - Juan Hernández-Lougedo
- HM Faculty of Health Sciences, Camilo José Cela University, 28692 Madrid, Spain; (B.P.-R.); (J.H.-L.)
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4
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Skubiszewska A, Broczek K, Maruniak-Chudek I, Oledzka G, Jonas MI, Puzianowska-Kuznicka M, Mossakowska M. Frailty and Survivability of Polish Caucasian Nonagenarians and Centenarians. Geriatrics (Basel) 2024; 9:14. [PMID: 38247989 PMCID: PMC10801576 DOI: 10.3390/geriatrics9010014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/02/2024] [Accepted: 01/11/2024] [Indexed: 01/23/2024] Open
Abstract
Frailty is a major geriatric problem leading to an increased risk of disability and death. Prevention, identification, and treatment of frailty are important challenges in gerontology and public health. The study aimed to estimate the prevalence of the frailty phenotype (FP) among the oldest-old Polish Caucasians and investigate the relationship between the FP and mortality. Baseline data were collected from 289 long-lived individuals, including 87 centenarians and 202 subjects aged 94-99. Mortality was obtained from population registers over the following 5 years. Sixty percent of subjects were classified as frail, 33% as prefrail, and 7% as robust. Frailty was more common in women than men and among centenarians than nonagenarians. During the 5-year observation period, 92.6% of the frail women and all frail men died, while mortality rates were lower among prefrail, 78.8% and 66.7%, and robust individuals, 60% and 54.5%, respectively. In the survival analysis, frailty was the strongest negative risk factor: HR = 0.328 (95% CI: 0.200-0.539). The inability to perform handgrip strength measurement was an additional predictor of short survival. In conclusion, the FP is prevalent in nonagenarians and centenarians and correlates with lower survivability. Future studies should address differences between unavoidable age-associated frailty and reversible disability in long-lived individuals.
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Affiliation(s)
- Agnieszka Skubiszewska
- Department of Medical Biology, Medical University of Warsaw, 00-575 Warsaw, Poland
- Study on Ageing and Longevity, International Institute of Molecular and Cell Biology, 02-109 Warsaw, Poland
| | - Katarzyna Broczek
- Mazovia Branch, Polish Society of Gerontology, 01-826 Warsaw, Poland
| | | | - Gabriela Oledzka
- Department of Medical Biology, Medical University of Warsaw, 00-575 Warsaw, Poland
| | - Marta Izabela Jonas
- Department of Human Epigenetics, Mossakowski Medical Research Institute, Polish Academy of Sciences, 02-106 Warsaw, Poland
| | - Monika Puzianowska-Kuznicka
- Department of Human Epigenetics, Mossakowski Medical Research Institute, Polish Academy of Sciences, 02-106 Warsaw, Poland
- Department of Geriatrics and Gerontology, Medical Centre of Postgraduate Education, 01-826 Warsaw, Poland
| | - Malgorzata Mossakowska
- Study on Ageing and Longevity, International Institute of Molecular and Cell Biology, 02-109 Warsaw, Poland
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5
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Liu Y, Cui J, Cao L, Stubbendorff A, Zhang S. Association of depression with incident sarcopenia and modified effect from healthy lifestyle: The first longitudinal evidence from the CHARLS. J Affect Disord 2024; 344:373-379. [PMID: 37805156 DOI: 10.1016/j.jad.2023.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 09/05/2023] [Accepted: 10/04/2023] [Indexed: 10/09/2023]
Abstract
BACKGROUND The prospective association of depression with incident sarcopenia remains unknown, as does whether such an association is modified by a healthy lifestyle. Thus, the goal of this study was to determine whether depression is independently related to the risk of developing sarcopenia and to detect the effect of a healthy lifestyle on its modification. METHODS The prospective study included 9486 participants from the China Health and Retirement Longitudinal Study who were followed from 2011 to 2015. We calculated a lifestyle score based on body mass index, drinking, smoking, social activities, and sleeping time. Cox proportional hazards regression models with hazard ratios (HRs) and 95 % confidence intervals were used to estimate the effect of depression on the risk of sarcopenia and the modification effect of lifestyle (CIs). RESULTS During a mean of 3.53 years of follow-up, 1373 individuals developed sarcopenia. After adjusting for confounding factors, depression was significantly associated with a higher risk of incident sarcopenia (HR = 1.34; 95 % CI: 1.19, 1.50). In addition, we observed that individuals adhering to a healthy lifestyle had an 18 % lower risk of sarcopenia onset, compared with individuals with an unhealthy lifestyle. LIMITATIONS We couldn't completely rule out potential residual bias due to its observational design. Second, ascertainment of the history of diseases in CHARLS was based on self-reported information, which may introduce recall bias or misclassification. CONCLUSIONS Depression was associated with a higher risk of sarcopenia in Chinese adults, and such a risk may be alleviated by adhering to a healthy lifestyle.
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Affiliation(s)
- Yunyun Liu
- School of Public Health, Zhejiang University, Hangzhou, Zhejiang, China
| | - Jiameng Cui
- School of Public Health, Zhejiang University, Hangzhou, Zhejiang, China
| | - Limin Cao
- Department of Science and Technology, The Third Central Hospital of Tianjin, Tianjin, China
| | - Anna Stubbendorff
- Nutritional Epidemiology, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - Shunming Zhang
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China.
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Gellhaus B, Böker KO, Schilling AF, Saul D. Therapeutic Consequences of Targeting the IGF-1/PI3K/AKT/FOXO3 Axis in Sarcopenia: A Narrative Review. Cells 2023; 12:2787. [PMID: 38132107 PMCID: PMC10741475 DOI: 10.3390/cells12242787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 12/05/2023] [Accepted: 12/06/2023] [Indexed: 12/23/2023] Open
Abstract
The high prevalence of sarcopenia in an aging population has an underestimated impact on quality of life by increasing the risk of falls and subsequent hospitalization. Unfortunately, the application of the major established key therapeutic-physical activity-is challenging in the immobile and injured sarcopenic patient. Consequently, novel therapeutic directions are needed. The transcription factor Forkhead-Box-Protein O3 (FOXO3) may be an option, as it and its targets have been observed to be more highly expressed in sarcopenic muscle. In such catabolic situations, Foxo3 induces the expression of two muscle specific ubiquitin ligases (Atrogin-1 and Murf-1) via the PI3K/AKT pathway. In this review, we particularly evaluate the potential of Foxo3-targeted gene therapy. Foxo3 knockdown has been shown to lead to increased muscle cross sectional area, through both the AKT-dependent and -independent pathways and the reduced impact on the two major downstream targets Atrogin-1 and Murf-1. Moreover, a Foxo3 reduction suppresses apoptosis, activates satellite cells, and initiates their differentiation into muscle cells. While this indicates a critical role in muscle regeneration, this mechanism might exhaust the stem cell pool, limiting its clinical applicability. As systemic Foxo3 knockdown has also been associated with risks of inflammation and cancer progression, a muscle-specific approach would be necessary. In this review, we summarize the current knowledge on Foxo3 and conceptualize a specific and targeted therapy that may circumvent the drawbacks of systemic Foxo3 knockdown. This approach presumably would limit the side effects and enable an activity-independent positive impact on skeletal muscle.
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Affiliation(s)
- Benjamin Gellhaus
- Department of Trauma, Orthopedics and Reconstructive Surgery, Georg-August University of Goettingen, 37075 Goettingen, Germany; (B.G.); (K.O.B.); (A.F.S.)
| | - Kai O. Böker
- Department of Trauma, Orthopedics and Reconstructive Surgery, Georg-August University of Goettingen, 37075 Goettingen, Germany; (B.G.); (K.O.B.); (A.F.S.)
| | - Arndt F. Schilling
- Department of Trauma, Orthopedics and Reconstructive Surgery, Georg-August University of Goettingen, 37075 Goettingen, Germany; (B.G.); (K.O.B.); (A.F.S.)
| | - Dominik Saul
- Department of Trauma, Orthopedics and Reconstructive Surgery, Georg-August University of Goettingen, 37075 Goettingen, Germany; (B.G.); (K.O.B.); (A.F.S.)
- Department of Trauma and Reconstructive Surgery, Eberhard Karls University Tuebingen, BG Trauma Center Tuebingen, 72072 Tuebingen, Germany
- Division of Endocrinology, Mayo Clinic, Rochester, MN 55905, USA
- Robert and Arlene Kogod Center on Aging, Mayo Clinic, Rochester, MN 55905, USA
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7
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Johansson J, Grimsgaard S, Strand BH, Sayer AA, Cooper R. Comparing associations of handgrip strength and chair stand performance with all-cause mortality-implications for defining probable sarcopenia: the Tromsø Study 2015-2020. BMC Med 2023; 21:451. [PMID: 37981689 PMCID: PMC10659040 DOI: 10.1186/s12916-023-03172-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 11/13/2023] [Indexed: 11/21/2023] Open
Abstract
BACKGROUND Widely adopted criteria suggest using either low handgrip strength or poor chair stand performance to identify probable sarcopenia. However, there are limited direct comparisons of these measures in relation to important clinical endpoints. We aimed to compare associations between these two measures of probable sarcopenia and all-cause mortality. METHODS Analyses included 7838 community-dwelling participants (55% women) aged 40-84 years from the seventh survey of the Tromsø Study (2015-2016), with handgrip strength assessed using a Jamar + Digital Dynamometer and a five-repetition chair stand test (5-CST) also undertaken. We generated sex-specific T-scores and categorised these as "not low", "low", and "very low" handgrip strength or 5-CST performance. Cox Proportional Hazard regression models were used to investigate associations between these two categorised performance scores and time to death (up to November 2020 ascertained from the Norwegian Cause of Death registry), adjusted for potential confounders including lifestyle factors and specific diseases. RESULTS A total of 233 deaths occurred (median follow-up 4.7 years) with 1- and 5-year mortality rates at 3.1 (95% confidence interval [CI] 2.1, 4.6) and 6.3 (95% CI 5.5, 7.2) per 1000 person-years, respectively. There was poor agreement between the handgrip strength and 5-CST categories for men (Cohen's kappa [κ] = 0.19) or women (κ = 0.20). Fully adjusted models including handgrip strength and 5-CST performance mutually adjusted for each other, showed higher mortality rates among participants with low (hazard ratio [HR] 1.22, 95% CI 0.87, 1.71) and very low (HR 1.68, 95% CI 1.02, 2.75) handgrip strength compared with the not low category. Similar associations, although stronger, were seen for low (HR 1.88, 95% CI 1.38, 2.56) and very low (HR 2.64, 95% CI 1.73, 4.03) 5-CST performance compared with the not low category. CONCLUSIONS We found poor agreement between T-score categories for handgrip strength and 5-CST performance and independent associations with mortality. Our findings suggest that these tests identify different people at risk when case-finding probable sarcopenia. As discussions on an international consensus for sarcopenia definitions proceed, testing both handgrip strength and chair stand performance should be recommended rather than viewing these as interchangeable assessments.
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Affiliation(s)
- Jonas Johansson
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway.
| | - Sameline Grimsgaard
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Bjørn Heine Strand
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
- Department for Physical Health and Ageing, Norwegian Institute of Public Health, Oslo, Norway
| | - Avan A Sayer
- AGE Research Group, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
- NIHR Newcastle Biomedical Research Centre, Newcastle University, Newcastle Upon Tyne NHS Foundation Trust and Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Rachel Cooper
- AGE Research Group, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
- NIHR Newcastle Biomedical Research Centre, Newcastle University, Newcastle Upon Tyne NHS Foundation Trust and Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle Upon Tyne, UK
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8
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Xu J, Wei Y, Huang Y, Weng X, Wei X. Current understanding and future perspectives on the extraction, structures, and regulation of muscle function of tea pigments. Crit Rev Food Sci Nutr 2023; 63:11522-11544. [PMID: 35770615 DOI: 10.1080/10408398.2022.2093327] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
With the aggravating aging of modern society, the sarcopenia-based aging syndrome poses a serious potential threat to the health of the elderly. Natural dietary supplements show great potential to reduce muscle wasting and enhance muscle performance. Tea has been widely recognized for its health-promoting effects. which contains active ingredients such as tea polyphenols, tea pigments, tea polysaccharides, theanine, caffeine, and vitamins. In different tea production processes, the oxidative condensation and microbial transformation of catechins and other natural substances from tea promotes the production of various tea pigments, including theaflavins (TFs), thearubigins (TRs), and theabrownins (TBs). Tea pigments have shown a positive effect on maintaining muscle health. Nevertheless, the relationship between tea pigments and skeletal muscle function has not been comprehensively elucidated. In addition, the numerous research on the extraction and purification of tea pigments is disordered with the limited recent progress due to the complexity of species and molecular structure. In this review, we sort out the strategies for the separation of tea pigments, and discuss the structures of tea pigments. On this basis, the regulation mechanisms of tea pigments on muscle functional were emphasized. This review highlights the current understanding on the extraction methods, molecular structures and regulation mechanisms of muscle function of tea pigments. Furthermore, main limitations and future perspectives are proposed to provide new insights into broadening theoretical research and industrial applications of tea pigments in the future.
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Affiliation(s)
- Jia Xu
- School of Agriculture and Biology, Shanghai Jiao Tong University, Shanghai, People's Republic of China
- School of Environmental and Chemical Engineering, Shanghai University, Baoshan, Shanghai, People's Republic of China
| | - Yang Wei
- School of Agriculture and Biology, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Yi Huang
- School of Agriculture and Biology, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Xinchu Weng
- School of Environmental and Chemical Engineering, Shanghai University, Baoshan, Shanghai, People's Republic of China
| | - Xinlin Wei
- School of Agriculture and Biology, Shanghai Jiao Tong University, Shanghai, People's Republic of China
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9
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Zhou C, Ma H, Liu C, Yang L. Exploring traditional Chinese medicine as a potential treatment for sarcopenia: A network pharmacology and data mining analysis of drug selection and efficacy. Medicine (Baltimore) 2023; 102:e35404. [PMID: 37832096 PMCID: PMC10578686 DOI: 10.1097/md.0000000000035404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 09/05/2023] [Indexed: 10/15/2023] Open
Abstract
Sarcopenia, as an increasingly pressing clinical issue, can be ameliorated through employment of traditional Chinese medicines. However, the current lack of specific pharmacological interventions for Sarcopenia necessitates further exploration of novel possibilities in traditional Chinese medicine for the treatment of this condition, utilizing advanced methodologies such as web pharmacology and data mining. Screening the essential targets of Sarcopenia, conducting matching between target and active molecules, as well as active molecules and herbs. Employing data mining techniques to analyze the screening outcomes, and molecular docking to compare the binding activities of active molecules with target proteins. The approach of using herbs for the treatment of Sarcopenia involves 13 targets, with 414 active compounds and 367 types of herbs. Data mining reveals that the herbs used in treating Sarcopenia are primarily characterized by their bitter taste, exerting their effects through dispelling dampness and promoting blood circulation. Moreover, 2 new formulas are postulated. Furthermore, molecular docking analysis indicates that the main active components of the herbs can be observed to tightly bind with the targets. Through network pharmacology and molecular docking, our findings reveal that herbs contain 15 key active components and 5 key targets, which correspond to 7 major herbs and 2 new formulas. Academically, these findings hold significant reference value for the development of novel drugs targeting Sarcopenia.
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Affiliation(s)
- Changwen Zhou
- The First Clinical Medical Research Institute, Shaanxi University of Chinese Medicine, Shaanxi, China
| | - Hongzhong Ma
- The First Clinical Medical Research Institute, Shaanxi University of Chinese Medicine, Shaanxi, China
| | - Ce Liu
- The First Clinical Medical Research Institute, Shaanxi University of Chinese Medicine, Shaanxi, China
| | - Lixue Yang
- The First Clinical Medical Research Institute, Shaanxi University of Chinese Medicine, Shaanxi, China
- Affiliated Hospital of Chinese Medicine, Shaanxi University of Chinese Medicine, Shaanxi, China
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10
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Liu J, Zhu Y, Tan JK, Ismail AH, Ibrahim R, Hassan NH. Factors Associated with Sarcopenia among Elderly Individuals Residing in Community and Nursing Home Settings: A Systematic Review with a Meta-Analysis. Nutrients 2023; 15:4335. [PMID: 37892411 PMCID: PMC10610239 DOI: 10.3390/nu15204335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 09/21/2023] [Accepted: 09/26/2023] [Indexed: 10/29/2023] Open
Abstract
To investigate the factors associated with sarcopenia in elderly individuals residing in nursing homes and community settings, we conducted a systematic search of databases, including MEDLINE, EMBASE, PubMed, Web of Science and Cochrane, up to May 2023. We incorporated a total of 70 studies into our analysis. Our findings revealed that the prevalence of sarcopenia in nursing homes ranged from 25% to 73.7%, while in community settings, it varied from 5.2% to 62.7%. The factors associated with sarcopenia in both nursing homes and community settings included male gender, BMI, malnutrition, and osteoarthritis. In community settings, these factors comprised age, poor nutrition status, small calf circumference, smoking, physical inactivity, cognitive impairment, diabetes, depression and heart disease. Currently, both the European Working Group on Sarcopenia in Older People (EWGSOP) and the Asian Working Group for Sarcopenia (AWGS) standards are widely utilized in nursing homes and community settings, with the EWGSOP standard being more applicable to nursing homes. Identifying factors associated with sarcopenia is of paramount significance, particularly considering that some of them can be modified and managed. Further research is warranted to investigate the impact of preventive measures on these factors in the management of sarcopenia among elderly individuals residing in nursing homes and community settings.
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Affiliation(s)
- Jia Liu
- Department of Nursing, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (J.L.); (A.H.I.)
| | - Yuezhi Zhu
- Department of Biochemistry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (Y.Z.); (J.K.T.)
| | - Jen Kit Tan
- Department of Biochemistry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (Y.Z.); (J.K.T.)
| | - Azera Hasra Ismail
- Department of Nursing, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (J.L.); (A.H.I.)
| | - Roszita Ibrahim
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia;
| | - Nor Haty Hassan
- Department of Nursing, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (J.L.); (A.H.I.)
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11
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Zhang J, Cheng Y, Chen C, Wang Q, Yang C, Qiu J, Li J, Liu X, Zhang Y, Liu L, Zhao Y. Interaction of estradiol and vitamin D with low skeletal muscle mass among middle-aged and elderly women. BMC Womens Health 2023; 23:491. [PMID: 37715186 PMCID: PMC10502989 DOI: 10.1186/s12905-023-02646-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 09/09/2023] [Indexed: 09/17/2023] Open
Abstract
BACKGROUND Since the connection between muscle atrophy and vitamin D and estradiol status ambiguous, this study was thus conducted to determine whether low skeletal muscle mass (SMM) in middle-aged and elderly women was affected by estradiol and vitamin D levels together. METHODS Baseline data from a sub-cohort of the China Northwest Natural Population Cohort: Ningxia Project (CNC-NX) were analyzed. Serum 25-hydroxyvitamin D (25(OH) D) and estradiol were measured by chemiluminescence immunoassay analyzer. Bivariate logistic regression and multiplicative interaction analyses were used to assess the impact of estradiol level and vitamin D status on low SMM, as well as the combined impact of estradiol and low vitamin D status on low SMM. RESULTS A total of 287 (9.49%) participants had low SMM, which had lower levels of estradiol and vitamin D concentration than normal SMM group. While, after adjusting the confounding variables, these correlations were maintained in estradiol Q1, Q2, Q3 and vitamin D Q1. Furthermore, the significant combined effect of the highest quartile of estradiol concentrations and non-vitamin D deficiency, and interactions between vitamin D Q1 and estradiol Q2, vitamin D Q1 and estradiol Q3, vitamin D Q2 and estradiol Q1, vitamin D Q3 and estradiol Q3 on low SMM were stably reflected (P for interaction < 0.05). CONCLUSIONS Estradiol and vitamin D were interrelated with low SMM in middle-aged and elderly women. Combination of estradiol and vitamin D supplements should be encouraged for middle-aged and elderly women who are at risk of muscle atrophy or experiencing muscle atrophy.
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Affiliation(s)
- Jiaxing Zhang
- School of Public Health, Ningxia Medical University, Ningxia Hui Autonomous Region, Yinchuan, China
| | - Yalong Cheng
- School of Public Health, Ningxia Medical University, Ningxia Hui Autonomous Region, Yinchuan, China
| | - Chen Chen
- Department of Public Health, People’s Hospital of Ningxia Hui Autonomous Region, Yinchuan, Ningxia China
| | - Qingan Wang
- School of Public Health, Ningxia Medical University, Ningxia Hui Autonomous Region, Yinchuan, China
- Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan, Ningxia China
| | - Chan Yang
- School of Nursing, Ningxia Medical University, Ningxia Hui Autonomous Region, Yinchuan, China
| | - Jiangwei Qiu
- School of Public Health, Ningxia Medical University, Ningxia Hui Autonomous Region, Yinchuan, China
| | - Juan Li
- School of Public Health, Ningxia Medical University, Ningxia Hui Autonomous Region, Yinchuan, China
| | - Xiaowei Liu
- School of Public Health, Ningxia Medical University, Ningxia Hui Autonomous Region, Yinchuan, China
| | - Yuhong Zhang
- School of Public Health, Ningxia Medical University, Ningxia Hui Autonomous Region, Yinchuan, China
- Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan, Ningxia China
| | - Lan Liu
- School of Public Health, Ningxia Medical University, Ningxia Hui Autonomous Region, Yinchuan, China
- Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan, Ningxia China
| | - Yi Zhao
- School of Public Health, Ningxia Medical University, Ningxia Hui Autonomous Region, Yinchuan, China
- Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan, Ningxia China
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Juby A, Davis C, Minimaana S, Mager D. Observational cohort study of highly functioning community-dwelling older adults to assess their sarcopenic status, leisure physical activity, and quality of life over 12-months. Heliyon 2023; 9:e20078. [PMID: 37809471 PMCID: PMC10559810 DOI: 10.1016/j.heliyon.2023.e20078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 09/10/2023] [Accepted: 09/11/2023] [Indexed: 10/10/2023] Open
Abstract
Background The prevalence of sarcopenia varies depending on the cohort evaluated, and the diagnostic criteria used. Older adults with sarcopenia report lower quality of life than their non-sarcopenic peers. Leisure physical activity is reported to have a variable effect on sarcopenic status. Most studies to date, have been done in "vulnerable" populations, with fewer done on independent community-dwelling older adults. None have been done in an Alberta, Canada population. Objectives To prospectively evaluate the sarcopenic status of independent community-dwelling older Albertan adults; whether this changed over 12-months; and any association with self-reported leisure activity or quality of life. Methods Independent community-dwelling older adults were invited to participate in a 12-month observational study. Assessments were done at baseline, 6 and 12-months for physical function (TUG, SPPB, gait speed, Tinetti, grip strength), muscle mass (DXA, arm and calf circumference), body fat (skinfold, DXA), reported daily exercise (aerobic, resistance), quality of life (EQ5D), and laboratory parameters. European Working Group on Sarcopenia in Older People (EWGSOP) definitions of sarcopenic status were used. Results All 50 participants (11 male), were independent of all basic activities of daily living at baseline, and most instrumental activities (some needed assistance with driving or finances). They had an average age of 75.8 (67-90) years, with average MMSE and MoCA cognitive scores of 28.1/30 (20-30) and 24.8/30 (14-30) respectively. Eight participants dropped out prior to their first DXA test. Of the remaining 42, 17 participants (5 male) fulfilled the EWGSOP revised criteria for probable, pre-sarcopenia, or sarcopenia, giving a rate of baseline total sarcopenia of 40.5% in this community-dwelling sample. The majority were pre-sarcopenic (28.6%), and sarcopenia was present only in 7.1%. The total sarcopenia group had a lower BMI (25.6 ± 5.1 versus 29 ± 5, p = 0.01), less body fat by skinfold measurement (36.4 ± 6.5 versus 39.3 ± 8.1, p = 0.01) and lower mid-calf (35.6 ± 3.2 versus 37.6 ± 3.4, p = 0.04) and mid-arm (29.1 ± 2.5 versus 31.9 ± 3.5, p = 0.02) circumferences when compared to their non-sarcopenic peers. After 12-months, 39 participants remained in the study. Of these, the sarcopenic status of 7 improved, 10 declined, with the remaining 56% not changing. There were no statistically significant differences in baseline laboratory parameters between the groups, including 25(OH)D status. But, of the status decliners, 40% had suboptimal 25(OH)D at baseline. Self-reported leisure activity (both total time and frequency) was not associated with sarcopenic status at 12-months. EuroQol -5D was not associated with sarcopenic status. Conclusions The rate of sarcopenia was 7.1%, but the total rate of pre, probable and sarcopenia in this highly functioning, community-dwelling older adult cohort was 40.5%. In the majority (75%), there was either no change, or an improvement, in their sarcopenic status over 12-months. There was no association identified with self-reported leisure activity or quality of life in this cohort.
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Affiliation(s)
- A.G. Juby
- Department of Medicine, Division of Geriatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - C.M.J. Davis
- Faculty of Kinesiology, University of Alberta, Edmonton, Alberta, Canada
| | - S. Minimaana
- Faculty of Science, University of Alberta, Edmonton, Alberta, Canada
| | - D.R. Mager
- Faculty of Agriculture, Food and Nutrition Sciences, University of Alberta, Edmonton, Alberta, Canada
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Saraiva RM, Costa ARD. Sarcopenia: An Important Entity Still Underinvestigated in Heart Failure. Arq Bras Cardiol 2023; 120:e20230387. [PMID: 37556659 PMCID: PMC10382147 DOI: 10.36660/abc.20230387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/11/2023] Open
Affiliation(s)
- Roberto Magalhães Saraiva
- Instituto Nacional de Infectologia Evandro Chagas/Fundação Oswaldo Cruz, Rio de Janeiro, RJ - Brasil
| | - Andréa Rodrigues da Costa
- Instituto Nacional de Infectologia Evandro Chagas/Fundação Oswaldo Cruz, Rio de Janeiro, RJ - Brasil
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Mballa Yene BV, Lee SY, Park KS, Kang YJ, Seo SH, Yoo JI. Prevalence of Sarcopenia in Africa: A Systematic Review. Clin Interv Aging 2023; 18:1021-1035. [PMID: 37427010 PMCID: PMC10329476 DOI: 10.2147/cia.s407917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 06/27/2023] [Indexed: 07/11/2023] Open
Abstract
Objective The world population gradually getting older, age-related sarcopenia is becoming more frequent. Known to be highly prevalent in high income countries, relative data in Africa are still scarce. This review aims to estimate the prevalence of sarcopenia in Africa and its characteristics. Study Design and Setting A literature search in PubMed, Web of Science, Google Scholar, and Scopus was conducted in October 2022. All studies reporting the prevalence of sarcopenia in Africa within 15 years were included, and we did an assessment of bias with Hoy et al's risk bias assessment tool. The estimated prevalence of sarcopenia was the outcome and we performed secondary analyses by age, gender, and diagnostic criteria. The random effect model was used for the prevalence estimation. The prevalence of sarcopenia and 95% confidence interval (95% CI) were calculated using the inverse-variance method. Results A total of 17 studies met our eligibility criteria, for a study population of 12,690 participants with 44.3% males and 55.7% females. The overall prevalence of sarcopenia was 25% (95% CI: 19-30%). The prevalence of sarcopenia among 50 years old and older was 23% (95% CI: 17-29%). We had a higher prevalence of sarcopenia among males (30%, %95 IC: 20-39%) than females (29%, %95 IC: 21-36%). The prevalence of sarcopenia was different depending on the diagnosis criteria used. Conclusion The prevalence of sarcopenia in Africa was relatively high. However, the fact that the majority of included studies were hospital-based studies shows the necessity of further community-based studies in order to have a more accurate representation of the situation in the general population.
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Affiliation(s)
| | - Sang-Yeob Lee
- Department of Biomedical Research Institute, Gyeongsang National University Hospital, Jinju, South Korea
| | - Ki-Soo Park
- Department of Preventive Medicine, School of Medicine, Gyeongsang National University, Jinju, South Korea
| | - Yang Jae Kang
- Division of Life Science Department, Gyeongsang National University, Jinju, South Korea
| | - Sung Hyo Seo
- Department of Biomedical Research Institute, Gyeongsang National University Hospital, Jinju, South Korea
| | - Jun-Il Yoo
- Department of Orthopaedic Surgery, Inha University Hospital, Incheon, South Korea
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15
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Shon OJ, Kim GB, Cho SJ. Does Sarcopenia Accompanying End-Stage Knee Osteoarthritis Affect the Outcomes following Total Knee Arthroplasty? MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1078. [PMID: 37374280 DOI: 10.3390/medicina59061078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 05/26/2023] [Accepted: 05/31/2023] [Indexed: 06/29/2023]
Abstract
Background and Objectives: This study aimed to investigate the prevalence of sarcopenia in patients undergoing total knee arthroplasty (TKA) for advanced knee osteoarthritis (OA), and to assess whether sarcopenia accompanying OA affects patient-reported outcome measures (PROMs) after TKA. We evaluated which predisposing factors could influence the development of sarcopenia in patients with advanced knee OA. Material and Methods: A total of 445 patients whose body composition, muscle strength, and physical performance could be measured before primary TKA were enrolled. Sarcopenia was defined according to the Asian Working Group for Sarcopenia 2019 criteria. Patients were categorized into sarcopenia (S, n = 42) and non-sarcopenia groups (NS, n = 403). PROMs were investigated using the Knee Injury and Osteoarthritis Outcome Score and Western Ontario and McMaster Universities Osteoarthritis Index. Additionally, postoperative complications and predisposing factors for sarcopenia were evaluated. Results: The incidence of sarcopenia in the entire sample was 9.4%; the prevalence was higher in men (15.4%) than in women (8.7%), and significantly increased with advancing age (p < 0.001). At the six-month follow-up, PROMs in group S were significantly inferior to those in group NS, except for the pain score; however, at the 12-month follow-up, no significant difference was observed between the groups. Multivariate logistic regression indicated that age, body mass index (BMI), and a higher modified Charlson Comorbidity Index (mCCI) were predisposing factors for sarcopenia. Conclusions: A higher prevalence of sarcopenia was observed in men with progressive knee OA. Up to six months after primary TKA, PROMs in group S were inferior to those in group NS, except for the pain score; however, no significant difference was observed between the groups at 12 months. Age, BMI, and higher mCCI were predisposing factors for sarcopenia in patients with OA.
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Affiliation(s)
- Oog-Jin Shon
- Department of Orthopedic Surgery, Yeungnam University College of Medicine, 170 Hyonchung-ro, Namgu, Daegu 42415, Republic of Korea
- Department of Orthopedic Surgery, Yeungnam University Medical Center, 170 Hyonchung-ro, Namgu, Daegu 42415, Republic of Korea
| | - Gi Beom Kim
- Department of Orthopedic Surgery, Yeungnam University College of Medicine, 170 Hyonchung-ro, Namgu, Daegu 42415, Republic of Korea
- Department of Orthopedic Surgery, Yeungnam University Medical Center, 170 Hyonchung-ro, Namgu, Daegu 42415, Republic of Korea
| | - Seung Jae Cho
- Department of Orthopedic Surgery, Yeungnam University Medical Center, 170 Hyonchung-ro, Namgu, Daegu 42415, Republic of Korea
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Buccheri E, Dell’Aquila D, Russo M, Chiaramonte R, Musumeci G, Vecchio M. Can artificial intelligence simplify the screening of muscle mass loss? Heliyon 2023; 9:e16323. [PMID: 37251872 PMCID: PMC10208931 DOI: 10.1016/j.heliyon.2023.e16323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 05/04/2023] [Accepted: 05/12/2023] [Indexed: 05/31/2023] Open
Abstract
Background Sarcopenia is a risk factor for morbidity and preventable mortality in old age, with consequent high costs for the national health system. Its diagnosis requires costly radiological examinations, such as the DEXA, which complicate screening in medical centers with a high prevalence of sarcopenia. Objectives Developing a nearly zero-cost screening tool to emulate the performance of DEXA in identifying patients with muscle mass loss. This can crucially help the early diagnosis of sarcopenia at large-scale, contributing to reduce its prevalence and related complications with timely treatments. Methods We exploit cross-sectional data for about 14,500 patients and 38 non-laboratory variables from successive NHANES over 7 years (1999-2006). Data are analyzed through a state-of-the-art artificial intelligence approach based on decision trees. Results A reduced number of anthropometric parameters allows to predict the outcome of DEXA with AUC between 0.92 and 0.94. The most complex model derived in this paper exploits 6 variables, related to the circumference of key corporal segments and to the evaluation of body fat. It achieves an optimal trade-off sensitivity of 0.89 and a specificity of 0.82. Restricting exclusively to variables related to lower limb, we obtain an even simpler tool with only slightly lower accuracy (AUC 0.88-0.90). Conclusions Anthropometric data seem to contain the entire informative content of a more complex set of non-laboratory variables, including anamnestic and/or morbidity factors. Compared to previously published screening tools for muscle mass loss, the newly developed models are less complex and achieve a better accuracy. The new results might suggest a possible inversion of the standard diagnostic algorithm of sarcopenia. We conjecture a new diagnostic scheme, which requires a dedicated clinical validation that goes beyond the scope of the present study.
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Affiliation(s)
- Enrico Buccheri
- Department of Biomedical and Biotechnological Sciences, Section of Pharmacology, University of Catania, 95123 Catania, Italy
| | - Daniele Dell’Aquila
- Dipartimento di Fisica “Ettore Pancini”, University of Naples “Federico II”, Napoli, Italy
- INFN – Sezione di Napoli, Napoli, Italy
| | - Marco Russo
- Department of Physics and Astronomy, University of Catania, Catania, Italy
- INFN – Sezione di Catania, Catania, Italy
| | - Rita Chiaramonte
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy
| | - Giuseppe Musumeci
- Department of Biomedical and Biotechnological Sciences, Human, Histology and Movement Science Section, University of Catania, 95123, Catania, Italy
| | - Michele Vecchio
- Department of Biomedical and Biotechnological Sciences, Section of Pharmacology, University of Catania, 95123 Catania, Italy
- Rehabilitation Unit, “AOU Policlinico G. Rodolico-San Marco”, 95123 Catania, Italy
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Bogucka A, Kopiczko A, Charzewska J. Sarcopenia: prevalence and its main risk factors in older women. ANTHROPOLOGICAL REVIEW 2023. [DOI: 10.18778/1898-6773.86.1.05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023] Open
Abstract
Introduction: Sarcopenia is a major public health concern. It is defined as a progressive and generalized skeletal muscle disorder that is associated with an increased likelihood of falls, fractures, physical disability, and ultimately, premature death.
Objective: The aim of the study was to assess the prevalence and determine the role of physical activity, nutrient intake, and selected risk factors for the development of sarcopenia in older women.
Methods: The study involved 302 women aged ≥65 years (mean age: 72.1± 5.9 years). Bioelectrical impedance analysis of body composition, static muscle strength measurements, Timed Up and Go test, and the assessment of current physical activity using accelerometers were performed. Diets were assessed using the 24-h recall method from two non-consecutive days. The energy and nutrient content of diets was calculated using the computer program DIETA 6.
Results: Sarcopenia was present in 28.8% of the women studied. The most important factor in the decrease in the risk of sarcopenia was protein intake ≥ 0.9 g/kg b.m. (OR=0.08;p<0.001), and physical activity ≥ 4000 steps/day. However, these results were not statistically significant (OR=0.58; p=0.08). Furthermore, the risk of developing sarcopenia increased as BMI (OR=1.36; p<0.001) or percent of body fat (OR=1.29; p<0.001) increased.
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18
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Curtis M, Swan L, Fox R, Warters A, O'Sullivan M. Associations between Body Mass Index and Probable Sarcopenia in Community-Dwelling Older Adults. Nutrients 2023; 15:nu15061505. [PMID: 36986233 PMCID: PMC10059806 DOI: 10.3390/nu15061505] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 03/09/2023] [Accepted: 03/16/2023] [Indexed: 03/30/2023] Open
Abstract
(1) Background/Objectives: The relationship between body mass index (BMI) and probable sarcopenia, a precursor to sarcopenia diagnosis, is unclear. While low BMI has been associated with sarcopenia risk, some evidence suggests that obesity may confer protection. We aimed to investigate the association between probable sarcopenia and BMI and, furthermore, to explore associations with waist circumference (WC). (2) Methods: This cross-sectional study included 5783 community-dwelling adults (mean age 70.4 ± 7.5 years) from Wave 6 of the English Longitudinal Study of Ageing (ELSA). Probable sarcopenia was defined using the European Working Group on Sarcopenia in Older People (EWGSOP2) criteria for low hand grip strength and/or slow chair rise. Associations between BMI and probable sarcopenia were examined using multivariable regression analysis and were similarly performed for WC. (3) Results: Our overall findings show that an underweight BMI was significantly associated with an increased likelihood of probable sarcopenia [OR (CI) 2.25 (1.17, 4.33), p = 0.015]. For higher BMI categories, the findings were conflicting. Overweight and obesity were associated with an increased likelihood of probable sarcopenia when defined by lower limb strength alone, [OR (CI), 2.32 (1.15, 4.70), p = 0.019; 1.23 (1.02, 1.49), p = 0.35, and 1.49 (1.21, 1.83), p < 0.001, respectively]. In contrast, overweight and obesity appeared protective when probable sarcopenia was assessed by low hand grip strength alone [OR (CI) 0.72 (0.60, 0.88), p = 0.001, and 0.64 (0.52, 0.79), p < 0.001, respectively]. WC was not significantly associated with probable sarcopenia on multivariable regression analysis. (4) Conclusion: This study supports the evidence that low BMI is associated with an increased likelihood of probable sarcopenia, highlighting an important at-risk group. The findings for overweight and obesity were inconsistent and may be measurement dependent. It seems prudent that all older adults at risk of probable sarcopenia, including those with overweight/obesity, are assessed to prevent underdetection of probable sarcopenia alone or with the double burden of obesity.
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Affiliation(s)
- Molly Curtis
- Department of Clinical Medicine, School of Medicine, Trinity Centre for Health Sciences, St. James's Healthcare Campus, Trinity College Dublin, D08 W9RT Dublin, Ireland
| | - Lauren Swan
- Department of Clinical Medicine, School of Medicine, Trinity Centre for Health Sciences, St. James's Healthcare Campus, Trinity College Dublin, D08 W9RT Dublin, Ireland
| | - Rebecca Fox
- Department of Clinical Medicine, School of Medicine, Trinity Centre for Health Sciences, St. James's Healthcare Campus, Trinity College Dublin, D08 W9RT Dublin, Ireland
| | - Austin Warters
- Older Person Services, Dublin North City and County Community Health Organisation, The Health Service Executive, D09 C8P5 Dublin, Ireland
| | - Maria O'Sullivan
- Department of Clinical Medicine, School of Medicine, Trinity Centre for Health Sciences, St. James's Healthcare Campus, Trinity College Dublin, D08 W9RT Dublin, Ireland
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Chen R, Xu J, Wang Y, Jiang B, Xu X, Lan Y, Wang J, Lin X. Prevalence of sarcopenia and its association with clinical outcomes in heart failure: An updated meta-analysis and systematic review. Clin Cardiol 2023; 46:260-268. [PMID: 36644878 PMCID: PMC10018088 DOI: 10.1002/clc.23970] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 12/19/2022] [Accepted: 12/28/2022] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Sarcopenia is thought to be strongly associated with heart failure, but meta-analyses with sufficient samples are still lacking to accurately address its clinical situation. HYPOTHESIS Sarcopenia has a high prevalence in patients with heart failure and is closely related to adverse clinical outcomes. METHODS Relevant databases were systematically searched in October 2021 and updated in July 2022. The data with high heterogeneity were combined with random effects model. RESULTS Twenty-one studies with 68,556 HF patients were included. The combined prevalence of sarcopenia in HF patients was 31%. Subgroup analysis found that the prevalence of sarcopenia in HF patients was 35% in Asia, 31% in Europe, 25% in the Americas, 31% in people aged ≥65 years, 25% in people with age <65 years, 28% in HF with reduced ejection fraction (HFrEF) patients and 18% in HF with preserved ejection fraction (HFpEF) patients. In addition, our analysis shows that sarcopenia in patients with HF is associated with an increased risk of poor prognosis, with a combined hazard ratio [HR] of 1.64 (95% confidence interval [CI] = 1.20-5.25), sarcopenia was also associated with poor outcomes in HFrEF patients with pooled HR of 2.77 (95% CI = 1.29-5.95). However, it was not associated with poor outcomes in HFpEF patients with pooled HR of 1.61 (95% CI = 0.82-3.16). CONCLUSIONS The prevalence of sarcopenia is high in HF patients, and patients with HF, particularly those with reduced ejection fraction, are at high risk of adverse outcomes from sarcopenia. Therefore, early identification and intervention for sarcopenia were beneficial for improving the prognosis of HF patients.
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Affiliation(s)
- Ruzhao Chen
- The Center of Gerontology and Geriatrics/National Clinical Research Center for Geriatrics, West China HospitalSichuan UniversityChengduChina
- Department of MedicineJingGangshan UniversityJi'anChina
| | - Jiachen Xu
- Department of MedicineJingGangshan UniversityJi'anChina
| | - Yuge Wang
- Department of MedicineJingGangshan UniversityJi'anChina
| | - Benyue Jiang
- Department of MedicineJingGangshan UniversityJi'anChina
| | - Xiao Xu
- Department of MedicineJingGangshan UniversityJi'anChina
| | - Yang Lan
- Department of MedicineJingGangshan UniversityJi'anChina
| | - Jiang Wang
- Department of MedicineJingGangshan UniversityJi'anChina
| | - Xiufang Lin
- The Center of Gerontology and Geriatrics/National Clinical Research Center for Geriatrics, West China HospitalSichuan UniversityChengduChina
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Marshall RN, Morgan PT, Smeuninx B, Quinlan JI, Brook MS, Atherton PJ, Smith K, Wilkinson DJ, Breen L. Myofibrillar Protein Synthesis and Acute Intracellular Signaling with Elastic Band Resistance Exercise in Young and Older Men. Med Sci Sports Exerc 2023; 55:398-408. [PMID: 36731005 DOI: 10.1249/mss.0000000000003061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
PURPOSE Resistance exercise training (RET) attenuates age-related muscle and strength loss ("sarcopenia"). However, compared with machine-based RET, the efficacy of cost-effective, accessible elastic band RET (EB-RET) for muscle adaptive remodeling lacks supporting mechanistic evidence. METHODS Eight young (YM; 24 ± 4 yr) and eight older (OM; 68 ± 6 yr) untrained males consumed an oral stable isotope tracer (D 2 O) combined with serial vastus lateralis muscle biopsies to measure integrated myofibrillar protein synthesis (iMyoPS) and regulatory signaling over ~48 h before (habitual) and after an acute bout of EB-RET (6 × 12 repetitions at ~70% of one-repetition maximum). iMyoPS was determined via gas chromatography-pyrolysis-isotope ratio mass spectroscopy and regulatory signaling expression by immunoblot. RESULTS Habitual iMyoPS did not differ between YM and OM (1.62% ± 0.21% vs 1.43% ± 0.47%·d -1 , respectively, P = 0.128). There was a significant increase in iMyoPS after EB-RET in YM (2.23% ± 0.69%·d -1 , P = 0.02), but not OM (1.75% ± 0.54%·d -1 , P = 0.30). EB-RET increased the phosphorylation of key anabolic signaling proteins similarly in YM and OM at 1 h postexercise, including p-IRS-1 Ser636/639 , p-Akt Ser473 , p-4EBP-1 Thr37/46 , p-P70S6K Thr389 , and p-RPS6 Ser240/244 , whereas p-TSC2 Thr1462 and p-mTOR Ser2448 increased only in YM (all P < 0.05). There were no differences in the expression of amino acid transporters/sensors or proteolytic markers after EB-RET. CONCLUSIONS iMyoPS was elevated after EB-RET in YM but not OM. However, the increase in acute anabolic signaling with EB-RET was largely similar between groups. In conclusion, the capacity for EB-RET to stimulate iMyoPS may be impaired in older age. Further work may be necessary to optimize prescriptive programming in YM and OM.
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Sallfeldt ES, Mallmin H, Karlsson MK, Mellström D, Hailer NP, Ribom EL. Sarcopenia prevalence and incidence in older men - a MrOs Sweden study. Geriatr Nurs 2023; 50:102-108. [PMID: 36774676 DOI: 10.1016/j.gerinurse.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 01/02/2023] [Accepted: 01/03/2023] [Indexed: 02/12/2023]
Abstract
INTRODUCTION The European Working Group on Sarcopenia in Older People (EWGSOP) published a revised definition of sarcopenia in 2018. There are few incidence studies of sarcopenia following the latest definition. OBJECTIVE To study prevalence, incidence proportion and incidence rate of sarcopenia in a simple random sample of older Swedish men using the EWGSOP2 definition. METHODS Men aged 69-81 were invited to participate in the Osteoporotic Fractures in Men (MrOs) Sweden study. Of 2,004 included participants, 1,266 participants (mean age 75.1, SD 3.1 years) completed baseline and 5-year follow-up measurements. We assessed muscle strength by measuring grip strength and chair stands test, lean mass by dual energy X-ray absorptiometry and physical performance by gait speed at baseline and follow-up. Sarcopenia prevalence and incidence were calculated according to the EWGSOP2 definition. RESULTS Sarcopenia prevalence increased from 5.6% at baseline to 12.0% at follow-up. During the mean 5.2-year follow-up period, 9.1% developed sarcopenia (incidence proportion), corresponding to an incidence rate of 1.8 per 100 person-years at risk while 39.4% of the participants with sarcopenia at baseline participating in follow-up reversed to no longer having confirmed sarcopenia at 5-year follow-up. CONCLUSION The prevalence of sarcopenia defined along EWGSOP2 criteria doubled within 5 years in older men, and more than a third of the study participants with sarcopenia at baseline did not have sarcopenia at follow-up. We conclude that sarcopenia is not a static condition.
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Affiliation(s)
- Ellen S Sallfeldt
- Department of Surgical Sciences, Orthopaedics, Uppsala University, S-751 85 Uppsala, Sweden.
| | - Hans Mallmin
- Department of Surgical Sciences, Orthopaedics, Uppsala University, S-751 85 Uppsala, Sweden
| | - Magnus K Karlsson
- Clinical and Molecular Osteoporosis Research Unit, Institution of Clinical Sciences Malmö (IKVM), Lund University, Department of Orthopaedics, Skåne University Hospital (SUS), SE-205 02 Malmo, Sweden
| | - Dan Mellström
- Department of Internal Medicine and Geriatrics, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden; Center for Bone and Arthritis Research, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Nils P Hailer
- Department of Surgical Sciences, Orthopaedics, Uppsala University, S-751 85 Uppsala, Sweden
| | - Eva L Ribom
- Department of Surgical Sciences, Orthopaedics, Uppsala University, S-751 85 Uppsala, Sweden
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MacDonell SO, Moyes SA, Teh R, Dyall L, Kerse N, Wham C. Is the Utility of the GLIM Criteria Used to Diagnose Malnutrition Suitable for Bicultural Populations? Findings from Life and Living in Advanced Age Cohort Study in New Zealand (LiLACS NZ). J Nutr Health Aging 2023; 27:67-74. [PMID: 36651488 DOI: 10.1007/s12603-022-1874-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVES To investigate associations between nutrition risk (determined by SCREEN-II) and malnutrition (diagnosed by the GLIM criteria) with five-year mortality in Māori and non-Māori of advanced age. DESIGN A longitudinal cohort study. SETTING Bay of Plenty and Lakes regions of New Zealand. PARTICIPANTS 255 Māori; 400 non-Māori octogenarians. MEASUREMENTS All participants were screened for nutrition risk using the Seniors in the Community: Risk Evaluation for Eating and Nutrition (SCREEN-II). Those at high nutrition risk (SCREEN-II score <49) had the Global Leadership Initiative in Malnutrition (GLIM) criteria applied to diagnose malnutrition or not. Demographic, physical and health characteristics were obtained by trained research nurses using a standardised questionnaire. Five-year mortality was calculated from Government data. The association of nutrition risk (SCREEN-II) and a malnutrition diagnosis (GLIM) with five-year mortality was examined using logistic regression and cox proportional hazard models of increasing complexity. RESULTS 56% of Māori and 46% of non-Māori participants had low SCREEN-II scores indicative of nutrition risk. The prevalence of GLIM diagnosed malnutrition was lower for both Māori and non-Māori (15% and 19% of all participants). Approximately one-third of participants (37% Māori and 32% non-Māori) died within the five-year follow-up period. The odds of death for both Māori and non-Māori was significantly lower with greater SCREEN II scores (better nutrition status), (OR (95% CI); 0.58 (0.38, 0.88), P < 0.05 and 0.53 (0.38, 0.75), P < 0.001, respectively). GLIM diagnosed malnutrition was not significantly associated with five-year mortality for Māori (OR (95% CI); 0.88 (0.41, 1.91), P >0.05) but was for non-Māori. This association remained significant after adjustment for other predictors of death (OR (95% CI); 0.50 (0.29, 0.86), P< 0.05). Reduced food intake was the only GLIM criterion predictive of five-year mortality for Māori (HR (95% CI); 10.77 (4.76, 24.38), P <0.001). For non-Māori, both aetiologic and phenotypic GLIM criteria were associated with five-year mortality. CONCLUSION Nutrition risk, but not malnutrition diagnosed by the GLIM criteria was significantly associated with mortality for Māori. Conversely, both nutrition risk and malnutrition were significantly associated with mortality for non-Māori. Appropriate phenotypic criteria for diverse populations are needed within the GLIM framework.
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Affiliation(s)
- S O MacDonell
- Sue MacDonell, Department of General Practice and Primary Health Care, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand,
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Swan L, Martin N, Horgan NF, Warters A, O’Sullivan M. Assessing Sarcopenia, Frailty, and Malnutrition in Community-Dwelling Dependant Older Adults-An Exploratory Home-Based Study of an Underserved Group in Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16133. [PMID: 36498213 PMCID: PMC9736424 DOI: 10.3390/ijerph192316133] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 11/29/2022] [Accepted: 11/30/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Adults of advanced age, with functional dependency, socioeconomic disadvantage, or a need for home care, are expected to be at high risk of sarcopenia, frailty and malnutrition, yet are likely to be underrepresented in research. We aimed to explore the assessment of sarcopenia, frailty, and malnutrition in-home, and to describe the practicality of performing these assessments. METHODS Home-based health assessments and post-study feedback surveys were conducted among community-dwelling older adults ≥65 years in receipt of state-funded home care (n = 31). Assessments included probable sarcopenia [hand-grip strength (HGS), chair rise-test, and SARC-F case-finding tool], the Mini Nutritional Assessment (MNA), and the Clinical Frailty Scale (CFS). RESULTS The study group was of mean age 83.2 ± 8.2 years, 74% were female and 23% lived in socioeconomically disadvantaged areas. Almost all met the criteria for probable sarcopenia (94%, n = 29/31), were frail or vulnerable by the CFS (97%, n = 30/31), and over a quarter were at risk of malnutrition (26%, n = 8). Participants had low physical activity (71.0%, n = 22/31), with a mean daytime average of 11.4 ± 1.6 h spent sitting. It was possible to assess probable sarcopenia (by HGS and SARC-F, but not the chair rise test), malnutrition (MNA), and frailty (CFS). Home-based research was a complex environment, and unearthed significant unmet need, prompting referrals to health services (36%, n = 11), in addition to technology assistance. The majority of participants (93%) reported a willingness to partake in future research. CONCLUSIONS Most community-dwelling older people in receipt of home support, assessed in this exploratory study, were at risk of probable sarcopenia, frailty, and low physical activity, with over a quarter were at risk of malnutrition. Our initial findings provide practical data for large scale studies and may inform the development of intervention studies aiming to support ageing in place.
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Affiliation(s)
- Lauren Swan
- Department of Clinical Medicine, Trinity College, D02 PN40 Dublin, Ireland
| | - Niamh Martin
- Older Person Services CHO9, Health Service Executive (HSE), D09 C8P5 Dublin, Ireland
| | - N Frances Horgan
- School of Physiotherapy, Royal College of Surgeons in Ireland (RCSI), University of Medicine and Health Sciences, D02 YN77 Dublin, Ireland
| | - Austin Warters
- Older Person Services CHO9, Health Service Executive (HSE), D09 C8P5 Dublin, Ireland
| | - Maria O’Sullivan
- Department of Clinical Medicine, Trinity College, D02 PN40 Dublin, Ireland
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Parra-Rodríguez L, Reyes-Ramírez E, Jiménez-Andrade JL, Carrillo-Calvet H, García-Peña C. Self-Organizing Maps to Multidimensionally Characterize Physical Profiles in Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12412. [PMID: 36231709 PMCID: PMC9565208 DOI: 10.3390/ijerph191912412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 09/10/2022] [Accepted: 09/18/2022] [Indexed: 06/16/2023]
Abstract
The aim of this study is to automatically analyze, characterize and classify physical performance and body composition data of a cohort of Mexican community-dwelling older adults. Self-organizing maps (SOM) were used to identify similar profiles in 562 older adults living in Mexico City that participated in this study. Data regarding demographics, geriatric syndromes, comorbidities, physical performance, and body composition were obtained. The sample was divided by sex, and the multidimensional analysis included age, gait speed over height, grip strength over body mass index, one-legged stance, lean appendicular mass percentage, and fat percentage. Using the SOM neural network, seven profile types for older men and women were identified. This analysis provided maps depicting a set of clusters qualitatively characterizing groups of older adults that share similar profiles of body composition and physical performance. The SOM neural network proved to be a useful tool for analyzing multidimensional health care data and facilitating its interpretability. It provided a visual representation of the non-linear relationship between physical performance and body composition variables, as well as the identification of seven characteristic profiles in this cohort.
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Affiliation(s)
| | | | - José Luis Jiménez-Andrade
- Facultad de Ciencias, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
- Centro de Ciencias de la Complejidad, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
- Centro de Investigación e Innovación en Tecnologías de la Información y Comunicación, INFOTEC, Mexico City 14050, Mexico
| | - Humberto Carrillo-Calvet
- Facultad de Ciencias, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
- Centro de Ciencias de la Complejidad, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
| | - Carmen García-Peña
- Research Department, Instituto Nacional de Geriatría, Mexico City 10200, Mexico
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Association between lower parity and low muscle mass in postmenopausal women: data from KNHANES (2010-2011). Menopause 2022; 29:1137-1144. [PMID: 36067383 DOI: 10.1097/gme.0000000000002036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE This study aimed to investigate whether parity is associated with the prevalence of low muscle mass in postmenopausal women. METHODS This study was performed using data from the 2010-2011 Korean National Health and Nutrition Examination Survey, which included 1,338 postmenopausal women aged 46 to 70 years. The association between parity and low muscle mass was analyzed after adjusting parity, multiparity, age, body mass index, diabetes mellitus, education level, and Homeostatic Model Assessment of Insulin Resistance and using weighted multiple logistic regression analysis. Modifiable risk factors were evaluated in a susceptible population. Low muscle mass was defined as an appendicular skeletal muscle mass index below 2 SDs with a cutoff value of 5.45 kg/m 2 . RESULTS The low muscle mass group ( n = 343) had lower parity, lower body mass index, more frequent previous history of diabetes mellitus, higher Homeostatic Model Assessment of Insulin Resistance, and higher education level compared with the non-low muscle mass group ( n = 995). After adjusting for the confounding factors, parity with three births or more was associated with a significantly lower odds of postmenopausal low muscle mass than nulliparity (model 1: odds ratio, 0.32; 95% confidence interval, 0.12-0.87; P = 0.03; model 2: odds ratio, 0.27; 95% confidence interval, 0.11-0.67; P < 0.05). In the subgroup analysis of the lower parity group, moderate aerobic activity was associated with a lower low muscle mass prevalence. CONCLUSIONS A lower parity is associated with increasing the odds of low muscle mass in postmenopausal Korean women. Moderate aerobic activity may be effective in lowering the odds of low muscle mass in postmenopausal women with lower parity.
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Dodds RM, Hurst C, Hillman SJ, Davies K, Roberts L, Aspray TJ, Granic A, Sayer AA. Advancing our understanding of skeletal muscle across the lifecourse: Protocol for the MASS_Lifecourse study and characteristics of the first 80 participants. Exp Gerontol 2022; 166:111884. [PMID: 35788023 DOI: 10.1016/j.exger.2022.111884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 06/17/2022] [Accepted: 06/28/2022] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Sarcopenia, the age-related loss of skeletal muscle strength and mass, carries a significant burden for affected individuals. There has been little investigation of sarcopenia using experimental medicine techniques to study human muscle tissue in detail. The aim of the Muscle Ageing Sarcopenia Studies Lifecourse (MASS_Lifecourse) study is to recruit up to 160 participants, equally divided between females and males between ages 45 and 85 years for detailed phenotyping of skeletal muscle health. Here we describe the protocol for the study and the characteristics of the first 80 participants. METHODS We are recruiting participants from three sources in the north-east of England. Study fieldwork comprises a home visit (or videocall) for consent and assessment of health, cognition, lifestyle, and wellbeing. This is followed by a visit to a clinical research facility for assessment of sarcopenia status and collection of samples including a vastus lateralis muscle biopsy. We produced descriptive statistics for the first 80 participants, including expressing their grip strength relative to normative data in the form of Z-scores. RESULTS The first 80 participants (53.8 % female) covered the target ages, ranging from 48 to 84 years. They were regularly physically active, reported good physical function and had a prevalence of sarcopenia (including probable sarcopenia) of 11.3 % based on the revised European consensus. Their grip strength was similar to that in the general population, with a mean Z-score of 0.09 standard deviations (95 % CI: -1.64, 1.83) above that expected. CONCLUSIONS The MASS_Lifecourse study combines comprehensive health and lifestyle data with a range of biological samples including skeletal muscle. The findings from planned analyses should contribute to improvements in the diagnosis, treatment, and prevention of sarcopenia.
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Affiliation(s)
- R M Dodds
- AGE Research Group, Newcastle University Institute for Translational and Clinical Research, Newcastle upon Tyne, UK; NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, UK
| | - C Hurst
- AGE Research Group, Newcastle University Institute for Translational and Clinical Research, Newcastle upon Tyne, UK; NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, UK
| | - S J Hillman
- AGE Research Group, Newcastle University Institute for Translational and Clinical Research, Newcastle upon Tyne, UK; NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, UK
| | - K Davies
- AGE Research Group, Newcastle University Institute for Translational and Clinical Research, Newcastle upon Tyne, UK
| | - L Roberts
- AGE Research Group, Newcastle University Institute for Translational and Clinical Research, Newcastle upon Tyne, UK; NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, UK
| | - T J Aspray
- AGE Research Group, Newcastle University Institute for Translational and Clinical Research, Newcastle upon Tyne, UK; NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, UK
| | - A Granic
- AGE Research Group, Newcastle University Institute for Translational and Clinical Research, Newcastle upon Tyne, UK; NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, UK
| | - A A Sayer
- AGE Research Group, Newcastle University Institute for Translational and Clinical Research, Newcastle upon Tyne, UK; NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, UK.
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Development and Verification of a Combined Diagnostic Model for Sarcopenia with Random Forest and Artificial Neural Network. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:2957731. [PMID: 36050999 PMCID: PMC9427323 DOI: 10.1155/2022/2957731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 07/16/2022] [Accepted: 07/26/2022] [Indexed: 11/18/2022]
Abstract
Background Sarcopenia is a chronic disease characterized by an age-related decline in skeletal muscle mass and function, and diagnosis is challenging owing to the lack of a clear “gold standard” assessment method. Objective This study is aimed at combining random forest (RF) and artificial neural network (ANN) methods to screen key potential biomarkers and establish an early sarcopenia diagnostic model. Methods Three gene expression datasets were downloaded and merged by searching the Gene Expression Omnibus (GEO) database. Differentially expressed genes (DEGs) in the merged dataset were identified by R software and subjected to Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses. Afterward, the STRING database was employed for interaction analysis of the differentially encoded proteins. Then, RF was used to identify key genes from the DEGs, and a sarcopenia diagnostic model was constructed by ANN. Finally, the diagnostic model was assessed using a validation dataset, while its diagnostic performance was evaluated by the area under curve (AUC) value. Results 107 sarcopenia-related DEGs were identified, and they were mainly enriched in the FoxO and AMPK signaling pathways involved in the molecular pathogenesis of sarcopenia. Thereafter, seven key genes (MT1X, FAM171A1, ZNF415, ARHGAP36, CISD1, ETNPPL, and WISP2) were identified by the RF classifier. The proteins encoded by three of these genes (CISD1, ETNPPL, and WISP2) may be potential biomarkers for sarcopenia. Finally, a diagnostic model for sarcopenia was successfully designed by ANN, achieving an AUC of 0.999 and 0.85 in the training and testing datasets, respectively. Conclusion We identified several potential genetic biomarkers and successfully developed an early predictive model with high diagnostic performance for sarcopenia. Moreover, our results provide a valuable reference for the early diagnosis and screening of sarcopenia in the future.
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Lin H, Wang D, Ma S, Suo Y, Zhou P, Zhao Q, Liu J, Ding G. Frailty's Prevalence and the Association with Aging-Related Health Conditions in Chinese Community Dwelling Elderly. COMPUTATIONAL INTELLIGENCE AND NEUROSCIENCE 2022; 2022:1748162. [PMID: 36017459 PMCID: PMC9398729 DOI: 10.1155/2022/1748162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 06/05/2022] [Accepted: 06/22/2022] [Indexed: 12/01/2022]
Abstract
In this paper, we have investigated the frailty's prevalence and the association with aging-related health conditions in Chinese community dwelling elderly aged ≥60 years in Lianyungang City of China. In this regard, participants were 1,072 adults aged ≥60 years from Houhe Community of Lianyungang City of China. All the enrolled participants were tested for following parameters: (1) the related risk factors of frailty: including economic status, personal health, understanding and communication skills, and mental and psychological status; (2) aging-related health conditions related to frailty: Charlson's comorbidity index (CCI), Mini Nutritional Assessment Short Form (MNA-SF), Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder 7-item (GAD-7); (3) body composition, physical strength, and function testing: appendicular skeletal muscle mass index (ASMI), grip strength, five-repetition sit-to-stand test, 6 m walking speed, and strength assistance rise-climb-fall (SARC-F); (4) assessment of the degree and severity of frailty: physical frailty phenotype (PFP), Morse fall scale (MFS), and activities of daily living (ADL). The frailty's prevalence among the elderly aged ≥60 years in the community of Lianyungang City was 13.8%, 55.4% were prefrail, and 30.8% were robust. The independent risk factors of frailty were age, appendicular skeletal muscle mass index, sarcopenia, education, nutrition, and strength assistance rise-climb-fall (P < 0.05). Aging-related health conditions were associated with frailty, including sarcopenia, nutrition, and falls. However, mental and psychological statuses were not significantly associated with frailty.
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Affiliation(s)
- Hongxiao Lin
- Department of Geratology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, China
- Department of Osteoporosis, The First Affiliated Hospital of Kangda College of Nanjing Medical University, 6 Zhenhua East Road, Lianyungang 222000, China
- Department of Osteoporosis, The Affiliated Lianyungang Hospital of Xuzhou Medical University, 6 Zhenhua East Road, Lianyungang 222000, China
| | - Dongyan Wang
- Department of Osteoporosis, The First Affiliated Hospital of Kangda College of Nanjing Medical University, 6 Zhenhua East Road, Lianyungang 222000, China
- Department of Osteoporosis, The Affiliated Lianyungang Hospital of Xuzhou Medical University, 6 Zhenhua East Road, Lianyungang 222000, China
| | - Shanjun Ma
- Department of Geratology, Xinpu Community Health Service Center, 146 Nanji North Road, Lianyungang 222000, China
| | - Yan Suo
- Department of Geratology, Xinpu Community Health Service Center, 146 Nanji North Road, Lianyungang 222000, China
| | - Peng Zhou
- Department of Geratology, Xinpu Community Health Service Center, 146 Nanji North Road, Lianyungang 222000, China
| | - Qing Zhao
- Department of Geratology, Xinpu Community Health Service Center, 146 Nanji North Road, Lianyungang 222000, China
| | - Juan Liu
- Department of Geratology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, China
| | - Guoxian Ding
- Department of Geratology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, China
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Park D, Park CJ, Jung MG, Choi YH, Park KS, Koh HS. High prevalence of sarcopenia in Asian female patients awaiting primary total knee arthroplasty: Application of updated diagnostic tools from the Asian working group for sarcopenia. J Orthop Surg (Hong Kong) 2022; 30:10225536221113034. [PMID: 35924635 DOI: 10.1177/10225536221113034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Sarcopenia, a loss of muscle mass and strength with aging, is associated with various TKA-related complications. In 2020, the AWGS published an undated guideline (AWGS 2019) based on studies from East and Southeast Asia. The purpose of this study was to determine the prevalence of sarcopenia in Asian female patients awaiting primary total knee arthroplasty due to advanced knee osteoarthritis using the updated AWGS criteria. MATERIALS AND METHODS The present study included 138 female patients who scheduled for primary TKA with severe osteoarthritis. The included patients were assessed with use of an AWGS 2019 diagnostic criteria based on muscle strength, physical performance, and appendicular skeletal muscle mass. Clinical parameters related to sarcopenia were collected and knee status assessed using the Knee Society scoring system. To better define the association with age, patients were stratified into following four groups: <60, 60-69, 70-79, ≥80. The prevalence of sarcopenia was identified, and the association between sarcopenia and clinical variables was analyzed. RESULTS The prevalence of sarcopenia and severe sarcopenia in this cohort according to the updated AWGS criteria was 35.5% and 21.7%. Prevalence of sarcopenia and severe sarcopenia significantly increased with advancing age (p = .003, p = .040, respectively). Although not statistically significant, the proportion of severe sarcopenia among sarcopenia also increased with age. Multivariate logistic regression analysis revealed that lower BMI and lower 25-OH-vitamin D3 level were independent risk factors associated with sarcopenia in women awaiting TKA. CONCLUSIONS In conclusion, our study confirmed that sarcopenia is more prominent amongst female patients awaiting primary TKA than the general population. Therefore, orthopedic surgeons should consider sarcopenia prevention and intervention in this group. Further studies are needed to investigate the effect of TKA on sarcopenia, and the difference of TKA outcomes between groups with or without underlying sarcopenia.
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Affiliation(s)
- Dojoon Park
- The Department of Orthopedic Surgery, St. Vincent Hospital, 26713The Catholic University of Korea, Seoul, Korea
| | - Chan Jin Park
- The Department of Orthopedic Surgery, St. Vincent Hospital, 26713The Catholic University of Korea, Seoul, Korea
| | - Min-Gee Jung
- The Department of Orthopedic Surgery, St. Vincent Hospital, 26713The Catholic University of Korea, Seoul, Korea
| | - Youn Ho Choi
- The Department of Orthopedic Surgery, St. Vincent Hospital, 26713The Catholic University of Korea, Seoul, Korea
| | | | - Hae Seok Koh
- The Department of Orthopedic Surgery, St. Vincent Hospital, 26713The Catholic University of Korea, Seoul, Korea
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Pap Z, Kalabiska I, Balogh Á, Bhattoa HP. Prevalence of sarcopenia in community dwelling outpatient postmenopausal Hungarian women. BMC Musculoskelet Disord 2022; 23:207. [PMID: 35246081 PMCID: PMC8897857 DOI: 10.1186/s12891-022-05167-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 02/25/2022] [Indexed: 11/23/2022] Open
Abstract
Background Ageing is an inherent feature of life and as per the United Nations, in the year 2020, 985 million women were ≥ 50 years of age worldwide, and the figure is expected to rise to 1.65 billion by 2050. Preservation of health and well-being in the elderly are challenging, and on the same note generalized changes in the musculoskeletal system contribute to this scenario. Musculoskeletal changes with ageing are referred to as sarcopenia. Reduced muscle mass and physical performance are hallmarks of sarcopenia, exclaimed with difficulty in independent activity and poor quality of life. Knowing that there is a hiatus in our knowledge as regards to the prevalence of sarcopenia in Hungary, the aim of this study was to determine the prevalence of sarcopenia in a community dwelling outpatient postmenopausal Hungarian cohort using the EWGSOP2 consensus recommendation. Methods In this cross-sectional study, women arriving for routine bone densitometry examination at the Regional Osteoporosis Center, Department of Obstetrics and Gynecology, Faculty of Medicine, University of Debrecen were invited to participate in the study. A total of a 100 community-dwelling women were recruited who confirmed to the inclusion criteria of self-reported postmenopausal status, ≥ 50 years of age and gave written informed consent. The study procedures included the self-administered SARC-F questionnaire, followed by assessment of muscle strength, muscle quantity and physical preformance. Muscle strength was determined with the hand grip strength (HGS), appendicular skeletal muscle mass was assessed using dual energy X-ray absorptiometry and physical performance was determined by the gait speed (GS) test. Results As per the EWGSOP2 definition, the percentage of study participants with probable sarcopenia (low muscle strength), sarcopenia (low muscle strength and low muscle quantity) and severe sarcopenia (low muscle strength, muscle quantity and low physical performance) was 36, 31 and 8%, respectively. Multiple linear regression analysis revealed that height, weight, HGS and GS were all independent predictors of appendicular skeletal muscle mass. Conclusion The 31% prevalence of sarcopenia in the studied post-menopausal women highlights the need for adequate assessment of the condition in the elderly. Our findings most probably bear public health implications and may accelerate formulation of policies promoting healthy ageing. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-022-05167-2.
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Affiliation(s)
- Zoltán Pap
- Kalman Laki Doctoral School of the University of Debrecen, Department of Traumatology and Hand Surgery, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Irina Kalabiska
- University of Physical Education, Research Center for Sport Physiology, Budapest, Hungary
| | - Ádám Balogh
- Regional Osteoporosis Center, Department of Obstetrics and Gynecology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Harjit Pal Bhattoa
- Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Nagyerdei Blvd. 98, Debrecen, H-4032, Hungary.
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Chen Z, Ho M, Chau PH. Prevalence, Incidence, and Associated Factors of Possible Sarcopenia in Community-Dwelling Chinese Older Adults: A Population-Based Longitudinal Study. Front Med (Lausanne) 2022; 8:769708. [PMID: 35083235 PMCID: PMC8784542 DOI: 10.3389/fmed.2021.769708] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 10/27/2021] [Indexed: 12/25/2022] Open
Abstract
Purpose: This study aimed to assess the prevalence, incidence, and associated factors of possible sarcopenia in a nationwide representative sample of the community-dwelling older Chinese population. Methods:This study used the data of participants aged 60 years and over from the China Health and Retirement Longitudinal Study (CHARLS). Data on participants from three waves (2011-2015) of CHARLS were extracted. Possible sarcopenia was defined as low muscle strength or low physical performance, based on the Asian Working Group for Sarcopenia 2019 consensus. We first described baseline prevalence and four-year incidence of possible sarcopenia. Then multiple logistic regression and multivariable parametric proportional hazard model with Weibull distribution were used to examine the association of risk factors with baseline prevalence and four-year incidence of possible sarcopenia, respectively. Results:The prevalence of possible sarcopenia was 46.0%. The four-year incidence of possible sarcopenia was 11.9 per 100 person-years. Multivariable analysis revealed that advanced age and depressive symptoms were associated with increased prevalence of possible sarcopenia, while receiving education and moderate or high physical activity were associated with a lower risk of possible sarcopenia prevalence. For incidence, only advanced age was associated with an increased risk of possible sarcopenia incidence. Conclusion:Our study revealed the substantial burden of possible sarcopenia and related risk factors in community-dwelling settings in China. It highlighted the importance of early detection and intervention in this subclinical group for the prevention of sarcopenia.
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Affiliation(s)
| | | | - Pui Hing Chau
- School of Nursing, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
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Tsekoura M, Billis E, Matzaroglou C, Tsepis E, Gliatis J. Prevalence of probable sarcopenia in community-dwelling older Greek people. J Frailty Sarcopenia Falls 2021; 6:204-208. [PMID: 34950810 PMCID: PMC8649860 DOI: 10.22540/jfsf-06-204] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2021] [Indexed: 01/05/2023] Open
Abstract
Objectives: The objective of this study was to assess the prevalence rate of probable sarcopenia and to determine the factors associated with it in older people living in Western Greece. Methods: Probable sarcopenia was estimated based on cut-off values for handgrip strength (HGS) as recommended by EWGSOP2. Information about socio-demographic, chronic diseases, fear of falls and lifestyle of the participants were also collected. HGS was assessed using a SAEHAN dynamometer. Calf circumference was assessed with inelastic tape. A logistic regression analysis was performed in order to determine associated risk factors. Results: The sample comprised 402 participants (292 women;110 men), with a mean age of 71.51±7.63 years. Overall, 25.4% of the elderly participants were diagnosed with probable sarcopenia (men:36.4%; women:21.2%). The findings of this study demonstrated that probable sarcopenia was positively associated with age (OR=0.14, 95% CI=0.008 to 0.200), gender (OR=-0.6, 95% CI=-0.700 to -0.530), Body mass Index (OR=0.01, 95% CI=-0.030 to -0.005), Skeletal muscle mass index (OR=0.05, 95% CI=0.030 to 0.080), calf circumference (OR=0.02, 95% CI=0.007 to 0.040), and comorbidities (OR=0.04, 95% CI=0.030 to 0.080). Conclusion: There was a 25.4% prevalence of probable sarcopenia in Greek elderly. The results highlight the importance of the detection of HGS and probable sarcopenia in older people in order to develop effective strategies of prevention and intervention of sarcopenia.
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Affiliation(s)
- Maria Tsekoura
- Department of Physiotherapy, School of Health Rehabilitation Sciences, University of Patras, Aigio, Greece
| | - Evdokia Billis
- Department of Physiotherapy, School of Health Rehabilitation Sciences, University of Patras, Aigio, Greece
| | - Charalampos Matzaroglou
- Department of Physiotherapy, School of Health Rehabilitation Sciences, University of Patras, Aigio, Greece
| | - Elias Tsepis
- Department of Physiotherapy, School of Health Rehabilitation Sciences, University of Patras, Aigio, Greece
| | - John Gliatis
- Department of Medicine, School of Health Studies, University of Patras, Rio, Greece
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Liu D, Fan YB, Tao XH, Pan WL, Wu YX, Wang XH, He YQ, Xiao WF, Li YS. Mitochondrial Quality Control in Sarcopenia: Updated Overview of Mechanisms and Interventions. Aging Dis 2021; 12:2016-2030. [PMID: 34881083 PMCID: PMC8612607 DOI: 10.14336/ad.2021.0427] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 04/27/2021] [Indexed: 12/22/2022] Open
Abstract
Sarcopenia is a common geriatric disorder characterized by decreased muscle strength, low muscle mass and poor physical performance. This aging-related skeletal muscle deterioration leads to adverse outcomes and severely impairs the quality of life of patients. The accumulation of dysfunctional mitochondria with aging is an important factor in the occurrence and progression of sarcopenia. Mitochondrial quality control (MQC) fundamentally ensures the normal mitochondrial functions and is comprised of four main parts: proteostasis, biogenesis, dynamics and autophagy. Therefore, any pathophysiologic factors compromising the quality control of homeostasis in the skeletal muscle may lead to sarcopenia. However, the specific theoretical aspects of these processes have not been fully elucidated. Current therapeutic interventions using nutritional and pharmaceutical treatments show a modest therapeutic efficacy; however, only physical exercise is recommended as the first-line therapy for sarcopenia, which can ameliorate skeletal muscle deficiency by maintaining the homeostatic MQC. In this review, we summarized the known mechanisms that contribute to the pathogenesis of sarcopenia by impairing normal mitochondrial functions and described potential interventions that mitigate sarcopenia through improving MQC.
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Affiliation(s)
- Di Liu
- 1Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China
| | - Yi-Bin Fan
- 2Department of Dermatology, Zhejiang provincial people's hospital, People's Hospital of Hangzhou Medical College, Hangzhou 310014, China
| | - Xiao-Hua Tao
- 2Department of Dermatology, Zhejiang provincial people's hospital, People's Hospital of Hangzhou Medical College, Hangzhou 310014, China
| | - Wei-Li Pan
- 2Department of Dermatology, Zhejiang provincial people's hospital, People's Hospital of Hangzhou Medical College, Hangzhou 310014, China
| | - Yu-Xiang Wu
- 3School of Kinesiology, Jianghan University, Wuhan 430056, China
| | - Xiu-Hua Wang
- 4Xiang Ya Nursing School, The Central South University, Changsha 410013, China
| | - Yu-Qiong He
- 1Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China
| | - Wen-Feng Xiao
- 1Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China.,5National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China
| | - Yu-Sheng Li
- 1Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China.,5National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China
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Deng L, Chen B, Zhan C, Yu H, Zheng J, Bao W, Deng T, Zheng C, Wu L, Yang Y, Yu Z, Wang Y, Chen G. A Novel Clinical-Radiomics Model Based on Sarcopenia and Radiomics for Predicting the Prognosis of Intrahepatic Cholangiocarcinoma After Radical Hepatectomy. Front Oncol 2021; 11:744311. [PMID: 34868941 PMCID: PMC8639693 DOI: 10.3389/fonc.2021.744311] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 11/03/2021] [Indexed: 12/26/2022] Open
Abstract
Background Intrahepatic cholangiocarcinoma (ICC) is a highly aggressive malignant tumor with a poor prognosis. This study aimed to establish a novel clinical-radiomics model for predicting the prognosis of ICC after radical hepatectomy. Methods A clinical-radiomics model was established for 82 cases of ICC treated with radical hepatectomy in our hospital from May 2011 to December 2020. Radiomics features were extracted from venous-phase and arterial-phase images of computed tomography. Kaplan-Meier survival analysis was generated to compare overall survival (OS) between different groups. The independent factors were identified by univariate and multivariate Cox regression analyses. Nomogram performance was evaluated regarding discrimination, calibration, and clinical utility. C-index and area under the curve (AUC) were utilized to compare the predictive performance between the clinical-radiomics model and conventional staging systems. Results The radiomics model included five features. The AUC of the radiomics model was 0.817 in the training cohort, and 0.684 in the validation cohort. The clinical-radiomics model included psoas muscle index, radiomics score, hepatolithiasis, carcinoembryonic antigen, and neutrophil/lymphocyte ratio. The reliable C-index of the model was 0.768, which was higher than that of other models. The AUC of the model for predicting OS at 1, and 3 years was 0.809 and 0.886, which was significantly higher than that of the American Joint Committee on Cancer 8th staging system (0.594 and 0.619), radiomics model (0.743 and 0.770), and tumor differentiation (0.645 and 0.628). After stratification according to the constructed model, the median OS was 59.8 months for low-risk ICC patients and 10.1 months for high-risk patients (p < 0.0001). Conclusion The clinical-radiomics model integrating sarcopenia, clinical features, and radiomics score was accurate for prognostic prediction for mass-forming ICC patients. It provided an individualized prognostic evaluation in patients with mass-forming ICC and could helped surgeons with clinical decision-making.
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Affiliation(s)
- Liming Deng
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,Key Laboratory of Diagnosis and Treatment of Severe Hepato-Pancreatic Diseases of Zhejiang Province, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Bo Chen
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,Key Laboratory of Diagnosis and Treatment of Severe Hepato-Pancreatic Diseases of Zhejiang Province, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Chenyi Zhan
- Department of Medical Imaging, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Haitao Yu
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,Key Laboratory of Diagnosis and Treatment of Severe Hepato-Pancreatic Diseases of Zhejiang Province, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Jiuyi Zheng
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,Key Laboratory of Diagnosis and Treatment of Severe Hepato-Pancreatic Diseases of Zhejiang Province, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Wenming Bao
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,Key Laboratory of Diagnosis and Treatment of Severe Hepato-Pancreatic Diseases of Zhejiang Province, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Tuo Deng
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,Key Laboratory of Diagnosis and Treatment of Severe Hepato-Pancreatic Diseases of Zhejiang Province, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Chongming Zheng
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,Key Laboratory of Diagnosis and Treatment of Severe Hepato-Pancreatic Diseases of Zhejiang Province, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Lijun Wu
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,Key Laboratory of Diagnosis and Treatment of Severe Hepato-Pancreatic Diseases of Zhejiang Province, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yunjun Yang
- Department of Medical Imaging, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Zhengping Yu
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,Key Laboratory of Diagnosis and Treatment of Severe Hepato-Pancreatic Diseases of Zhejiang Province, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yi Wang
- Department of Epidemiology and Biostatistics, School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Gang Chen
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,Key Laboratory of Diagnosis and Treatment of Severe Hepato-Pancreatic Diseases of Zhejiang Province, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
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Shang G, Han L, Wang Z, Song M, Wang D, Tan Y, Li Y, Li Y, Zhang W, Zhong M. Pim1 knockout alleviates sarcopenia in aging mice via reducing adipogenic differentiation of PDGFRα + mesenchymal progenitors. J Cachexia Sarcopenia Muscle 2021; 12:1741-1756. [PMID: 34435457 PMCID: PMC8718082 DOI: 10.1002/jcsm.12770] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 07/01/2021] [Accepted: 07/10/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Sarcopenia widely exists in elderly people and triggers numerous age-related events. The essential pathologic change lies in the increased intramuscular adipose tissue after aging with no exception to non-obese objects. Pim1 appears to be associated with adipogenic differentiation in recent studies, inspiring us to explore whether it regulates adipogenesis in aging muscles and affects sarcopenia. METHODS Wild-type and Pim1 knockout C57/BL6J mice were randomized into young and old groups. Histo-pathological and molecular biological methods were applied to assess the intramuscular adipose tissue content, the atrophy and regeneration, and the expressions of Pim1 and adipogenic transcription factors. PDGFRα+ mesenchymal progenitors were separated and their replicative aging model were established. Different time of adipogenic induction and different amounts of Pim1 inhibitor were applied, after which the adipogenic potency were evaluated. The expressions of Pim1 and adipogenic transcription factors were measured through western blotting. RESULTS The aging mice demonstrated decreased forelimb grip strength (P = 0.0003), hanging impulse (P < 0.0001), exhaustive running time (P < 0.0001), tetanic force (P = 0.0298), lean mass (P = 0.0008), and percentage of gastrocnemius weight in body weight (P < 0.0001), which were improved by Pim1 knockout (P = 0.0015, P = 0.0222, P < 0.0001, P = 0.0444, P = 0.0004, and P = 0.0003, respectively). To elucidate the mechanisms, analyses showed that Pim1 knockout decreased the fat mass (P = 0.0005) and reduced the intramuscular adipose tissue content (P = 0.0008) by inhibiting the C/EBPδ pathway (P = 0.0067) in aging mice, resulting in increased cross-sectional area of all and fast muscle fibres (P = 0.0017 and 0.0024 respectively), decreased levels of MuRF 1 and atrogin 1 (P = 0.0001 and 0.0329 respectively), and decreased content of Pax7 at the basal state (P = 0.0055). In vitro, senescent PDGFRα+ mesenchymal progenitors showed significantly increased the intracellular adipose tissue content (OD510) compared with young cells after 6 days of adipogenic induction (P < 0.0001). The Pim1 expression was elevated during adipogenic differentiation, and Pim1 inhibition significantly reduced the OD510 in senescent cells (P = 0.0040) by inhibiting the C/EBPδ pathway (P = 0.0047). CONCLUSIONS Pim1 knockout exerted protective effects in sarcopenia by inhibiting the adipogenic differentiation of PDGFRα+ mesenchymal progenitors induced by C/EBPδ activation and thus reducing the intramuscular adipose tissue content in aging mice. These results provide a potential target for the treatment of sarcopenia.
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Affiliation(s)
- Guo‐kai Shang
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital, Cheeloo College of MedicineShandong UniversityJinanShandongChina
| | - Lu Han
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital, Cheeloo College of MedicineShandong UniversityJinanShandongChina
- Department of General Practice, Qilu Hospital, Cheeloo College of MedicineShandong UniversityJinanShandongChina
| | - Zhi‐hao Wang
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital, Cheeloo College of MedicineShandong UniversityJinanShandongChina
- Department of Geriatric Medicine, Qilu Hospital, Cheeloo College of MedicineShandong University; Shandong key Laboratory of Cardiovascular ProteomicsJinanShandongChina
| | - Ming Song
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital, Cheeloo College of MedicineShandong UniversityJinanShandongChina
| | - Di Wang
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital, Cheeloo College of MedicineShandong UniversityJinanShandongChina
| | - Yan‐min Tan
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital, Cheeloo College of MedicineShandong UniversityJinanShandongChina
| | - Yi‐hui Li
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital, Cheeloo College of MedicineShandong UniversityJinanShandongChina
- Department of Critical Care Medicine, Qilu Hospital, Cheeloo College of MedicineShandong UniversityJinanShandongChina
| | - Yu‐lin Li
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital, Cheeloo College of MedicineShandong UniversityJinanShandongChina
| | - Wei Zhang
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital, Cheeloo College of MedicineShandong UniversityJinanShandongChina
| | - Ming Zhong
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital, Cheeloo College of MedicineShandong UniversityJinanShandongChina
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Gao Q, Hu K, Yan C, Zhao B, Mei F, Chen F, Zhao L, Shang Y, Ma Y, Ma B. Associated Factors of Sarcopenia in Community-Dwelling Older Adults: A Systematic Review and Meta-Analysis. Nutrients 2021; 13:nu13124291. [PMID: 34959843 PMCID: PMC8707132 DOI: 10.3390/nu13124291] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 10/31/2021] [Accepted: 11/05/2021] [Indexed: 12/19/2022] Open
Abstract
(1) Background: To review the associated factors of sarcopenia in community-dwelling older adults. (2) Methods: PubMed, Embase, Web of Science, and four Chinese electronic databases were searched for observational studies that reported the associated factors of sarcopenia from inception to August 2021. Two researchers independently selected the literature, evaluated their quality, and extracted relevant data. The pooled odds ratio (OR) and its 95% confidence interval (CI) were calculated for each associated factors of sarcopenia using random-effects/fixed-effects models. Publication bias was assessed using funnel plot and the Eggers test. We performed statistical analysis using Stata 15.0 software. (3) Results: A total of 68 studies comprising 98,502 cases were included. Sociodemographic associated factors of sarcopenia among community-dwelling older adults included age (OR = 1.12, 95% CI: 1.10-1.13), marital status (singled, divorced, or widowed) (OR = 1.57, 95% CI: 1.08-2.28), disability for activities of daily living (ADL) (OR = 1.49, 95% CI: 1.15-1.92), and underweight (OR = 3.78, 95% CI: 2.55-5.60). Behavioral associated factors included smoking (OR = 1.20, 95% CI: 1.10-1.21), physical inactivity (OR = 1.73, 95% CI: 1.48-2.01), malnutrition/malnutrition risk (OR = 2.99, 95% CI: 2.40-3.72), long (OR = 2.30, 95% CI: 1.37-3.86) and short (OR = 3.32, 95% CI: 1.86-5.93) sleeping time, and living alone (OR = 1.55, 95% CI: 1.00-2.40). Disease-related associated factors included diabetes (OR = 1.40, 95% CI: 1.18-1.66), cognitive impairment (OR = 1.62, 95% CI: 1.05-2.51), heart diseases (OR = 1.14, 95% CI: 1.00-1.30), respiratory diseases (OR = 1.22, 95% CI: 1.09-1.36), osteopenia/osteoporosis (OR = 2.73, 95% CI: 1.63-4.57), osteoarthritis (OR = 1.33, 95% CI: 1.23-1.44), depression (OR = 1.46, 95% CI: 1.17-1.83), falls (OR = 1.28, 95% CI: 1.14-1.44), anorexia (OR = 1.50, 95% CI: 1.14-1.96), and anemia (OR = 1.39, 95% CI: 1.06-1.82). However, it remained unknown whether gender (female: OR = 1.10, 95% CI: 0.80-1.51; male: OR = 1.50, 95% CI: 0.96-2.34), overweight/obesity (OR = 0.27, 95% CI: 0.17-0.44), drinking (OR = 0.92, 95% CI: 0.84-1.01), hypertension (OR = 0.98, 95% CI: 0.84-1.14), hyperlipidemia (OR = 1.14, 95% CI: 0.89-1.47), stroke (OR = 1.70, 95% CI: 0.69-4.17), cancer (OR = 0.88, 95% CI: 0.85-0.92), pain (OR = 1.08, 95% CI: 0.98-1.20), liver disease (OR = 0.88, 95% CI: 0.85-0.91), and kidney disease (OR = 2.52, 95% CI: 0.19-33.30) were associated with sarcopenia. (4) Conclusions: There are many sociodemographic, behavioral, and disease-related associated factors of sarcopenia in community-dwelling older adults. Our view provides evidence for the early identification of high-risk individuals and the development of relevant interventions to prevent sarcopenia in community-dwelling older adults.
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Affiliation(s)
- Qianqian Gao
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China; (Q.G.); (K.H.); (B.Z.); (F.M.); (F.C.); (L.Z.)
- Evidence-based Nursing Center, School of Nursing, Lanzhou University, Lanzhou 730000, China;
| | - Kaiyan Hu
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China; (Q.G.); (K.H.); (B.Z.); (F.M.); (F.C.); (L.Z.)
| | - Chunjuan Yan
- School of Public Health, Gansu University of Traditional Chinese Medicine, Lanzhou 730000, China;
| | - Bing Zhao
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China; (Q.G.); (K.H.); (B.Z.); (F.M.); (F.C.); (L.Z.)
| | - Fan Mei
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China; (Q.G.); (K.H.); (B.Z.); (F.M.); (F.C.); (L.Z.)
- Evidence-based Nursing Center, School of Nursing, Lanzhou University, Lanzhou 730000, China;
| | - Fei Chen
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China; (Q.G.); (K.H.); (B.Z.); (F.M.); (F.C.); (L.Z.)
- Evidence-based Nursing Center, School of Nursing, Lanzhou University, Lanzhou 730000, China;
| | - Li Zhao
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China; (Q.G.); (K.H.); (B.Z.); (F.M.); (F.C.); (L.Z.)
- Evidence-based Nursing Center, School of Nursing, Lanzhou University, Lanzhou 730000, China;
| | - Yi Shang
- Department of General Surgery, The Second Hospital, Lanzhou University, Lanzhou 730000, China;
| | - Yuxia Ma
- Evidence-based Nursing Center, School of Nursing, Lanzhou University, Lanzhou 730000, China;
| | - Bin Ma
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China; (Q.G.); (K.H.); (B.Z.); (F.M.); (F.C.); (L.Z.)
- Evidence-based Nursing Center, School of Nursing, Lanzhou University, Lanzhou 730000, China;
- Key Laboratory of Evidence-Based Medicine and Knowledge Translation of Gansu Province, Lanzhou 730000, China
- Correspondence: ; Tel.: +86-139-1998-8858
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Chan AK, Eastlack RK, Fessler RG, Than KD, Chou D, Fu KM, Park P, Wang MY, Kanter AS, Okonkwo DO, Nunley PD, Anand N, Uribe JS, Mundis GM, Bess S, Shaffrey CI, Le VP, Mummaneni PV. Two- and three-year outcomes of minimally invasive and hybrid correction of adult spinal deformity. J Neurosurg Spine 2021; 36:595-608. [PMID: 34740175 DOI: 10.3171/2021.7.spine21138] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 07/01/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Previous studies have demonstrated the short-term radiographic and clinical benefits of circumferential minimally invasive surgery (cMIS) and hybrid (i.e., minimally invasive anterior or lateral interbody fusion with an open posterior approach) techniques to correct adult spinal deformity (ASD). However, it is not known if these benefits are maintained over longer periods of time. This study evaluated the 2- and 3-year outcomes of cMIS and hybrid correction of ASD. METHODS A multicenter database was retrospectively reviewed for patients undergoing cMIS or hybrid surgery for ASD. Patients were ≥ 18 years of age and had one of the following: maximum coronal Cobb angle (CC) ≥ 20°, sagittal vertical axis (SVA) > 5 cm, pelvic incidence-lumbar lordosis mismatch (PI-LL) ≥ 10°, or pelvic tilt (PT) > 20°. Radiographic parameters were evaluated at the latest follow-up. Clinical outcomes were compared at 2- and 3-year time points and adjusted for age, preoperative CC, levels operated, levels with interbody fusion, presence of L5-S1 anterior lumbar interbody fusion, and upper and lower instrumented vertebral level. RESULTS Overall, 197 (108 cMIS, 89 hybrid) patients were included with 187 (99 cMIS, 88 hybrid) and 111 (60 cMIS, 51 hybrid) patients evaluated at 2 and 3 years, respectively. The mean (± SD) follow-up duration for cMIS (39.0 ± 13.3 months, range 22-74 months) and hybrid correction (39.9 ± 16.8 months, range 22-94 months) were similar for both cohorts. Hybrid procedures corrected the CC greater than the cMIS technique (adjusted p = 0.022). There were no significant differences in postoperative SVA, PI-LL, PT, and sacral slope (SS). At 2 years, cMIS had lower Oswestry Disability Index (ODI) scores (adjusted p < 0.001), greater ODI change as a percentage of baseline (adjusted p = 0.006), less visual analog scale (VAS) back pain (adjusted p = 0.006), and greater VAS back pain change as a percentage of baseline (adjusted p = 0.001) compared to hybrid techniques. These differences were no longer significant at 3 years. At 3 years, but not 2 years, VAS leg pain was lower for cMIS compared to hybrid techniques (adjusted p = 0.032). Those undergoing cMIS had fewer overall complications compared to hybrid techniques (adjusted p = 0.006), but a higher odds of pseudarthrosis (adjusted p = 0.039). CONCLUSIONS In this review of a multicenter database for patients undergoing cMIS and hybrid surgery for ASD, hybrid procedures were associated with a greater CC improvement compared to cMIS techniques. cMIS was associated with superior ODI and back pain at 2 years, but this difference was no longer evident at 3 years. However, cMIS was associated with superior leg pain at 3 years. There were fewer complications following cMIS, with the exception of pseudarthrosis.
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Affiliation(s)
- Andrew K Chan
- 1Department of Neurological Surgery, University of California, San Francisco, California
| | | | - Richard G Fessler
- 3Department of Neurological Surgery, Rush University Medical Center, Chicago, Illinois
| | - Khoi D Than
- 4Department of Neurosurgery, Duke University, Durham, North Carolina
| | - Dean Chou
- 1Department of Neurological Surgery, University of California, San Francisco, California
| | - Kai-Ming Fu
- 5Department of Neurosurgery, Weill Cornell Medical Center, New York, New York
| | - Paul Park
- 6Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan
| | - Michael Y Wang
- 7Department of Neurosurgery, University of Miami, Florida
| | - Adam S Kanter
- 8Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - David O Okonkwo
- 8Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | | | - Neel Anand
- 10Department of Orthopaedics, Cedars-Sinai Medical Center, Los Angeles, California
| | - Juan S Uribe
- 11Department of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona; and
| | | | - Shay Bess
- 12Denver International Spine Center, Presbyterian St. Luke's/Rocky Mountain Hospital for Children, Denver, Colorado
| | | | - Vivian P Le
- 1Department of Neurological Surgery, University of California, San Francisco, California
| | - Praveen V Mummaneni
- 1Department of Neurological Surgery, University of California, San Francisco, California
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Kim JW, Kim R, Choi H, Lee SJ, Bae GU. Understanding of sarcopenia: from definition to therapeutic strategies. Arch Pharm Res 2021; 44:876-889. [PMID: 34537916 DOI: 10.1007/s12272-021-01349-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 09/07/2021] [Indexed: 12/23/2022]
Abstract
Sarcopenia refers to the gradual loss of skeletal muscle mass and function along with aging and is a social burden due to growing healthcare cost associated with a super-aging society. Therefore, researchers have established guidelines and tests to diagnose sarcopenia. Several studies have been conducted actively to reveal the cause of sarcopenia and find an economic therapy to improve the quality of life in elderly individuals. Sarcopenia is caused by multiple factors such as reduced regenerative capacity, imbalance in protein turnover, alteration of fat and fibrotic composition in muscle, increased reactive oxygen species, dysfunction of mitochondria and increased inflammation. Based on these mechanisms, nonpharmacological and pharmacological strategies have been developed to prevent and treat sarcopenia. Although several studies are currently in progress, no treatment is available yet. This review presents the definition of sarcopenia and summarizes recent understanding on the detailed mechanisms, diagnostic criteria, and strategies for prevention and treatment.
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Affiliation(s)
- Jee Won Kim
- Drug Information Research Institute, College of Pharmacy, Sookmyung Women's University, Seoul, 04310, Republic of Korea
| | - Ryuni Kim
- Drug Information Research Institute, College of Pharmacy, Sookmyung Women's University, Seoul, 04310, Republic of Korea
| | - Hyerim Choi
- Drug Information Research Institute, College of Pharmacy, Sookmyung Women's University, Seoul, 04310, Republic of Korea
| | - Sang-Jin Lee
- Research Institute of Aging-Related Disease, AniMusCure Inc., Suwon, 16419, Republic of Korea.
| | - Gyu-Un Bae
- Drug Information Research Institute, College of Pharmacy, Sookmyung Women's University, Seoul, 04310, Republic of Korea.
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González-Fernández M, Perez-Nogueras J, Serrano-Oliver A, Torres-Anoro E, Sanz-Arque A, Arbones-Mainar JM, Sanz-Paris A. Masseter Muscle Thickness Measured by Ultrasound as a Possible Link with Sarcopenia, Malnutrition and Dependence in Nursing Homes. Diagnostics (Basel) 2021; 11:1587. [PMID: 34573928 PMCID: PMC8469670 DOI: 10.3390/diagnostics11091587] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/06/2021] [Accepted: 08/30/2021] [Indexed: 01/13/2023] Open
Abstract
Sarcopenia is a progressive and generalized loss of skeletal muscle mass and strength. It is frequently associated with malnutrition and dependence in nursing homes. Masticatory muscle strength could be the link between sarcopenia, malnutrition and dependence. We aimed to study the relation between sarcopenia, malnutrition and dependence with masseter muscle thickness measured by ultrasound. A cross-sectional study was realized, with 464 patients from 3 public nursing homes in Zaragoza (Spain). The diagnosis of sarcopenia was assessed according to the European Working Group on Sarcopenia in Older People 2 criteria, malnutrition by the Mini Nutritional Assessment (MNA) and the Global Leadership Initiative on Malnutrition (GLIM) criteria and functional capacity by the Barhel Index and the texture diet. Masseter muscle thickness (MMT) was measured by ultrasound. The median age was 84.7 years, and 70% of the participants were women. Sarcopenia was confirmed in 39.2% of patients, malnutrition in 26.5% (risk 47.8%), total dependence in 37.9% and diet texture was modified in 44.6%. By logistic regression, once the model was adjusted for age, sex, Barthel index and texture diet, our analyses indicated that each 1 mm decrease in MMT increased the risk of sarcopenia by ~57% (OR: 0.43), the risk of malnutrition by MNA by ~63% (OR: 0.37) and the risk of malnutrition by GLIM by ~34% (OR: 0.66). We found that MMT was reduced in sarcopenic, malnourished and dependent patients, and it could be the common point of a vicious cycle between sarcopenia and malnutrition. Further studies are needed to establish causality.
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Affiliation(s)
| | | | | | | | | | - Jose M. Arbones-Mainar
- Instituto de Investigación Sanitaria Aragon (IIS-Aragon), 50007 Zaragoza, Spain;
- Adipocyte and Fat Biology Laboratory (AdipoFat), Translational Research Unit, Instituto Aragones de Ciencias de la Salud (IACS), University Hospital Miguel Servet, 50007 Zaragoza, Spain
- Centro de Investigación Biomédica en Red Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, 28029 Madrid, Spain
| | - Alejandro Sanz-Paris
- Nutrition Department, University Hospital Miguel Servet, 50007 Zaragoza, Spain;
- Instituto de Investigación Sanitaria Aragon (IIS-Aragon), 50007 Zaragoza, Spain;
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40
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Yoo JI, Chung HJ, Kim BG, Jung YK, Baek KW, Song MG, Cho MC. Comparative analysis of the association between various serum vitamin D biomarkers and sarcopenia. J Clin Lab Anal 2021; 35:e23946. [PMID: 34350631 PMCID: PMC8418464 DOI: 10.1002/jcla.23946] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/27/2021] [Accepted: 07/28/2021] [Indexed: 12/16/2022] Open
Abstract
Background Vitamin D status is associated with muscle strength and maintenance of muscle fibers. However, which serum vitamin D biomarker better reflects sarcopenia remains unclear. The aim of this study was to investigate associations between various serum vitamin D biomarkers (total 25‐hydroxy vitamin D [25(OH)D], bioavailable 25(OH)D, 24,25‐dihydroxyvitamin D [24,25(OH)2D], and vitamin D metabolite ratio [VMR]) and sarcopenia. Methods The data for 83 hip fracture patients were finally included in the analysis. Sarcopenia was defined according to the Asia Working Group for Sarcopenia (AWGS) criteria. Measurements of 24,25(OH)2D and 25(OH)D were made using solid‐phase extraction (SPE) and subsequent liquid chromatography‐tandem mass spectrometry (LC‐MS/MS). Vitamin D binding protein (VDBP) concentration was measured using an enzyme‐linked immunosorbent assay. The VMR was calculated by dividing serum 24,25(OH)2D by serum 25(OH)D and then multiplying by 100. Based on total 25(OH)D, VDBP, and albumin concentrations, bioavailable 25(OH)D concentrations were calculated using the equations from the other previous studies. Results Bioavailable 25(OH)D levels were significantly (p = 0.030) decreased in the sarcopenia group compared with the non‐sarcopenia group. Results of ROC analysis for the diagnosis of sarcopenia using serum level of bioavailable of 25(OH)D revealed that the cutoff point for bioavailable 25(OH)D was 1.70 ng/ml (AUC = 0.649, p < 0.001). In the group with a bioavailable 25(OH)D less than 1.70 ng/ml, the incidence of sarcopenia increased by 3.3 times (odds ratio: 3.33, p = 0.013). Conclusion We demonstrated that bioavailable 25(OH)D was associated with sarcopenia among the various serum vitamin D biomarkers. Bioavailable vitamin D might be helpful for assessing the risk of sarcopenia.
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Affiliation(s)
- Jun-Il Yoo
- Department of Orthopaedic Surgery, Gyeongsang National University Hospital, Jinju, Korea
| | - Hye Jin Chung
- College of Pharmacy and Research institute of Pharmaceutical Sciences, Gyeongsang National University, Jinju, Korea
| | - Bo Gyu Kim
- Biomedical Research Institute, Gyeongsang National University Hospital, Jinju, Korea
| | - Youn-Kwan Jung
- Biomedical Research Institute, Gyeongsang National University Hospital, Jinju, Korea
| | - Kyung-Wan Baek
- Department of Orthopaedic Surgery, Gyeongsang National University Hospital, Jinju, Korea
| | - Myung-Geun Song
- Department of Orthopaedic Surgery, Gyeongsang National University Hospital, Jinju, Korea
| | - Min-Chul Cho
- Department of Laboratory Medicine, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Korea.,Institute of Health Science, Gyeongsang National University, Jinju, Korea
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Pan SQ, Li YM, Li XF, Xiong R. Sarcopenia in geriatric patients from the plateau region of Qinghai-Tibet: A cross-sectional study. World J Clin Cases 2021; 9:5092-5101. [PMID: 34307560 PMCID: PMC8283610 DOI: 10.12998/wjcc.v9.i19.5092] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 04/08/2021] [Accepted: 04/20/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Sarcopenia is an age-related decline in skeletal muscle mass, which depends on an assessment of muscle strength and muscle mass. It has been reported that the prevalence of sarcopenia in non-hospitalized elderly people was 9.0%-18.5% in the lowland plains. However, epidemiological investigations of sarcopenia in plateau regions are limited. The city of Xining in Qinghai Province (altitude 2260 m) is the sole point of access to the Qinghai-Tibet plateau. We hypothesized that the diverse ethnicities or dietary habits of the people living in the plateau may influence the prevalence of sarcopenia.
AIM To investigate the prevalence and risk factors of sarcopenia in geriatric patients from the Qinghai-Tibet plateau region.
METHODS From October to December 2018, 150 hospitalized geriatric patients (72.4 ± 5.60 years) from Xining City (altitude 2260 m) in Qinghai Province were recruited. Collected data included demographics, history of fall, nutritional status, self-care ability, depression, handgrip, muscle mass, and 6-m gait speed. Sarcopenia was diagnosed based on the 2014 criteria of the Asian Working Group for Sarcopenia.
RESULTS The overall rate of sarcopenia was 20% (8.7 and 11.3% in men and women, respectively). Binary logistic regression analysis indicated that widowhood was associated with sarcopenia, while higher body mass index and beef and mutton consumption were protective.
CONCLUSION The prevalence of sarcopenia in hospitalized geriatric patients in the Qinghai-Tibet plateau region was higher than that in the plain region and in non-hospitalized geriatric people (reported elsewhere). Specific cultural features of the region, including ethnicity, brewed tea and ghee consumption, were not significantly associated with sarcopenia. Higher body mass index and consumption of beef and mutton were protective, while patients who were widowed was at increased risk.
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Affiliation(s)
- Shi-Qin Pan
- Department of Nursing, Qinghai Provincial People’s Hospital, Xining 810007, Qinghai Province, China
| | - Yue-Mei Li
- Department of Nursing, Qinghai Provincial People’s Hospital, Xining 810007, Qinghai Province, China
| | - Xiao-Fang Li
- Department of Nursing, Qinghai Provincial People’s Hospital, Xining 810007, Qinghai Province, China
| | - Rui Xiong
- Department of Nursing, Qinghai Provincial People’s Hospital, Xining 810007, Qinghai Province, China
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Dodds RM, Murray JC, Granic A, Hurst C, Uwimpuhwe G, Richardson S, Brayne C, Matthews FE, Sayer AA. Prevalence and factors associated with poor performance in the 5-chair stand test: findings from the Cognitive Function and Ageing Study II and proposed Newcastle protocol for use in the assessment of sarcopenia. J Cachexia Sarcopenia Muscle 2021; 12:308-318. [PMID: 33463015 PMCID: PMC8061374 DOI: 10.1002/jcsm.12660] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 11/08/2020] [Accepted: 11/24/2020] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Poor performance in the 5-chair stand test (5-CST) indicates reduced lower limb muscle strength. The 5-CST has been recommended for use in the initial assessment of sarcopenia, the accelerated loss of muscle strength and mass. In order to facilitate the use of the 5-CST in sarcopenia assessment, our aims were to (i) describe the prevalence and factors associated with poor performance in the 5-CST, (ii) examine the relationship between the 5-CST and gait speed, and (iii) propose a protocol for using the 5-CST. METHODS The population-based study Cognitive Function and Ageing Study II recruited people aged 65 years and over from defined geographical localities in Cambridgeshire, Newcastle, and Nottingham. The study collected data for assessment of functional ability during home visits, including the 5-CST and gait speed. We used multinomial logistic regression to assess the associations between factors including the SARC-F questionnaire and the category of 5-CST performance: fast (<12 s), intermediate (12-15 s), slow (>15 s), or unable, with slow/unable classed as poor performance. We reviewed previous studies on the protocol used to carry out the 5-CST. RESULTS A total of 7190 participants aged 65+ from the three diverse localities of Cognitive Function and Ageing Study II were included (54.1% female). The proportion of those with poor performance in the 5-CST increased with age, from 34.3% at age 65-69 to 89.7% at age 90+. Factors independently associated with poor performance included positive responses to the SARC-F questionnaire, physical inactivity, depression, impaired cognition, and multimorbidity (all P < 0.005). Most people with poor performance also had slow gait speed (57.8%) or were unable to complete the gait speed test (18.4%). We found variation in the 5-CST protocol used, for example, timing until a participant stood up for the fifth time or until they sat down afterwards. CONCLUSIONS Poor performance in the 5-CST is increasingly common with age and is associated with a cluster of other factors that characterize risk for poor ageing such as physical inactivity, impaired cognition, and multimorbidity. We recommend a low threshold for performing the 5-CST in clinical settings and provide a protocol for its use.
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Affiliation(s)
- Richard Matthew Dodds
- AGE Research Group, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, UK.,NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle upon Tyne NHS Foundation Trust, Newcastle, UK
| | - James C Murray
- AGE Research Group, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, UK.,NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle upon Tyne NHS Foundation Trust, Newcastle, UK
| | - Antoneta Granic
- AGE Research Group, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, UK.,NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle upon Tyne NHS Foundation Trust, Newcastle, UK
| | - Christopher Hurst
- AGE Research Group, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, UK.,NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle upon Tyne NHS Foundation Trust, Newcastle, UK
| | - Germaine Uwimpuhwe
- Department of Anthropology, Durham University, Durham, UK.,Durham Research Methods Centre, Durham University, Durham, UK
| | - Sarah Richardson
- AGE Research Group, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, UK.,NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle upon Tyne NHS Foundation Trust, Newcastle, UK
| | - Carol Brayne
- Cambridge Public Health, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Fiona E Matthews
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, UK
| | - Avan A Sayer
- AGE Research Group, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, UK.,NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle upon Tyne NHS Foundation Trust, Newcastle, UK
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Wu X, Li X, Xu M, Zhang Z, He L, Li Y. Sarcopenia prevalence and associated factors among older Chinese population: Findings from the China Health and Retirement Longitudinal Study. PLoS One 2021; 16:e0247617. [PMID: 33661964 PMCID: PMC7932529 DOI: 10.1371/journal.pone.0247617] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 02/09/2021] [Indexed: 12/25/2022] Open
Abstract
Sarcopenia a recognised geriatric syndrome. This study aims to evaluate the prevalence of possible sarcopenia, sarcopenia and severe sarcopenia among older Chinese adults and to identify any associated factors for possible sarcopenia according to the updated diagnostic criteria of the Asian Working Group for Sarcopenia 2019 (AWGS 2019). We used data from the China Health and Retirement Longitudinal Study (CHARLS). The main outcome of this study was possible sarcopenia. Handgrip strength was measured via a dynamometer. The muscle mass was estimated by anthropometric measures. Physical performance was measured by 5-time chair stand test and gait speed test. A multivariate logistic regression model with stepwise method was employed to identify factors associated with possible sarcopenia. A total of 6172 participants aged 60–94 years were included. The prevalence of possible sarcopenia, sarcopenia and severe sarcopenia was 38.5%, 18.6%, and 8.0%, respectively. Age, rural area, falls, higher C-reactive protein (CRP), and chronic diseases (including hypertension, chronic lung diseases, heart disease, psychiatric disease and arthritis) were associated with a higher risk of possible sarcopenia. Conversely, alcohol consumption, higher gait speed and high levels of hemoglobin were associated with decreased risk of possible sarcopenia. However, the associations between possible sarcopenia with alcohol consumption, heart disease, psychiatric disease and hemoglobin were not significant after Bonferroni correction. Our study reported a relatively high prevalence of sarcopenia among older Chinese population, and identified a range of factors associated with sarcopenia. We also found rural elders are more vulnerable to sarcopenia than urban elders. Additionally, we discovered systemic inflammation might be one of the contributing factors between sarcopenia and related comorbidities. We believe the findings of this study would help to identify individuals at high risk of sarcopenia early and therefore implement the prevention and treatment strategies to reduce the disease burden in China.
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Affiliation(s)
- Xin Wu
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, China
- Peking University Research Center on Aging, Beijing Key Laboratory of Protein Posttranslational Modifications and Cell Function, Department of Biochemistry and Molecular Biology, School of Basic Medical Science, Peking University, Beijing, China
| | - Xue Li
- School of Public Health, Zhejiang University, Hangzhou, China
| | - Meihong Xu
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, China
| | - Zhaofeng Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, China
| | - Lixia He
- Division of Molecular and Cellular Oncology, Dana-Farber Cancer Institute, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Yong Li
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, China
- * E-mail:
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Coll PP, Phu S, Hajjar SH, Kirk B, Duque G, Taxel P. The prevention of osteoporosis and sarcopenia in older adults. J Am Geriatr Soc 2021; 69:1388-1398. [PMID: 33624287 DOI: 10.1111/jgs.17043] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 12/21/2020] [Accepted: 12/22/2020] [Indexed: 12/25/2022]
Abstract
Osteoporosis and sarcopenia are common in older adults. Osteoporosis is a systemic skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture. Bone fractures can result in changes in posture, pain, the need for surgical repair and functional impairment. Sarcopenia is the progressive and generalized loss of skeletal muscle mass, strength and/or physical performance. Older adults with sarcopenia experience increased risk of frailty, disability, hospitalizations, mortality, and a reduced quality of life. In this narrative review we provide guidance regarding the prevention of both osteoporosis and sarcopenia, including interventions that prevent both conditions from occurring, recommended screening and treatment to prevent progression.
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Affiliation(s)
- Patrick P Coll
- Department of Family Medicine, UConn Health, Farmington, Connecticut, USA.,Center on Aging, UConn Health, Farmington, Connecticut, USA
| | - Steven Phu
- Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, St Albans, Victoria, Australia.,Falls, Balance, and Injury Research Centre, Neuroscience Research Australia (NeuRA), Sydney, New South Wales, Australia
| | - Samah H Hajjar
- Center on Aging, UConn Health, Farmington, Connecticut, USA.,Department of Medicine, Taibah University, Madina, Saudi Arabia
| | - Ben Kirk
- Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, St Albans, Victoria, Australia.,Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St Albans, Victoria, Australia
| | - Gustavo Duque
- Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, St Albans, Victoria, Australia.,Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St Albans, Victoria, Australia
| | - Pam Taxel
- Department of Medicine, Division of Endocrinology & Metabolism, UConn Health, Farmington, Connecticut, USA
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Connolly K, Cunningham C, Murphy N, Romero-Ortuno R, Horgan F. Prevalence of sarcopenia and associated factors in older adults attending a day hospital service in Ireland. Eur Geriatr Med 2021; 12:851-862. [PMID: 33583001 PMCID: PMC7882055 DOI: 10.1007/s41999-021-00463-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 01/30/2021] [Indexed: 11/29/2022]
Abstract
Aim The aim of this study was to describe the prevalence and associated factors of sarcopenia in community-dwelling older adults attending a day hospital service in Ireland, using the latest European Working Group of Sarcopenia in Older People (EWGSOP) guidelines. Findings The prevalence of sarcopenia in older adults attending a day hospital service in Ireland was 27–37% and varied depending on the strength test used. Sarcopenia was associated with older age, female gender, reduced BMI, reduced calf circumference, frailty, malnutrition, and reduced gait speed, irrespective of how muscle strength was assessed. Message Further consideration on the assessment of sarcopenia needs to be considered, regarding the use of muscle strength assessment, whether to assess upper limb, lower limb, or both. Purpose Sarcopenia is a muscle disease that is linked to the effects of ageing, chronic diseases, physical inactivity, and poor nutrition. In Ireland, there is a lack of readily available information on sarcopenia in older adults. The aim of this study was to describe the prevalence and associated factors of sarcopenia in community-dwelling older adults attending a day hospital service in Ireland, using the European Working Group of Sarcopenia in Older People (EWGSOP) guidelines. Methods An observational cross-sectional study was conducted, where a consecutive series of older adults attending a day hospital service were invited to participate. The measure of primary interest was the diagnosis of sarcopenia using the EWGSOP 2019 guidelines. We also collected other Comprehensive Geriatric Assessment measures including cognition, nutrition, frailty and physical activity. Results A total of 134 participants took part in the study. The mean age was 81.7 (SD ± 7.1). Sixty-one percent (N = 82) were female. The prevalence of sarcopenia ranged from 27 to 37% depending on the assessment tool used to assess muscle strength. Sarcopenia was associated with older age, frailty, reduced nutritional state, poor physical performance and reduced anthropometric measures, irrespective of how muscle strength was measured. Independently associated factors differed depending on muscle strength test, except for older age. Conclusion The prevalence of sarcopenia in the day hospital ranged from 27 to 37%. The assessment tool used to assess muscle strength influenced both the prevalence and associated factors of sarcopenia, suggesting scope for further research.
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Affiliation(s)
- Kieron Connolly
- Physiotherapy Department, St James's Hospital, Dublin 8, Ireland. .,School of Physiotherapy, Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences, Dublin 2, Ireland.
| | - Conal Cunningham
- St James's Hospital, Mercers Institute of Successful Ageing, Dublin 8, Ireland
| | - Niamh Murphy
- Physiotherapy Department, St James's Hospital, Dublin 8, Ireland
| | - Roman Romero-Ortuno
- St James's Hospital, Mercers Institute of Successful Ageing, Dublin 8, Ireland.,Department of Medical Gerontology, Trinity College Dublin, Dublin 2, Ireland
| | - Frances Horgan
- School of Physiotherapy, Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences, Dublin 2, Ireland
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Beltrami M, Fumagalli C, Milli M. Frailty, sarcopenia and cachexia in heart failure patients: Different clinical entities of the same painting. World J Cardiol 2021; 13:1-10. [PMID: 33552398 PMCID: PMC7821009 DOI: 10.4330/wjc.v13.i1.1] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/25/2020] [Accepted: 12/28/2020] [Indexed: 02/06/2023] Open
Abstract
Heart Failure (HF) in elderly patients is a systemic syndrome where advanced age, comorbidities with organ system deterioration, frailty and impaired cognition significantly impact outcome. Cardiac cachexia, sarcopenia and frailty despite overlap in definitions are different clinical entities that frequently coexist in HF patients. However, these co-factors often remain unaddressed, resulting in poor quality-of-life, prolonged physical disability and exercise intolerance and finally with higher rehospitalization rates and mortality. Strategy aim to increase muscle mass and muscle strength and delay the occurrence of frailty state appear essential in this regard. Common HF drugs therapy (b-blockers, angiotensin-converting enzyme inhibitors) and prescription of physical exercise program remain the cornerstone of therapeutic approach in HF patients with new promising data regarding nutritional supplementation. However, the treatment of all these conditions still remain debated and only a profound knowledge of the specific mechanisms and patterns of disease progression will allow to use the appropriate therapy in a given clinical setting. For all these reasons we briefly review current knowledge on frailty, sarcopenia and cachexia in HF patients with the attempt to define clinically significant degrees of multiorgan dysfunction, specific "red alert" thresholds in clinical practice and therapeutic approach.
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Affiliation(s)
- Matteo Beltrami
- Cardiology Unit, San Giovanni di Dio Hospital, Florence 50142, Italy
| | - Carlo Fumagalli
- Cardiomyopathy Unit, Careggi University Hospital, Florence 50139, Italy
| | - Massimo Milli
- Cardiology Unit, San Giovanni di Dio Hospital, Florence 50142, Italy
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Chang HK, Lee JY, Gil CR, Kim MK. Prevalence of Sarcopenia in Community-Dwelling Older Adults According to Simplified Algorithms for Sarcopenia Consensus Based on Asian Working Group for Sarcopenia. Clin Interv Aging 2020; 15:2291-2299. [PMID: 33324043 PMCID: PMC7732054 DOI: 10.2147/cia.s281131] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 11/04/2020] [Indexed: 01/20/2023] Open
Abstract
Purpose This study sought to identify the prevalence of sarcopenia in community-dwelling Korean older adults and validate two simplified diagnostic algorithms based on the Asian Working Group for Sarcopenia (AWGS) algorithm for identifying sarcopenia. Patients and Methods Patients (n = 338) aged ≥65 years participated in this cross-sectional study. Muscle strength was measured by hand grip strength, physical performance by gait speed, and muscle mass by the skeletal muscle mass index (SMI). Sarcopenia was assessed using the AWGS-recommended algorithm and two simplified algorithms (A and B). Algorithms A and B were validated with respect to the AWGS-recommended algorithm using the chi-square test, and the sensitivity and specificity were obtained. Results Sarcopenia prevalence, determined using the AWGS-recommended algorithm, was 40.3% and 41.3% in men and women, respectively. The overall prevalence of sarcopenia was 41.0% by the AWGS-recommended algorithm, 37.6% by algorithm A, and 37.6% by algorithm B; 111 participants were diagnosed with sarcopenia using all three methods (p = 0.157). Conclusion We established sarcopenia prevalence among rural community-dwelling adults in Korea and confirmed that the simplified algorithms were suitable for the identification of sarcopenia in rural community-dwelling older adults in Korea. Further studies are needed to assess whether these simplified algorithms are applicable to older Asian adults with functional and/or cognitive impairment and nursing home residents.
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Affiliation(s)
- Hee-Kyung Chang
- College of Nursing, Senior Health Research Center of the Health & Science Institute, Gyeongsang National University, Jinju, Gyeongnam-do, South Korea
| | - Ji-Yeon Lee
- Nursing Department, Samsung Changwon Hospital, Changwon, Gyeongnam-do, South Korea.,Graduate College of Nursing, Gyeongsang National University, Jinju, Gyeongnam-do, South Korea
| | - Cho-Rong Gil
- Graduate College of Nursing, Gyeongsang National University, Jinju, Gyeongnam-do, South Korea
| | - Mi-Kyoung Kim
- Graduate College of Nursing, Gyeongsang National University, Jinju, Gyeongnam-do, South Korea.,Nursing Department, Hamyang Center Clinic, Hamyang, Gyeongnam-do, South Korea
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Daskalopoulou C, Wu YT, Pan W, Giné Vázquez I, Prince M, Prina M, Tyrovolas S. Factors related with sarcopenia and sarcopenic obesity among low- and middle-income settings: the 10/66 DRG study. Sci Rep 2020; 10:20453. [PMID: 33235211 PMCID: PMC7686337 DOI: 10.1038/s41598-020-76575-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 09/07/2020] [Indexed: 12/25/2022] Open
Abstract
Sarcopenia and sarcopenic obesity research in low- and middle- income countries (LMICs) is limited. We investigated sarcopenia and sarcopenic obesity prevalence and sociodemographic, bio-clinical and lifestyle factors in LMICs settings. For the purposes of this study, the 10/66 Dementia Research Group follow-up wave information from individuals aged 65 and over in Cuba, Dominican Republic, Peru, Mexico, Puerto Rico, China, was employed and analysed (n = 8.694). Based on indirect population formulas, we calculated body fat percentage (%BF) and skeletal muscle mass index (SMI). Sarcopenia prevalence ranged from 12.4% (Dominican Republic) to 24.6% (rural Peru); sarcopenic obesity prevalence ranged from 3.0% (rural China) to 10.2% (rural Peru). Odds ratios (OR) with 95% confidence intervals (CI) for sarcopenia were higher for men 2.82 (2.22-3.57) and those with higher %BF 1.08 (1.07-1.09), whereas higher number of assets was associated with a decreased likelihood 0.93 (0.87-1.00). OR of sarcopenic obesity were higher for men 2.17 (1.70-2.76), those reporting moderate alcohol drinking 1.76 (1.21-2.57), and those with increased number of limiting impairments 1.54 (1.11-2.14). We observed heterogeneity in the prevalence of sarcopenia and sarcopenic obesity in the 10/66 settings. We also found a variety of factors to be associated with those. Our results reveal the need for more research among the older population of LMICs.
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Affiliation(s)
- Christina Daskalopoulou
- Department of Health Service and Population Research, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, SE5 8AF, UK
| | - Yu-Tzu Wu
- Department of Health Service and Population Research, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, SE5 8AF, UK
| | - William Pan
- Nicholas School of the Environment, Duke University, Durham, NC, 27708, USA
- Global Health Institute, Duke University, Durham, NC, 27708, USA
| | - Iago Giné Vázquez
- Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Dr. Antoni Pujades, 42, 08830, Sant Boi de Llobregat, Barcelona, Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Monforte de Lemos 3-5. Pabellón 11, 28029, Madrid, Spain
| | - Martin Prince
- Department of Health Service and Population Research, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, SE5 8AF, UK
| | - Matthew Prina
- Department of Health Service and Population Research, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, SE5 8AF, UK
| | - Stefanos Tyrovolas
- Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Dr. Antoni Pujades, 42, 08830, Sant Boi de Llobregat, Barcelona, Spain.
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Monforte de Lemos 3-5. Pabellón 11, 28029, Madrid, Spain.
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China.
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Kuzuya M. Nutritional status related to poor health outcomes in older people: Which is better, obese or lean? Geriatr Gerontol Int 2020; 21:5-13. [PMID: 33200583 DOI: 10.1111/ggi.14088] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 09/14/2020] [Accepted: 10/29/2020] [Indexed: 12/30/2022]
Abstract
Good nutritional status is crucial for maintaining growth and health in all stages of life. However, the relationship between nutritional status and health and the effect on various health-related outcomes differ, depending on the life stage. Many adverse outcomes in older adults, directly linked to different nutritional status, are not present in middle-aged adults, and their ideal nutritional status may differ. This article will review the optimal nutritional status, mainly evaluated by anthropometric measurements such as body mass index, for older adults from various perspectives. Overall, in older adults low body mass index is at higher risk of health problems such as mortality and difficulties in physical functioning compared with middle-aged adults, reducing the risk of health problems for overweight and (abdominal) obesity. Overweight may be more beneficial than lower level of normal weight in older-old and vulnerable older people. While, with or without obesity, skeletal muscle loss or weakness as well as unintentional weight loss induces health problems in older adults. The impact of metabolic syndrome on the prognosis of older adults is clearly reduced compared with middle-aged adults, requiring a shift in medical attention in older adults from metabolic syndrome to frailty. There are still many unclear points regarding the optimal nutritional status of older people, and further research is needed to support healthy longevity. Geriatr Gerontol Int 2021; 21: 5-13.
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Affiliation(s)
- Masafumi Kuzuya
- Department of Community Healthcare & Geriatrics, Nagoya University Graduate School of Medicine, Institutes of Innovation for Future Society, Nagoya University, Nagoya, Japan
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Matsumoto H, Tanimura C, Kushida D, Osaka H, Kawabata Y, Hagino H. FRAX score and recent fall history predict the incidence for sarcopenia in community-dwelling older adults: a prospective cohort study. Osteoporos Int 2020; 31:1985-1994. [PMID: 32448948 DOI: 10.1007/s00198-020-05447-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 05/04/2020] [Indexed: 12/21/2022]
Abstract
UNLABELLED We hypothesized that the baseline FRAX score and previous falls would predict the incidence of sarcopenia in community-dwelling older adults who received medical check-ups. The FRAX score (hazard ratio [HR] = 1.087, 95% CI 1.014-1.167) and previous falls (HR = 5.181, 95% CI 1.002-26.777) were determined to be independent risk factors for the incidence of sarcopenia. PURPOSE This prospective study was performed to elucidate the prevalence and incidence of sarcopenia in community-dwelling older adults who received medical check-ups, and to determine whether FRAX score and fall history predict the incidence of sarcopenia. METHODS Participants were recruited from a group of individuals who had registered for an annual town-sponsored medical check-up. Study inclusion criteria were aged older than 60 years, living independently, and ability to walk without assistance. Individuals who received nursing care were excluded from the study. A total of 426 residential participants were analyzed. Demographic information, fall history of the previous year, and FRAX score without bone mineral density were assessed. The assessment for sarcopenia was based on the recommendations of the Asian Working Group for Sarcopenia. RESULTS The final sample for the assessment of sarcopenia incidence comprised 258 participants. The mean follow-up time was 2.92 years. The rate of sarcopenia was 1.06 cases per 100 person-years at risk. The Cox multivariate logistic regression model in our analysis was adjusted for age, gender, muscle mass, and covariates and showed that the FRAX score (HR = 1.087, 95% CI 1.014-1.167) and recent history of falls (HR = 5.181, 95% CI 1.002-26.777) were independent risk factors for the incidence of sarcopenia. CONCLUSION FRAX and history of falling can be a simple screening tool to raise awareness of the prevention of osteoporosis and sarcopenia in clinical settings.
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Affiliation(s)
- H Matsumoto
- Department of Physical Therapist, Faculty of Rehabilitation, Kawasaki University of Medical Welfare, Matsushima 288, Kurashiki, Okayama, 701-0193, Japan.
| | - C Tanimura
- School of Health Science, Faculty of Medicine, Tottori University, Nishicho 86, Yonago, Tottori, 683-8503, Japan
| | - D Kushida
- Department of Electrical Engineering & Computer Science, Faculty of Engineering, (Cross-Informatics Research Center), Tottori University, Koyama-cho Minami 4-101, Tottori, 680-8552, Japan
| | - H Osaka
- Department of Physical Therapist, Faculty of Rehabilitation, Kawasaki University of Medical Welfare, Matsushima 288, Kurashiki, Okayama, 701-0193, Japan
| | - Y Kawabata
- Department of Rehabilitation Medicine, Shuto General Hospital, JA Yamaguchi Prefectural Welfare Federation of Agricultural Cooperative, Kogaisaku 1000-1, Yanai, Yamaguchi, 742-0032, Japan
| | - H Hagino
- School of Health Science, Faculty of Medicine, Tottori University, Nishicho 86, Yonago, Tottori, 683-8503, Japan
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