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Nagai T, Miyagami M, Nakamura S, Sakamoto K, Ishikawa K, Okano I, Kasai F, Kudo Y, Kawate N. Relationship between sacral-abdominal wall distance, movement performance, and spinal alignment in osteoporosis: a retrospective study. BMC Geriatr 2024; 24:252. [PMID: 38475741 PMCID: PMC10936102 DOI: 10.1186/s12877-024-04865-x] [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: 08/27/2023] [Accepted: 03/02/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Aging is associated with muscle atrophy, as typified by sarcopenia. Loss of abdominal muscle strength can cause abdominal wall laxity. The purpose of this study was to investigate the relationship between the sacral vertebra-abdominal wall distance (SAD) and movement performance using a simple lateral spine X-ray image for measuring the SAD. METHODS In this retrospective study, we included women aged ≥ 65 years who were attending the outpatient clinic for osteoporosis at our hospital. A total of 287 patients (mean age ± SD, 76.8 ± 7.1 years) with measured SAD were included in the analysis. Patients were divided into two groups based on SAD cutoff (160 mm) and age (75 years), respectively. The patients were examined using the two-foot 20 cm rise test, 3 m Timed Up and Go (TUG) test, two-step test, open-eyed one-leg standing time, and spinal alignment. Normally distributed data are expressed as means (standard deviations) and non-normally distributed data as medians (interquartile range), depending on the results of the Kolmogorov-Smirnov test. Student's t-test and χ2 test were used for between-group comparisons. Regression analysis was performed with SAD as the objective variable. A two-sided p < 0.05 was considered statistically significant. RESULTS The shorter SAD group performed better in the two-step test, TUG test, and open-eyed one-leg standing time (p < 0.001) as well as in the two-foot 20 cm rise test (p < 0.01) compared to the longer SAD group. Spinal alignment was better in the shorter SAD group than in the longer SAD group, with a shorter sagittal vertical axis (p < 0.001), smaller pelvic tilt (p < 0.001), and greater sacral slope (p < 0.05). CONCLUSION SAD was associated with posterior pelvic tilt and movement performance parameters. In addition to testing for osteoporosis, movement performance parameters should be evaluated in women with osteoporosis who are aged ≥ 65 and have greater SAD (≥ 160 mm in this study). The SAD is a new assessment method, and further research is required to verify its validity and reproducibility. This is the first attempt to determine how age and SAD affect movement performance in older adults.
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Affiliation(s)
- Takashi Nagai
- Department of Rehabilitation Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, 142-8666, Tokyo, Japan.
- Orthopaedic Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, 142-8666, Tokyo, Japan.
| | - Makoto Miyagami
- Department of Rehabilitation Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, 142-8666, Tokyo, Japan
| | - Shota Nakamura
- Department of Rehabilitation Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, 142-8666, Tokyo, Japan
| | - Keizo Sakamoto
- Department of Rehabilitation Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, 142-8666, Tokyo, Japan
| | - Koji Ishikawa
- Department of Rehabilitation Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, 142-8666, Tokyo, Japan
| | - Ichiro Okano
- Department of Rehabilitation Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, 142-8666, Tokyo, Japan
| | - Fumihito Kasai
- Orthopaedic Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, 142-8666, Tokyo, Japan
| | - Yoshifumi Kudo
- Department of Rehabilitation Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, 142-8666, Tokyo, Japan
| | - Nobuyuki Kawate
- Orthopaedic Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, 142-8666, Tokyo, Japan
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Nagai T, Miyagami M, Okano I, Nakamura S, Okazaki Y, Sakamoto K, Kasai F, Kudo Y, Kawate N. Association of Spinal Alignment and Abdominal Circumference with Sarcopenia Status and Fall Risk in Patients with Osteoporosis: A Retrospective Study. Nutrients 2023; 15:nu15112571. [PMID: 37299534 DOI: 10.3390/nu15112571] [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: 04/08/2023] [Revised: 05/26/2023] [Accepted: 05/29/2023] [Indexed: 06/12/2023] Open
Abstract
Since vertebral kyphosis and abdominal circumference are thought to influence sarcopenia and fall risk in osteoporosis, we evaluated sarcopenia and fall risk in patients with different measurements of abdominal circumference and sagittal longitudinal axis (SVA). In this post hoc study, 227 patients aged 65 years or more who visited an outpatient osteoporosis clinic were included in the analysis. Sarcopenia was determined from lean body mass, grip strength, and walking speed by dual energy X-ray absorptiometry; SVA (median 40 mm) and abdominal circumference (median 80 cm) were compared between the four groups, each divided into two groups. Nutritional management, falls, and fall anxiety scores were also examined. The incidence of sarcopenia was significantly increased in those with abdominal circumference < 80 cm in both the SVA < 40 mm and SVA ≥ 40 mm groups (p < 0.05). Nonetheless, the fall scores of those with SVA < 40 mm were lower than those of individuals with SVA ≥ 40 mm (p < 0.01). Based on the results of this study, SVA and abdominal circumference values may predict the risk of sarcopenia and falls. More research is needed before our results can be translated into clinical practice.
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Affiliation(s)
- Takashi Nagai
- Department of Rehabilitation Medicine, Showa University School of Medicine, Tokyo 142-866, Japan
- Department of Orthopedic Surgery, Showa University School of Medicine, Tokyo 142-866, Japan
| | - Makoto Miyagami
- Department of Orthopedic Surgery, Showa University School of Medicine, Tokyo 142-866, Japan
| | - Ichiro Okano
- Department of Orthopedic Surgery, Showa University School of Medicine, Tokyo 142-866, Japan
| | - Shota Nakamura
- Department of Orthopedic Surgery, Showa University School of Medicine, Tokyo 142-866, Japan
| | - Yuichiro Okazaki
- Department of Orthopedic Surgery, Showa University School of Medicine, Tokyo 142-866, Japan
| | - Keizo Sakamoto
- Department of Orthopedic Surgery, Showa University School of Medicine, Tokyo 142-866, Japan
| | - Fumihito Kasai
- Department of Rehabilitation Medicine, Showa University School of Medicine, Tokyo 142-866, Japan
| | - Yoshifumi Kudo
- Department of Orthopedic Surgery, Showa University School of Medicine, Tokyo 142-866, Japan
| | - Nobuyuki Kawate
- Department of Rehabilitation Medicine, Showa University School of Medicine, Tokyo 142-866, Japan
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Lu CH, Lee CH, Wu LW, Liao CC, Su SC, Liu JS, Li PF, Huang CL, Ho LJ, Lin CM, Lin MH, Chang CY, Liu YC, Lin CP, Cheng AC, Kuo FC. Gender-specific impacts of thigh skinfold thickness and grip strength for predicting osteoporosis in type 2 diabetes. Diabetol Metab Syndr 2023; 15:103. [PMID: 37198661 DOI: 10.1186/s13098-023-01087-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 05/12/2023] [Indexed: 05/19/2023] Open
Abstract
BACKGROUND Diabetes with co-existing bone fragility or osteoporosis is common in elderly patients, whereas is frequently underestimated. METHODS We conducted dual-energy x-ray absorptiometry (DXA) with 7-site skinfold (SF) and dominant hand grip strength measurements among patients with type 2 diabetes (T2DM) to assess their gender-specific associations. A total of 103 patients with T2DM (60 females and 43 males), aged between 50 and 80 years (median 68.0 years) were enrolled and 45 non-DM females were also included to compare with T2DM females. RESULTS Our results revealed osteoporosis was negatively correlated with grip strength in both genders, negatively correlated with lean mass solely in males and negatively correlated with fat mass (particular the gynoid fat mass and thigh SF thickness) in females. Via performing multivariable stepwise logistic regression, we identified grip strength in both genders and thigh SF thickness in females as predictors for osteoporosis. Receiver operating characteristic curve analysis further disclosed 20.5 mm female thigh skinfold thickness, 18.1 kg female grip strength and 29.0 kg male grip strength as reasonable cutoff levels for predicting osteoporosis in the Taiwanese patients with T2DM. CONCLUSIONS Patients with T2DM presented gender-specific associations between osteoporosis, body composition and grip strength. Grip strength and thigh SF thickness might serve as predictors for detection of osteoporosis in patients with T2DM.
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Affiliation(s)
- Chieh-Hua Lu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, 325, Section 2, Cheng-Kung Road, 114, Taipei, Taiwan, ROC
| | - Chien-Hsing Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, 325, Section 2, Cheng-Kung Road, 114, Taipei, Taiwan, ROC
| | - Li-Wei Wu
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, ROC
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, ROC
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Chun-Cheng Liao
- Department of Family Medicine, Taichung Armed Forces General Hospital, Taichung, Taiwan, ROC
- School of Medicine, National Defense Medical Center, Taipei, Taiwan, ROC
- Department of Medical Education and Research, Taichung Armed Forces General Hospital, Taichung, Taiwan, ROC
| | - Sheng-Chiang Su
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, 325, Section 2, Cheng-Kung Road, 114, Taipei, Taiwan, ROC
| | - Jhih-Syuan Liu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, 325, Section 2, Cheng-Kung Road, 114, Taipei, Taiwan, ROC
| | - Peng-Fei Li
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, 325, Section 2, Cheng-Kung Road, 114, Taipei, Taiwan, ROC
| | - Chia-Luen Huang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, 325, Section 2, Cheng-Kung Road, 114, Taipei, Taiwan, ROC
| | - Li-Ju Ho
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, 325, Section 2, Cheng-Kung Road, 114, Taipei, Taiwan, ROC
| | - Chien-Ming Lin
- Department of Pediatrics, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Ming-Hsun Lin
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, 325, Section 2, Cheng-Kung Road, 114, Taipei, Taiwan, ROC
| | - Chun-Yung Chang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan, ROC
| | - Yi-Chen Liu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, 325, Section 2, Cheng-Kung Road, 114, Taipei, Taiwan, ROC
| | - Chih-Ping Lin
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, 325, Section 2, Cheng-Kung Road, 114, Taipei, Taiwan, ROC
| | - An-Che Cheng
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, 325, Section 2, Cheng-Kung Road, 114, Taipei, Taiwan, ROC
| | - Feng-Chih Kuo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, 325, Section 2, Cheng-Kung Road, 114, Taipei, Taiwan, ROC.
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Hasegawa S, Mizokami F, Kameya Y, Hayakawa Y, Watanabe T, Matsui Y. Machine learning versus binomial logistic regression analysis for fall risk based on SPPB scores in older adult outpatients. Digit Health 2023; 9:20552076231219438. [PMID: 38107982 PMCID: PMC10722919 DOI: 10.1177/20552076231219438] [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] [Accepted: 11/21/2023] [Indexed: 12/19/2023] Open
Abstract
Objective To compare the performance of the diagnostic model for fall risk based on the short physical performance battery (SPPB) developed using commercial machine learning software (MLS) and binomial logistic regression analysis (BLRA). Methods We enrolled 797 out of 850 outpatients who visited the clinic between March 2016 and November 2021. Patients were categorized into the development (n = 642) and validation (n = 155) datasets. Age, sex, number of comorbidities, number of medications, body mass index (BMI), calf circumference (left-right average), handgrip strength (left-right average), total SPPB score, and history of falls were determined. We defined fall risk by an SPPB score of ≤6 in men and ≤9 in women. The main metrics used for evaluating the machine learning model and BLRA were the area under the curve (AUC), accuracy, precision, recall (sensitivity), specificity, and F-measure. The commercial MLS automatically calculates the parameter range of the highest contribution. Results The participants included 797 outpatients (mean age, 76.3 years; interquartile range, 73.0-81.0; 288 men). The metrics of the current diagnostic model in the commercial MLS were as follows: AUC = 0.78, accuracy = 0.74, precision = 0.46, recall (sensitivity) = 0.81, specificity = 0.71, F-measure = 0.59. The metrics of the current diagnostic model in the BLRA were as follows: AUC = 0.77, accuracy = 0.75, precision = 0.47, recall (sensitivity) = 0.67, specificity = 0.77, F-measure = 0.55. The risk factors for falls in older adult outpatients were handgrip strength, female sex, experience of falls, BMI, and calf circumference in the commercial MLS. Conclusions The diagnostic model for fall risk based on SPPB scores constructed using commercial MLS is noninferior to BLRA.
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Affiliation(s)
- Sho Hasegawa
- Department of Pharmacotherapeutics and Informatics, Fujita Health University, Toyoake, Japan
- Department of Education and Innovation, Training for Pharmacy, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Fumihiro Mizokami
- Department of Education and Innovation, Training for Pharmacy, National Center for Geriatrics and Gerontology, Obu, Japan
- Department of Pharmacy, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Yoshitaka Kameya
- Department of Information Engineering, Meijo University, Nagoya, Japan
| | - Yuji Hayakawa
- Department of Education and Innovation, Training for Pharmacy, National Center for Geriatrics and Gerontology, Obu, Japan
- Department of Pharmacy, National Hospital Organization, Nagoya Medical Center, Nagoya, Japan
| | - Tsuyoshi Watanabe
- Department of Orthopaedic Surgery, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Yasumoto Matsui
- Center for Frailty and Locomotive Syndrome, National Center for Geriatrics and Gerontology, Obu, Japan
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Effect of Preoperative Oral Carbohydrates on Insulin Resistance in Older Adults Who Underwent Total Hip or Knee Arthroplasty: A Prospective Randomized Trial. J Am Acad Orthop Surg 2022; 30:971-978. [PMID: 35576534 DOI: 10.5435/jaaos-d-21-00656] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 04/04/2022] [Indexed: 02/01/2023] Open
Abstract
INTRODUCTION Preoperative carbohydrate drinks are recommended to reduce fasting time before surgery. Older adults are at risk of pulmonary aspiration and hyperglycemia after consuming carbohydrate drinks because of increased insulin resistance and delayed gastric emptying. We investigated the effects of oral carbohydrate drinks on perioperative insulin resistance, metabolic responses, and gastric volume in older adults. METHODS Fifty-six patients (aged more than 65 years) were randomly assigned to the control or carbohydrate (CHO) group. The CHO group received 400 mL of a carbohydrate drink 2 to 3 hours before anesthesia. The control group was allowed clear fluid intake 2 hours before anesthesia. Blood glucose and insulin levels were measured before intake of the carbohydrate drink and 1 hour postoperatively. Gastric volume was measured before spinal anesthesia. Insulin resistance was calculated using the homeostasis model assessment for insulin resistance. RESULTS Homeostasis model assessment for insulin resistance was not different between the control and CHO groups preoperatively (2.5 versus 3.3, P = 0.156) or postoperatively (2.6 versus 2.4, P = 0.817). Preoperative gastric volume was comparable between the control and CHO groups (35.5 versus 30.8 mL, P = 0.696). DISCUSSION Preoperative oral consumption of carbohydrates did not affect insulin resistance or gastric volume in older adults undergoing total knee or hip arthroplasty. Preoperative carbohydrate loading is safe in older adults undergoing total knee or hip arthroplasty. DATA AVAILABILITY The data that support the findings of this study are available from the corresponding author on reasonable request. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov (No. NCT04206189).
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Lin X, Guo H, Lian Y, Kou J, Wang G, Chen Y, Wang J, Han X, Jiang M, Yang Q. Osteoporosis and Related Health Status Among the Elderly Urban Residents in Elderly-Care Inns in Beijing, a Multicenter DXA Survey. Front Endocrinol (Lausanne) 2022; 13:875678. [PMID: 35957840 PMCID: PMC9359074 DOI: 10.3389/fendo.2022.875678] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 04/19/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Identification of the high risk population for osteoporosis and timely prevention are the best strategies at present. Detailed epidemiological investigation in a well-defined population is necessary to explore the population-based characteristics and risk factors of osteoporosis, thus to facilitate better prevention programs. METHOD In this prospective cross-sectional study, 1423 questionnaires were given out to the urban residents (female ≥ 40 years of age, male ≥50 years) who lived in the 27 Elderly-Care Inns interspersed among the seven central urban areas of Beijing. All participants were voluntary and underwent routine physical examination and spine and hip BMD measurements using the DXA instrument. The study protocols were approved by the Medical Ethics Committee of Dongzhimen Hospital, Beijing University of Chinese Medicine (JDZX2015079). RESULTS Altogether 1407 participants fulfilled the survey. Among 359 men, the prevalence of osteoporosis, osteopenia, and normal BMD were 18.1%, 56.6%, and 25.3%, respectively; among 1048 women, the corresponding figures were 40.3%, 42.8%, and 16.9%, respectively. After adjustment of age and BMI, both hands grip strength, height loss over 3 cm, serum levels of β-CTx, PINP, and OST were the independent risk factors for osteoporosis in both men and women; besides, familial Alzheimer's disease history in men; and history of steatohepatitis and fracture, serum levels of PTH and ALT, age of menarche, age of menopause, and duration of menstruation in women were also risk factors of osteoporosis. In both genders, the cost-effective method, which adopted both hands grip strength, height loss over 3 cm, and medical history, indicated a good predictive ability to evaluate the risk of osteoporosis (in men AUC=0.730, 95%CI=0.642~0.817; in women AUC=0.769, 95%CI=0.724~0.813). CONCLUSIONS In the population of elderly Beijing urban residents in Elderly-Care Inns, the prevalence of osteoporosis in women is higher than that in men and increases with aging more rapidly; the prevalence of osteopenia in men is higher than in women. The cost-effective method, including both hands grip strength, height loss over 3 cm, and familial Alzheimer's disease history in men; fracture and steatohepatitis history as well as menstrual history in women is recommended in identifying the high-risk subjects for osteoporosis.
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Affiliation(s)
- XinChao Lin
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - HongTao Guo
- The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - YiGang Lian
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Jiajing Kou
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - GuangLei Wang
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - YiYun Chen
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Juan Wang
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xu Han
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Miao Jiang
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
- *Correspondence: QiaoHui Yang, ; Miao Jiang,
| | - QiaoHui Yang
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
- *Correspondence: QiaoHui Yang, ; Miao Jiang,
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Mckirdy S, Nichols B, Williamson S, Gerasimidis K. Handgrip strength as a surrogate marker of lean mass and risk of malnutrition in paediatric patients. Clin Nutr 2021; 40:5189-5195. [PMID: 34464858 PMCID: PMC8460712 DOI: 10.1016/j.clnu.2021.08.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 08/04/2021] [Accepted: 08/05/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND & AIMS The use of handgrip strength (HGS) as a proxy of nutritional status in sick children has not been studied. This study created HGS centile charts in healthy children and explored the utility of HGS z-scores as markers of body composition and screening of malnutrition risk in sick children. METHODS Data from 535 healthy children aged 5-16 years were used for the development of HGS centiles adjusted either for age or height. In 595 sick children, relationships between HGS z-scores with body composition, malnutrition risk (Paediatric Yorkhill Malnutrition Score-PYMS), length of hospital stay (LOS) and biomarkers of disease severity were explored. The use of HGS z-score to identify sick children in need of further dietetic assessment was investigated. RESULTS Children scoring at high malnutrition risk with PYMS had lower HGS z-scores for age (by 0.51 SD, p < 0.001) and height (by 0.46 SD, p = 0.001) than those who scored low. A HGS z-score at cut-offs of -0.81 SD and -1.2 SD for age and height, respectively, was predictive of need for dietetic intervention in sick children with sensitivity of 79% and 70% and specificity of 56% and 69%, respectively. HGS z-scores were predictive of fat free mass (FFM) in sick and healthy (all p < 0.001) children, while fat mass was not. HGS z-scores were inversely related with plasma CRP (rho, age: -0.21; height: -0.23, both p = 0.001). HGS was not predictive of LOS. CONCLUSION HGS is predictive of FFM, could compliment assessment of malnutrition risk, and may help identify children for further dietetic intervention on admission to hospital.
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Affiliation(s)
- Shona Mckirdy
- Human Nutrition, School of Medicine, Dentistry and Life Sciences, University of Glasgow, New Lister Building, Glasgow Royal Infirmary, G31 2ER, Glasgow, UK
| | - Ben Nichols
- Human Nutrition, School of Medicine, Dentistry and Life Sciences, University of Glasgow, New Lister Building, Glasgow Royal Infirmary, G31 2ER, Glasgow, UK
| | - Sarah Williamson
- Human Nutrition, School of Medicine, Dentistry and Life Sciences, University of Glasgow, New Lister Building, Glasgow Royal Infirmary, G31 2ER, Glasgow, UK
| | - Konstantinos Gerasimidis
- Human Nutrition, School of Medicine, Dentistry and Life Sciences, University of Glasgow, New Lister Building, Glasgow Royal Infirmary, G31 2ER, Glasgow, UK.
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Yin M, Zhang H, Liu Q, Ding F, Deng Y, Hou L, Wang H, Yue J, He Y. Diagnostic Performance of Clinical Laboratory Indicators With Sarcopenia: Results From the West China Health and Aging Trend Study. Front Endocrinol (Lausanne) 2021; 12:785045. [PMID: 34956096 PMCID: PMC8702640 DOI: 10.3389/fendo.2021.785045] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 11/12/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Sarcopenia is an age-related and skeletal muscle disorder involving the loss of muscle mass or strength, and physiological function. Although the diagnostic indicators used in the different guidelines are for muscle mass, strength and physical performance, there are currently no uniform diagnostic criteria. Therefore, we aimed to explore the relationship between a series of biomarkers with sarcopenia in southwest China. METHODS We included 4302 patients from West China Health and Aging Trend (WCHAT) study. Sarcopenia was defined according to the Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment. Thyroxine、albumin、total protein、prealbumin、albumin to globulin ratio (A/G)、25(OH)VD、fasting insulin、adrenal cortisol、triglyceride、high-density lipoprotein、hemoglobin and aspartate aminotransferase to alanine aminotransferase ratio (AST/ALT) were measured. The receiver operating characteristic curves (ROC) were established to describe the predictive value for sarcopenia and we also used multivariate logistic regression analysis to identify risk factors of the disease. RESULTS In terms of protein state, patients with sarcopenia had lower value in total protein, albumin, prealbumin, A/G than the control (P<0.001). Patients had lower value in triglyceride but higher value in high-density lipoprotein compared with the healthy in the indicators of lipid metabolism (P<0.001). In the aspect of hormone state, patients had lower free triiodothyronine, fasting insulin but higher free tetraiodothyronine and adrenal cortisol than the healthy (P<0.001). The fasting insulin level (AUC=0.686) and the AST/ALT ratio (AUC=0.682) were the best predictors of sarcopenia among biomarkers. The diagnostic performance of fasting insulin combined with the AST/ALT ratio (AUC=0.720) is equal to multiple indicators (AUC=0.742). CONCLUSION The fasting insulin combined with the AST/ALT ratio exhibits good diagnostic performance for sarcopenia.
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Affiliation(s)
- Mengting Yin
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - He Zhang
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Qianhui Liu
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Fei Ding
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Yiping Deng
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Lisha Hou
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Hui Wang
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Jirong Yue
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
- *Correspondence: Jirong Yue, ; Yong He,
| | - Yong He
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China
- *Correspondence: Jirong Yue, ; Yong He,
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