1
|
Rodrigues PS, Mendonça FM, Neves JS, Luís C, Rodrigues I, Moreno T, Festas D, Pedro J, Varela A, Fernandes A, Costa EL, Freitas P. Effects of Bariatric Surgery on Sarcopenic Obesity Outcomes: A One-Year Prospective Study in Middle-Aged Women. Obes Surg 2024; 34:1674-1683. [PMID: 38523172 DOI: 10.1007/s11695-024-07164-x] [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: 01/14/2024] [Revised: 03/04/2024] [Accepted: 03/06/2024] [Indexed: 03/26/2024]
Abstract
INTRODUCTION Sarcopenic obesity (SO) is characterised by the confluence of muscle deterioration and high adiposity. When non-surgical interventions prove insufficient, bariatric surgery (BS) becomes the primary approach. This study aimed to address BS effects on SO outcomes 1 year post-surgery among middle-aged women, also considering physical exercise's impact. METHODS Prospective single-centre study of 140 patients who underwent Roux-en-Y gastric bypass or sleeve gastrectomy between November 2019 and December 2022. Participants were categorised into tertiles according to SO's diagnosis and severity (group 1-patients with the most severe SO; group 2-intermediate; group 3-the least severe or without SO), calculated considering the consensus issued by ESPEN and EASO in 2022. Evaluations of clinical and biochemical parameters were conducted before and 12 months after BS, and the variation was used for comparative purposes. Body composition was assessed using bone density scans. Linear regression analysis accounted for both surgery type and baseline body mass index (BMI). RESULTS Before BS, SO prevalence in the overall sample was 89.3%, decreasing to 2.9% after BS. Group 1 had more body fat mass (56.9 vs 54.8 vs 50.7 kg, p < 0.001), total, trunk and leg fat at baseline and a significantly lower total skeletal muscle mass (47.2 vs 49.4 vs 51.8 kg, p < 0.001). One year post-BS, group 1 presented more weight loss (- 39.8 ± 11.4 kg, p = 0.031), BMI reduction (- 15.9 ± 4.6 kg/m2, p = 0.005) and lost more fat mass (- 32.6 vs - 30.5 vs - 27.9 kg, p = 0.005), but not total skeletal muscle mass (- 5.8 vs - 5.9 vs - 6.8 kg, p = 0.130). Remission rates for comorbidities were substantial among all groups, but more marked among patients within group 1 (type 2 diabetes mellitus 75%, hypertension 47.1% and dyslipidemia 52.8%). Engagement in physical exercise of any kind has increased post-BS (33.1% vs 79.1%). CONCLUSION Despite concerns about malabsorptive mechanisms potentially worsening muscle loss, patients with the most severe SO undergoing BS lost more fat mass while experiencing the smallest reduction in total skeletal muscle mass. Remission rates for comorbidities following BS were notable among all groups.
Collapse
Affiliation(s)
- Pietra S Rodrigues
- Biochemistry Unit, Biomedicine Department, FMUP-Faculty of Medicine, University of Porto, 4200-450, Porto, Portugal
| | - Fernando M Mendonça
- Endocrinology, Diabetes and Metabolism Service, São João Hospital and University Centre, 4200-319, Porto, Portugal.
- CRIO group (Centro de Responsabilidade Integrada de Obesidade), São João Hospital and University Centre, 4200-319, Porto, Portugal.
| | - João S Neves
- Endocrinology, Diabetes and Metabolism Service, São João Hospital and University Centre, 4200-319, Porto, Portugal
- Cardiovascular Research and Development Center, Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Carla Luís
- Biochemistry Unit, Biomedicine Department, FMUP-Faculty of Medicine, University of Porto, 4200-450, Porto, Portugal
- i3S (Instituto de Investigação e Inovação em Saúde), Universidade do Porto, 4200-135, Porto, Portugal
| | - Ilda Rodrigues
- Biochemistry Unit, Biomedicine Department, FMUP-Faculty of Medicine, University of Porto, 4200-450, Porto, Portugal
| | - Telma Moreno
- Endocrinology, Diabetes and Metabolism Service, São João Hospital and University Centre, 4200-319, Porto, Portugal
| | - Diana Festas
- Endocrinology, Diabetes and Metabolism Service, São João Hospital and University Centre, 4200-319, Porto, Portugal
- CRIO group (Centro de Responsabilidade Integrada de Obesidade), São João Hospital and University Centre, 4200-319, Porto, Portugal
| | - Jorge Pedro
- Endocrinology, Diabetes and Metabolism Service, São João Hospital and University Centre, 4200-319, Porto, Portugal
- CRIO group (Centro de Responsabilidade Integrada de Obesidade), São João Hospital and University Centre, 4200-319, Porto, Portugal
| | - Ana Varela
- Endocrinology, Diabetes and Metabolism Service, São João Hospital and University Centre, 4200-319, Porto, Portugal
- CRIO group (Centro de Responsabilidade Integrada de Obesidade), São João Hospital and University Centre, 4200-319, Porto, Portugal
| | - Ana Fernandes
- Nuclear Medicine Department, São João Hospital and University Centre, 4200-319, Porto, Portugal
- CINTESIS.UFP@RISE (Centro de Investigação em Tecnologias e Serviços de Saúde, Rede de Investigação em Saúde), Universidade Fernando Pessoa, 4249-004, Porto, Portugal
| | - Eduardo L Costa
- CRIO group (Centro de Responsabilidade Integrada de Obesidade), São João Hospital and University Centre, 4200-319, Porto, Portugal
| | - Paula Freitas
- CRIO group (Centro de Responsabilidade Integrada de Obesidade), São João Hospital and University Centre, 4200-319, Porto, Portugal
- i3S (Instituto de Investigação e Inovação em Saúde), Universidade do Porto, 4200-135, Porto, Portugal
| |
Collapse
|
2
|
Seo E, Kwon Y, ALRomi A, Eledreesi M, Park S. A multifaceted and inclusive methodology for the detection of sarcopenia in patients undergoing bariatric surgery: an in-depth analysis of current evidence. Rev Endocr Metab Disord 2024:10.1007/s11154-023-09864-8. [PMID: 38427134 DOI: 10.1007/s11154-023-09864-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/11/2023] [Indexed: 03/02/2024]
Abstract
Bariatric surgery is widely recognized as the most effective intervention for obesity and offers benefits beyond weight loss. However, not all patients achieve satisfactory weight loss, balanced changes in body composition, and resolution of comorbidities. Therefore, thorough pre- and postoperative evaluations are important to predict success and minimize adverse effects. More comprehensive assessments require broadening the focus beyond body weight and fat measurements to consider quantitative and qualitative evaluations of muscles. Introducing the concept of sarcopenia is useful for assessing the degradative and pathological changes in muscles associated with cardiometabolic function, physical performance, and other obesity-related comorbidities in patients undergoing bariatric surgery. However, there is currently no consensus or definition regarding the research and clinical use of sarcopenia in patients undergoing bariatric surgery. Therefore, this review aimed to define the concept of sarcopenia applicable to patients undergoing bariatric surgery, based on the consensus reached for sarcopenia in the general population. We also discuss the methods and significance of measuring muscle mass, quality, and strength, which are key variables requiring a comprehensive assessment.
Collapse
Affiliation(s)
- Eunhye Seo
- Keimyung University College of Nursing, Daegu, Republic of Korea
| | - Yeongkeun Kwon
- Division of Foregut Surgery, Korea University College of Medicine, 73 Goryeodae- ro, Seongbuk-gu, 02841, Seoul, Republic of Korea
- Center for Obesity and Metabolic Diseases, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Ahmad ALRomi
- Ministry of Health Jordan, General surgery affiliationision, prince Hamzah hospital, Amman, Jordan
| | | | - Sungsoo Park
- Division of Foregut Surgery, Korea University College of Medicine, 73 Goryeodae- ro, Seongbuk-gu, 02841, Seoul, Republic of Korea.
- Center for Obesity and Metabolic Diseases, Korea University Anam Hospital, Seoul, Republic of Korea.
| |
Collapse
|
3
|
Fornelli C, Sofia Cento A, Nevi L, Mastrocola R, Ferreira Alves G, Caretti G, Collino M, Penna F. The BET inhibitor JQ1 targets fat metabolism and counteracts obesity. J Adv Res 2024:S2090-1232(24)00051-1. [PMID: 38365172 DOI: 10.1016/j.jare.2024.02.001] [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: 08/17/2023] [Revised: 01/03/2024] [Accepted: 02/01/2024] [Indexed: 02/18/2024] Open
Abstract
INTRODUCTION Obesity, one of the most frequent health problems in the adult population, is a condition characterized by excessive white adipose tissue accumulation and accompanied by the increased risk to develop other disorders such as type II diabetes, cardiovascular disorders, physical disability, frailty and sarcopenia. Total fat mass frequently increases during aging, often coexisting with sarcopenia, thus resulting in an emerging condition defined sarcopenic obesity (SO). Our previous data demonstrated the relevant role of the bromo and extra-terminal domain (BET) proteins inhibitor JQ1 in attenuating inflammation and fibrosis in sarcopenic mice. Moreover, we preliminarily observed that JQ1 administration markedly reduces white adipose tissue mass, suggesting a potential role of BET proteins on visceral fat deposition during aging. OBJECTIVES Starting from those observations, the aim of this study was to investigate the ability of JQ1 to reduce adiposity in a chronic diet-induced obesity (DIO) mouse model mimicking the human metabolic syndrome. METHODS Male C57BL/6J mice were divided in subgroups, either fed a standard diet or a high fat diet for 22 or 12 weeks, treated over the last 14 days with JQ1 or with vehicle. RESULTS The results showed that JQ1 administration reduces fat mass, preserving skeletal muscle mass and function. A direct JQ1 lipolytic effect was demonstrated on mature adipocyte cultures. JQ1-mediated loss of adipose tissue mass was not associated with systemic inflammation or with lipid accumulation in muscle and liver. JQ1 administration did not impinge on skeletal muscle metabolism and oxidative capability, as shown by the lack of significant impact on mitochondrial mass and biogenesis. CONCLUSION In conclusion, the current data highlight a potential benefit of JQ1 administration to counteract obesity, suggesting epigenetic modulation as a prospective target in the treatment of obesity and sarcopenic obesity, despite the underlying multiorgan molecular mechanism is still not completely elucidated.
Collapse
Affiliation(s)
- Claudia Fornelli
- Department of Clinical and Biological Sciences, University of Torino, Turin, Italy
| | - Alessia Sofia Cento
- Department of Clinical and Biological Sciences, University of Torino, Turin, Italy
| | - Lorenzo Nevi
- Department of Biosciences, University of Milano, Milan, Italy
| | - Raffaella Mastrocola
- Department of Clinical and Biological Sciences, University of Torino, Turin, Italy
| | | | | | - Massimo Collino
- Department of Neurosciences "Rita Levi Montalcini", University of Torino, Turin, Italy
| | - Fabio Penna
- Department of Clinical and Biological Sciences, University of Torino, Turin, Italy.
| |
Collapse
|
4
|
Mojas E, Santisteban A, Muñoz-Pérez I, Larrinaga-Undabarrena A, Arietaleanizbeaskoa MS, Mendizabal-Gallastegui N, Grandes G, Cacicedo J, Río X. Differences in Functional Capacity between Oncologic and Non-Oncologic Populations: Reference Values. Healthcare (Basel) 2024; 12:318. [PMID: 38338203 PMCID: PMC10855221 DOI: 10.3390/healthcare12030318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/12/2024] [Accepted: 01/22/2024] [Indexed: 02/12/2024] Open
Abstract
This study is focused on the fact that in the context of increasing global aging and cancer diagnoses, additional challenges arise in clinical care. Adequate functionality and body composition are key to coping with antineoplastic treatment, which can lead to better treatment tolerance, survival, and quality of life. This is a cross-sectional comparative study focused on the assessment and comparison of body composition and functionality between cancer patients and a reference population, with the aim of establishing meaningful baseline values. Techniques such as manual dynamometry, the Five-Times Sit-to-Stand test, and bioimpedance were used to collect data from 374 oncologic patients and 1244 reference individuals. The results reveal significant disparities in functionality and body composition among participants, and provide age group-specific adjusted baseline values for those diagnosed with cancer. These findings may have crucial clinical implications for applying particular cut-off points designed for this population group, which makes the assessment process faster and more accurate, enhances the capacity of medical personnel to act quickly, and improves the management of frailty in cancer patients.
Collapse
Affiliation(s)
- Egoitz Mojas
- Department of Physical Activity and Sport Science, Faculty of Education and Sport, University of Deusto, 48007 Bilbao, Spain; (A.S.); (I.M.-P.); (A.L.-U.); (X.R.)
| | - Aitor Santisteban
- Department of Physical Activity and Sport Science, Faculty of Education and Sport, University of Deusto, 48007 Bilbao, Spain; (A.S.); (I.M.-P.); (A.L.-U.); (X.R.)
| | - Iker Muñoz-Pérez
- Department of Physical Activity and Sport Science, Faculty of Education and Sport, University of Deusto, 48007 Bilbao, Spain; (A.S.); (I.M.-P.); (A.L.-U.); (X.R.)
| | - Arkaitz Larrinaga-Undabarrena
- Department of Physical Activity and Sport Science, Faculty of Education and Sport, University of Deusto, 48007 Bilbao, Spain; (A.S.); (I.M.-P.); (A.L.-U.); (X.R.)
| | - Maria Soledad Arietaleanizbeaskoa
- Comprehensive Care Group for Patients with Chronic Diseases, Biocruces Bizkaia Health Research Institute, Plaza de Cruces 12, 48903 Barakaldo, Spain; (M.S.A.); (N.M.-G.); (G.G.)
| | - Nere Mendizabal-Gallastegui
- Comprehensive Care Group for Patients with Chronic Diseases, Biocruces Bizkaia Health Research Institute, Plaza de Cruces 12, 48903 Barakaldo, Spain; (M.S.A.); (N.M.-G.); (G.G.)
| | - Gonzalo Grandes
- Comprehensive Care Group for Patients with Chronic Diseases, Biocruces Bizkaia Health Research Institute, Plaza de Cruces 12, 48903 Barakaldo, Spain; (M.S.A.); (N.M.-G.); (G.G.)
| | - Jon Cacicedo
- Radiation Oncology Department, Biocruces Bizkaia Health Research Institute, Cruces University Hospital, Osakidetza, 48903 Barakaldo, Spain;
- Department of Surgery, Radiology and Physical Medicine, University of the Basque Country (UPV/EHU), 48940 Leioa, Spain
| | - Xabier Río
- Department of Physical Activity and Sport Science, Faculty of Education and Sport, University of Deusto, 48007 Bilbao, Spain; (A.S.); (I.M.-P.); (A.L.-U.); (X.R.)
| |
Collapse
|
5
|
Fonfría-Vivas R, Pérez-Ros P, Barrachina-Igual J, Pablos-Monzó A, Martínez-Arnau FM. Assessing quality of life with SarQol is useful in screening for sarcopenia and sarcopenic obesity in older women. Aging Clin Exp Res 2023; 35:2069-2079. [PMID: 37442906 PMCID: PMC10520098 DOI: 10.1007/s40520-023-02488-7] [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: 04/11/2023] [Accepted: 06/27/2023] [Indexed: 07/15/2023]
Abstract
BACKGROUND Health-related quality of life (HRQoL) may be impaired in the presence of sarcopenia. Since a specific quality of life questionnaire became available for sarcopenia (SarQol), cutoffs to screen for this condition have been proposed, prompting the need to assess them in different populations. Due to the lack of consensus on diagnostic criteria, the tool has not yet been analyzed in screening for sarcopenic obesity. AIM Our aim is to measure the SarQoL's metric properties and establish a cutoff in QoL assessments that could be used along the diagnostic pathway for sarcopenia and sarcopenic obesity in community-dwelling older women. METHODS This cross-sectional study assessed women aged ≥ 70 years using the SarQol, sarcopenia criteria (EWGSOP2) and sarcopenic obesity criteria (ESPEN/EASO). Cutoffs for the SarQol were defined with a receiver-operating characteristics (ROC) curve, and sensitivity and specificity were analyzed. RESULTS Of the 95 included women (mean age 76.0 years, standard deviation [SD] 5.7), 7.3% (n = 7) were classified as having sarcopenic obesity, 22.1% (n = 21) as having sarcopenia, and 70.5% (n = 67) as not having sarcopenia. The total SarQol score was higher in women without sarcopenia (66.5 SD 16.2) versus those with sarcopenia (56.6 SD 15.6) and sarcopenic obesity (45.1 SD 7.9). A cutoff of ≤ 60 points is proposed for sarcopenia screening (area under the ROC curve [AUC] 0.67; 95% confidence interval [CI] 0.53-0.80; sensitivity 61.9%; specificity 62%), and ≤ 50 points for sarcopenic obesity (AUC 0.85; 95% CI 0.74-0.95; sensitivity 71.4%; specificity 76.9%). CONCLUSIONS Quality of life is compromised in women with sarcopenia and especially in those with sarcopenic obesity. The SarQol could be useful in screening for these conditions, providing insight into health-related quality of life in older people with sarcopenia.
Collapse
Affiliation(s)
- Rosa Fonfría-Vivas
- Department of Nursing, Universitat de València, Av. Menendez Pelayo 19, 46010, Valencia, Spain
- Frailty and Cognitive Impairment Research Group (FROG), University of Valencia, Menéndez I Pelayo, 19, 46010, Valencia, Spain
| | - Pilar Pérez-Ros
- Department of Nursing, Universitat de València, Av. Menendez Pelayo 19, 46010, Valencia, Spain.
- Frailty and Cognitive Impairment Research Group (FROG), University of Valencia, Menéndez I Pelayo, 19, 46010, Valencia, Spain.
| | - Joaquín Barrachina-Igual
- Faculty of Physical Activity and Sport Sciences, Universidad Católica de Valencia San Vicente Mártir, Ramiro de Maetzu 14, 46900, Torrent, Valencia, Spain
| | - Ana Pablos-Monzó
- Faculty of Physical Activity and Sport Sciences, Universidad Católica de Valencia San Vicente Mártir, Ramiro de Maetzu 14, 46900, Torrent, Valencia, Spain
| | - Francisco M Martínez-Arnau
- Frailty and Cognitive Impairment Research Group (FROG), University of Valencia, Menéndez I Pelayo, 19, 46010, Valencia, Spain
- Department of Physiotherapy, Universitat de Valencia, Gascó Oliag 5, 46010, Valencia, Spain
| |
Collapse
|
6
|
Simó-Servat A, Guevara E, Perea V, Alonso N, Quirós C, Puig-Jové C, Barahona MJ. Role of Muscle Ultrasound for the Study of Frailty in Elderly Patients with Diabetes: A Pilot Study. BIOLOGY 2023; 12:884. [PMID: 37372168 DOI: 10.3390/biology12060884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 05/29/2023] [Accepted: 06/15/2023] [Indexed: 06/29/2023]
Abstract
BACKGROUND Sarcopenia and diabetes contribute to the development of frailty. Therefore, accessible methods, such as muscle ultrasounds (MUSs), to screen for sarcopenia should be implemented in clinical practice. METHODS We conducted a cross-sectional pilot study including 47 patients with diabetes (mean age: 77.72 ± 5.08 years, mean weight: 75.8 kg ± 15.89 kg, and body mass index: 31.19 ± 6.65 kg/m2) categorized as frail by the FRAIL Scale or Clinical Frailty Scale and confirmed by Fried's Frailty Phenotype or Rockwood's 36-item Frailty Index. We used the SARC-F questionnaire to identify sarcopenia. The Short Physical Performance Battery (SPPB) and the Timed Up and Go (TUG) tests were used to assess physical performance and the risk of falls, respectively. In addition, other variables were measured: fat-free mass (FFM) and Sarcopenia Risk Index (SRI) with the bioimpedance analysis (BIA); thigh muscle thickness (TMT) of the quadriceps with MUS; and hand-grip strength with dynamometry. RESULTS We observed correlations between the SARC-F and FFM (R = -0.4; p < 0.002) and hand-grip strength (R = -0.5; p < 0.0002), as well as between the TMT and FFM of the right leg (R = 0.4; p < 0.02) and the SRI (R = 0.6; p < 0.0001). We could predict sarcopenia using a logistic regression model with a ROC curve (AUC = 0.78) including FFM, handgrip strength, and TMT. The optimal cut-off point for maximum efficiency was 1.58 cm for TMT (sensitivity = 71.4% and specificity = 51.5%). However, we did not observe differences in the TMT among groups of greater/less frailty based on the SARC-F, SPPB, and TUG (p > 0.05). CONCLUSIONS MUSs, which correlated with the BIA (R = 0.4; p < 0.02), complemented the diagnosis, identifying regional sarcopenia of the quadriceps in frail patients with diabetes and improving the ROC curve to AUC = 0.78. In addition, a TMT cut-off point for the diagnosis of sarcopenia of 1.58 cm was obtained. Larger studies to validate the MUS technique as a screening strategy are warranted.
Collapse
Affiliation(s)
- Andreu Simó-Servat
- Department of Endocrinology and Nutrition, Hospital Universitari Mútua Terrassa, 08221 Terrassa, Spain
- Department of Medicine, Autonomous University of Barcelona, 08193 Barcelona, Spain
| | - Ernesto Guevara
- Department of Geriatrics, Hospital Universitari Mútua Terrassa, 08221 Terrassa, Spain
| | - Verónica Perea
- Department of Endocrinology and Nutrition, Hospital Universitari Mútua Terrassa, 08221 Terrassa, Spain
| | - Núria Alonso
- Department of Endocrinology and Nutrition, Hospital Universitari Mútua Terrassa, 08221 Terrassa, Spain
| | - Carmen Quirós
- Department of Endocrinology and Nutrition, Hospital Universitari Mútua Terrassa, 08221 Terrassa, Spain
| | - Carlos Puig-Jové
- Department of Endocrinology and Nutrition, Hospital Universitari Mútua Terrassa, 08221 Terrassa, Spain
| | - María-José Barahona
- Department of Endocrinology and Nutrition, Hospital Universitari Mútua Terrassa, 08221 Terrassa, Spain
| |
Collapse
|
7
|
Protein Supplementation with Short Peptides Prevents Early Muscle Mass Loss after Roux-en-Y-Gastric Bypass. Nutrients 2022; 14:nu14235095. [PMID: 36501125 PMCID: PMC9736680 DOI: 10.3390/nu14235095] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 11/23/2022] [Accepted: 11/26/2022] [Indexed: 12/03/2022] Open
Abstract
Introduction: A significant reduction in fat-free mass (FFM) following bariatric surgery (BS) has been reported, and adequate protein intake is recommended for FFM preservation. Current guidelines of nutritional management after BS recommend complex protein (CP) compounds. However, Roux-en-Y-gastric bypass (RYGB) has a negative impact on CP digestion, leading to protein malabsorption. At present, there is no data regarding the impact of early supplementation with short peptide-based (SPB) or hydroxy methylbutyrate (HMB)-enriched formulas on the evolution of the FFM after the BS. Aim: The aim of this study is to evaluate the effect of nutritional products based on CP, HBM-enriched, or SPB formulas on the FFM of patients that undergo RYGB. Material and methods: This is a prospective interventional study, including three groups of patients (according to the type of protein product) as candidates for BS, recruited between December 2021 and April 2022, matched by age, gender, and BMI. All patients underwent evaluations at baseline and one month post-BS, including: medical history, physical and anthropometric evaluation, bioimpedance, and biochemical analysis. Results: A total of 60 patients were recruited: 63% women, mean age 43.13 ± 9.4 years, and BMI 43.57 ± 4.1 kg/m2. The % of FFM loss from total weight loss (TWL) was significantly lower in the SPB group than CP and HMB groups despite the major %TWL in this group (40.60 ± 17.27 in CP, 34.57 ± 13.15 in HMB, and 19.14 ± 9.38 in SPB, p < 0.001). TWL% was 9.98 ± 1.82 vs. 9.83 ± 2.71 vs. 13.56 ± 4.30, p < 0.001, respectively. Conclusion: In our study, the SPB supplementation prevented almost 50% FFM lost from the TWL than the CP- or HMB-enriched compounds at one month post-BS. These results are significant in the setting of muscle mass preservation after the BS, and have the potential to change the current guidelines for the management of nutritional supplementation after BS.
Collapse
|
8
|
Monterrosa-Castro Á, Prada-Tobar M, Monterrosa-Blanco A, Pérez-Romero D, Salas-Becerra C, Redondo-Mendoza V. Clinical suspicion of sarcopenic obesity and probable sarcopenic obesity in Colombian women with a history of surgical menopause: a cross-sectional study. Menopause 2022; 29:664-670. [PMID: 35674647 DOI: 10.1097/gme.0000000000001960] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To identify the frequency of clinical suspicion of sarcopenic obesity (CSSO) and probable sarcopenic obesity (PSO) and to estimate the association between them and surgical menopause. METHODS A cross-sectional study carried out in women residing in Colombia, ages 60 to 75 years. Body mass index, the SARC-F scale, SARC-CalF < 31, and SARC-CalF <33 versions adding the calf circumference measurement in the last two were used to identify CSSO. Muscle strength measurement was added to the above measures to establish PSO. Surgical menopause was defined in women who underwent bilateral oophorectomy simultaneously with hysterectomy before natural menopause. Adjusted and unadjusted logistic regression were performed between CSSO or PSO with surgical menopause, bilateral oophorectomy after natural menopause, and abdominal hysterectomy with ovarian preservation. All participants provided informed consent. P < 0.05 was statistically significant. RESULTS Seven hundred women 67.0 ± 4.8 years old were included; 23.7% were obese, 68.1% had reduced muscle strength, and 4.2% had surgical menopause. CSSO was found in 3.0% with SARC-F and with SARC-CalF < 31; whereas 2.0% were found with SARC-CalF <33. PSO was found in 2.4%, 1.5%, and 2.2% with SARC-F, SARC-CalF <31, and SARC-CalF <33, respectively. Surgical menopause was associated with PSO but was not associated with CSSO. Bilateral oophorectomy after menopause and hysterectomy with ovarian preservation were not associated with CSSO or PSO. CONCLUSIONS In a group of older adult women, the frequency of CSSO was up to 3.0% and PSO up to 2.4%. Surgical menopause was statistically significantly associated with PSO. On the contrary, CSSO was not associated.
Collapse
Affiliation(s)
- Álvaro Monterrosa-Castro
- Grupo de Investigación Salud de la Mujer, Faculty of Medicine, University of Cartagena, Cartagena, Colombia
| | | | | | | | | | | |
Collapse
|
9
|
Wagner PP, Foesser D, Chapurlat R, Szulc P. Risk Factors for the Incident Decline of Physical Performance in Older Men: The Prospective Strambo Study. Calcif Tissue Int 2022; 110:428-440. [PMID: 34718830 DOI: 10.1007/s00223-021-00926-0] [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: 06/17/2021] [Accepted: 10/17/2021] [Indexed: 11/25/2022]
Abstract
Risk factors of physical performance decline in older men remain uncertain. We assessed risk factors of incident physical performance deterioration in older men followed up prospectively. In a cohort of 821 men aged 60-87, physical performance was assessed by four tests (five chair stands, standing with closed eyes, forward and backward tandem walk) at baseline, 4 and 8 years. Various predictive biological measurements were performed at baseline. Serum creatinine/ cystatin C (Cr/CysC) ratio was used as an index of muscle mass. In multivariate models, higher age, higher fat mass index (FMI = fat mass/height2), low physical activity, prior stroke and fracture were associated with poor physical performance at baseline. Higher age, low physical activity, low calcium intake, prior non-vertebral fractures, low apparent free testosterone concentration and poor health status were associated with higher risk of loss to follow-up. Low grip strength, Parkinson's disease and stroke were associated with higher risk of incident inability to do five chair stands. Low Cr/CysC ratio and high FMI were associated with high risk of incident inability to perform forward and backward tandem walk. Sarcopenic obesity (co-occurrence of lower tertile of Cr/CysC and upper tertile of FMI) was associated with higher risk of incident inability to perform forward (OR = 3.31, 95% CI 1.88-5.84, p < 0.001) and backward tandem walk and of incident inability to perform more than one test (OR = 5.82, 95% CI 1.29-26.27, p < 0.001). In conclusion, sarcopenic obesity and poor health are associated with higher risk of incident severe decline of physical performance.
Collapse
Affiliation(s)
- Philippe Paul Wagner
- INSERM UMR1033, University of Lyon, Hôpital Edouard Herriot, Pavillon F, Place d'Arsonval, 69437, Lyon, France
| | - Dominique Foesser
- INSERM UMR1033, University of Lyon, Hôpital Edouard Herriot, Pavillon F, Place d'Arsonval, 69437, Lyon, France
| | - Roland Chapurlat
- INSERM UMR1033, University of Lyon, Hôpital Edouard Herriot, Pavillon F, Place d'Arsonval, 69437, Lyon, France
- Department of Rheumatology, Hospices Civils de Lyon, Hôpital Edouard Herriot, Pavillon F, Place d'Arsonval, 69437, Lyon, France
| | - Pawel Szulc
- INSERM UMR1033, University of Lyon, Hôpital Edouard Herriot, Pavillon F, Place d'Arsonval, 69437, Lyon, France.
| |
Collapse
|
10
|
Nuijten MAH, Eijsvogels TMH, Monpellier VM, Janssen IMC, Hazebroek EJ, Hopman MTE. The magnitude and progress of lean body mass, fat-free mass, and skeletal muscle mass loss following bariatric surgery: A systematic review and meta-analysis. Obes Rev 2022; 23:e13370. [PMID: 34664391 PMCID: PMC9285034 DOI: 10.1111/obr.13370] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 09/09/2021] [Accepted: 09/09/2021] [Indexed: 12/14/2022]
Abstract
Postbariatric loss of muscle tissue could negatively affect long-term health due to its role in various bodily processes, such as metabolism and functional capacity. This meta-analysis aimed to unravel time-dependent changes in the magnitude and progress of lean body mass (LBM), fat-free mass (FFM), and skeletal muscle mass (SMM) loss following bariatric surgery. A systematic literature search was conducted in Pubmed, Embase, and Web of Science. Fifty-nine studies assessed LBM (n = 37), FFM (n = 20), or SMM (n = 3) preoperatively and ≥1 time points postsurgery. Random-effects meta-analyses were performed to determine pooled loss per outcome parameter and follow-up time point. At 12-month postsurgery, pooled LBM loss was -8.13 kg [95%CI -9.01; -7.26]. FFM loss and SMM loss were -8.23 kg [95%CI -10.74; -5.73] and -3.18 kg [95%CI -5.64; -0.71], respectively. About 55% of 12-month LBM loss occurred within 3-month postsurgery, followed by a more gradual decrease up to 12 months. Similar patterns were seen for FFM and SMM. In conclusion, >8 kg of LBM and FFM loss was observed within 1-year postsurgery. LBM, FFM, and SMM were predominantly lost within 3-month postsurgery, highlighting that interventions to mitigate such losses should be implemented perioperatively.
Collapse
Affiliation(s)
- Malou A H Nuijten
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Thijs M H Eijsvogels
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | | | - Eric J Hazebroek
- Departement of Surgery, Rijnstate Hospital/Vitalys Clinics, Arnhem, The Netherlands
| | - Maria T E Hopman
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands
| |
Collapse
|
11
|
Nicolau J, Ayala L, Sanchís P, Rodríguez I, Romano A, Dotres K, Pujol A, Masmiquel L. The coexistence of low albumin levels and obesity worsens clinical outcomes among subjects admitted for sars-cov-2 infection. Clin Nutr ESPEN 2021; 46:434-438. [PMID: 34857231 PMCID: PMC8463107 DOI: 10.1016/j.clnesp.2021.09.722] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 09/17/2021] [Accepted: 09/19/2021] [Indexed: 01/08/2023]
Abstract
Background and aims The clinical spectrum of the SARS-CoV-2 infection is very broad, ranging from asymptomatic infection to severe pneumonia. However, the majority of fatalities related to COVID-19 have involved old, frail and patients with comorbidities, such as obesity, groups that also have high rates of a poor nutritional status. To assess the impact on clinical outcomes of the coexistence of any degree of obesity and low albumin levels on admission among patients with COVID-19. Methods This is a sub-analysis of a former study where 75 patients admitted due to COVID-19 were evaluated cross-sectionally. In this analysis, patients were divided in two groups, according to the presence of obesity and albumin levels on admission lower than 3.5 g/dl. Results 11 out 75 patients evaluated (14.7%) had obesity and albumin levels lower than 3.5 g/dl. Patients with obesity and hypoalbuminemia were older than patients without these two conditions (65.3 ± 7.7 vs 54.2 ± 17 years; p = 0.01). CRP (141.4 ± 47.9 vs 70.1 ± 60.6 mg/l; p = 0.002), D-dimer (2677.3 ± 2358.3 vs 521.7 ± 480.3 ng/ml; p = 0.001), fibrinogen (765.9 ± 123.9 vs 613.5 ± 158gr/L; p = 0.007) ferritin levels (903.1 ± 493 vs 531.4 ± 418.9 mcg/l; p = 0.01) and procalcitonin (3.5 ± 0.6 vs 1.1 ± 0.7 ng/ml; p = 0.009) were significantly higher in the group with obesity and hypoalbuminemia. Among patients with low albumin and obesity, length of hospital was higher (21.9 ± 18.7 vs 10.5 ± 9.5 days; p = 0.004) and the proportion of subjects admitted to ICU was greater (81.8% vs 11.5%; p < 0.0001). However, mortality rates were comparable between the two groups (3.8% vs 0%; p = 0.5). Conclusions The combination of obesity and hypoalbuminemia may worsen the prognosis of patients with a SARS-CoV-2 infection. Therefore, prompt identification and amelioration of nutritional status could be beneficial.
Collapse
Affiliation(s)
- Joana Nicolau
- Endocrinology and Nutrition Department, Hospital Universitario Son Llàtzer, Health Research Institute of the Balearic Islands (IdISBa), Ctra Manacor Km 4, 07198, Palma de Mallorca, Baleares, Spain.
| | - Luisa Ayala
- Endocrinology and Nutrition Department, Hospital Universitario Son Llàtzer, Health Research Institute of the Balearic Islands (IdISBa), Ctra Manacor Km 4, 07198, Palma de Mallorca, Baleares, Spain
| | - Pilar Sanchís
- Endocrinology and Nutrition Department, Hospital Universitario Son Llàtzer, Health Research Institute of the Balearic Islands (IdISBa), Ctra Manacor Km 4, 07198, Palma de Mallorca, Baleares, Spain
| | - Irene Rodríguez
- Endocrinology and Nutrition Department, Hospital Universitario Son Llàtzer, Health Research Institute of the Balearic Islands (IdISBa), Ctra Manacor Km 4, 07198, Palma de Mallorca, Baleares, Spain
| | - Andrea Romano
- Endocrinology and Nutrition Department, Hospital Universitario Son Llàtzer, Health Research Institute of the Balearic Islands (IdISBa), Ctra Manacor Km 4, 07198, Palma de Mallorca, Baleares, Spain
| | - Keyla Dotres
- Endocrinology and Nutrition Department, Hospital Universitario Son Llàtzer, Health Research Institute of the Balearic Islands (IdISBa), Ctra Manacor Km 4, 07198, Palma de Mallorca, Baleares, Spain
| | - Antelm Pujol
- Endocrinology and Nutrition Department, Hospital Universitario Son Llàtzer, Health Research Institute of the Balearic Islands (IdISBa), Ctra Manacor Km 4, 07198, Palma de Mallorca, Baleares, Spain
| | - Lluís Masmiquel
- Endocrinology and Nutrition Department, Hospital Universitario Son Llàtzer, Health Research Institute of the Balearic Islands (IdISBa), Ctra Manacor Km 4, 07198, Palma de Mallorca, Baleares, Spain
| |
Collapse
|
12
|
Haigis D, Matting L, Wagner S, Sudeck G, Frahsa A, Thiel A, Eschweiler G, Nieß AM. Identification of Sarcopenic Obesity in German Nursing Home Residents-The Role of Body Composition and Malnutrition in the BaSAlt Cohort-Study. Nutrients 2021; 13:nu13113791. [PMID: 34836048 PMCID: PMC8625583 DOI: 10.3390/nu13113791] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 10/21/2021] [Accepted: 10/25/2021] [Indexed: 12/28/2022] Open
Abstract
Background: Sarcopenic obesity (SO) is a phenotype, which is defined by reduced muscle strength, muscle mass, and obesity. Limited mobility leads to increased sedentary behavior and decreased physical activity. Both sarcopenia and obesity are aggravated by these factors. In combination, SO is an additional challenge for the setting nursing home (NH). Previous studies have shown a low prevalence of residents with SO in comparable settings, such as community-dwelling. We hypothesize that the BaSAlt cohort also has a small proportion of residents with SO. Methods: For the analysis, 66 residents (women: 74.2%) aged ≥ 65 years from NH, were screened for SO based on EWGSOP2 specifications and cut-off values to classify obesity. Results: Severe sarcopenia was quantified in eleven residents (16.7%). The majority of sarcopenic residents were women (n = 10) compared to men (n = 1). However, no SO could be identified by assessment of body mass index, fat mass in percentage, and fat mass index. Conclusion: As expected, the setting-specific cohort showed a low number of SO. Furthermore, no case of SO was identified in our study. Sarcopenia was associated with an increased fat-free mass in NH residents. Nevertheless, sarcopenia and obesity play important roles in the preservation of residents’ health.
Collapse
Affiliation(s)
- Daniel Haigis
- Department of Sports Medicine, University Hospital of Tuebingen, 72076 Tübingen, Germany; (S.W.); (A.M.N.)
- Interfaculty Research Institute for Sport and Physical Activity, University of Tuebingen, 72074 Tübingen, Germany; (L.M.); (G.S.); (A.F.); (A.T.)
- Correspondence:
| | - Leon Matting
- Interfaculty Research Institute for Sport and Physical Activity, University of Tuebingen, 72074 Tübingen, Germany; (L.M.); (G.S.); (A.F.); (A.T.)
- Institute of Sport Science, Faculty of Economics and Social Sciences, Eberhard Karls University of Tuebingen, 72074 Tübingen, Germany
| | - Silas Wagner
- Department of Sports Medicine, University Hospital of Tuebingen, 72076 Tübingen, Germany; (S.W.); (A.M.N.)
- Interfaculty Research Institute for Sport and Physical Activity, University of Tuebingen, 72074 Tübingen, Germany; (L.M.); (G.S.); (A.F.); (A.T.)
| | - Gorden Sudeck
- Interfaculty Research Institute for Sport and Physical Activity, University of Tuebingen, 72074 Tübingen, Germany; (L.M.); (G.S.); (A.F.); (A.T.)
- Institute of Sport Science, Faculty of Economics and Social Sciences, Eberhard Karls University of Tuebingen, 72074 Tübingen, Germany
| | - Annika Frahsa
- Interfaculty Research Institute for Sport and Physical Activity, University of Tuebingen, 72074 Tübingen, Germany; (L.M.); (G.S.); (A.F.); (A.T.)
- Institute of Sport Science, Faculty of Economics and Social Sciences, Eberhard Karls University of Tuebingen, 72074 Tübingen, Germany
- Institute of Social and Preventive Medicine, Faculty of Medicine, University of Bern, 3012 Bern, Switzerland
| | - Ansgar Thiel
- Interfaculty Research Institute for Sport and Physical Activity, University of Tuebingen, 72074 Tübingen, Germany; (L.M.); (G.S.); (A.F.); (A.T.)
- Institute of Sport Science, Faculty of Economics and Social Sciences, Eberhard Karls University of Tuebingen, 72074 Tübingen, Germany
| | - Gerhard Eschweiler
- Centre for Geriatric Medicine, Faculty of Medicine, University Hospital of Tuebingen, 72076 Tübingen, Germany;
| | - Andreas Michael Nieß
- Department of Sports Medicine, University Hospital of Tuebingen, 72076 Tübingen, Germany; (S.W.); (A.M.N.)
- Interfaculty Research Institute for Sport and Physical Activity, University of Tuebingen, 72074 Tübingen, Germany; (L.M.); (G.S.); (A.F.); (A.T.)
| |
Collapse
|
13
|
Understanding the biology of volumetric muscle loss for an individualized exercise rehabilitation approach in breast cancer patients. Curr Opin Pharmacol 2021; 58:27-34. [PMID: 33848933 DOI: 10.1016/j.coph.2021.03.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 02/11/2021] [Accepted: 03/14/2021] [Indexed: 12/11/2022]
Abstract
Muscle maintenance relies on a multidimensional biologic balance that is extremely delicate in breast cancer patients, particularly those with advanced-stage disease. The biology that underpins breast cancer tumorigenesis, tumor progression and response to pharmacotherapies can modify muscle homeostasis, resulting in volumetric muscle loss. This condition dramatically increases the overall patients' frailty, leading to reduced survival and impaired quality of life. Physical activity may potentially improve muscle health in these patients, providing that an optimal patients selection is performed. The understanding of volumetric muscle loss biology in breast cancer survivors, coupled with focused clinical studies, would allow for the implementation of individualized rehabilitation protocols.
Collapse
|