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Guo B, Liu X, Si Q, Zhang D, Li M, Li X, Zhao Y, Hu F, Zhang M, Liu Y, Hu D. Associations of CBC-Derived inflammatory indicators with sarcopenia and mortality in adults: evidence from Nhanes 1999 ∼ 2006. BMC Geriatr 2024; 24:432. [PMID: 38755603 PMCID: PMC11100216 DOI: 10.1186/s12877-024-05012-2] [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: 02/14/2024] [Accepted: 04/25/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND It has been proposed that inflammation plays a role in the development of sarcopenia. This study aimed to investigate the links of complete blood cell count (CBC) parameters and CBC-derived inflammatory indicators with sarcopenia and mortality. METHODS Data pertaining to sarcopenia were extracted from the 1999-2006 National Health and Nutrition Examination Survey (NHANES), and mortality events were ascertained through the National Death Index up to December 31, 2019. The CBC-derived inflammatory indicators assessed in this study included the neutrophil-to-lymphocyte ratio (NLR), derived neutrophil-to-lymphocyte ratio (dNLR), monocyte-to-lymphocyte ratio (MLR), neutrophil-monocyte to lymphocyte ratio (NMLR), systemic inflammatory response index (SIRI), and systemic immune-inflammation index (SII). The prognostic significance of these CBC-derived inflammatory indicators was evaluated using the random survival forests (RSF) analysis. RESULTS The study encompassed a cohort of 12,689 individuals, among whom 1,725 were diagnosed with sarcopenia. Among individuals with sarcopenia, 782 experienced all-cause mortality, and 195 succumbed to cardiovascular causes. Following adjustment for confounding variables, it was observed that elevated levels of NLR, dNLR, NMLR, SIRI, and SII were associated with an increased prevalence of sarcopenia. Among participants with sarcopenia, those in the highest quartile of NLR (HR = 1.336 [1.095-1.631]), dNLR (HR = 1.274 [1.046-1.550]), MLR (HR = 1.619 [1.290-2.032]), NMLR (HR = 1.390 [1.132-1.707]), and SIRI (HR = 1.501 [1.210-1.862]) exhibited an elevated risk of all-cause mortality compared to those in the lowest quartile of these inflammation-derived indicators. These associations were similarly observed in cardiovascular mortality (HR = 1.874 [1.169-3.003] for MLR, HR = 1.838 [1.175-2.878] for SIRI). The RSF analysis indicated that MLR exhibited the highest predictive power for both all-cause and cardiovascular mortality among individuals with sarcopenia. CONCLUSIONS Our findings underscore the association between CBC-derived inflammatory indicators and mortality in adults with sarcopenia. Of note, MLR emerged as the most robust predictor of all-cause and cardiovascular mortality in this population.
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Affiliation(s)
- Botang Guo
- Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University Medical School, YouYi Road 47, Shenzhen, 518000, Guangdong, People's Republic of China
| | - Xinqing Liu
- College of Medical Administration, Harbin Medical University, Heilongjiang Province, Harbin, 150078, China
| | - Qi Si
- College of Medical Administration, Harbin Medical University, Heilongjiang Province, Harbin, 150078, China
| | - Dongdong Zhang
- Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University Medical School, YouYi Road 47, Shenzhen, 518000, Guangdong, People's Republic of China
| | - Minyao Li
- Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University Medical School, YouYi Road 47, Shenzhen, 518000, Guangdong, People's Republic of China
| | - Xi Li
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Henan Province, Zhengzhou, 450001, China
| | - Yang Zhao
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Henan Province, Zhengzhou, 450001, China
| | - Fulan Hu
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Medical School, Shenzhen, 518073, Guangdong Province, China
| | - Ming Zhang
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Medical School, Shenzhen, 518073, Guangdong Province, China
| | - Yu Liu
- Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University Medical School, YouYi Road 47, Shenzhen, 518000, Guangdong, People's Republic of China.
| | - Dongsheng Hu
- Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University Medical School, YouYi Road 47, Shenzhen, 518000, Guangdong, People's Republic of China.
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Medical School, Shenzhen, 518073, Guangdong Province, China.
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Nie L, Yang Q, Song Q, Zhou Y, Zheng W, Xu Q. Sarcopenia in peripheral arterial disease: Establishing and validating a predictive nomogram based on clinical and computed tomography angiography indicators. Heliyon 2024; 10:e28732. [PMID: 38590906 PMCID: PMC10999995 DOI: 10.1016/j.heliyon.2024.e28732] [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: 12/20/2023] [Revised: 03/21/2024] [Accepted: 03/22/2024] [Indexed: 04/10/2024] Open
Abstract
Purpose To establish, validate, and clinically evaluate a nomogram for predicting the risk of sarcopenia in patients with peripheral arterial disease (PAD) based on clinical and lower extremity computed tomography angiography (LE-CTA) imaging characteristics. Methods Clinical data and CTA imaging features from 281 PAD patients treated between January 1, 2019, and May 1, 2023, at two hospitals were retrospectively analyzed using binary logistic regression to identify the independent risk factors for sarcopenia. These identified risk factors were used to develop a predictive nomogram. The nomogram's effectiveness was assessed through various metrics, including the receiver operating characteristic (ROC) curve, area under the curve (AUC), concordance index (C-index), Hosmer-Lemeshow (HL) test, and calibration curve. Its clinical utility was demonstrated using decision curve analysis (DCA). Results Several key independent risk factors for sarcopenia in PAD patients were identified, namely age, body mass index (BMI), history of coronary heart disease (CHD), and white blood cell (WBC) count, as well as the severity of luminal stenosis (P < 0.05). The discriminative ability of the nomogram was supported by the C-index and an AUC of 0.810 (95% confidence interval: 0.757-0.862). A robust concordance between predicted and observed outcomes was reflected by the calibration curve. The HL test further affirmed the model's calibration with a P-value of 0.40. The DCA curve validated the nomogram's favorable clinical utility. Lastly, the model underwent internal validation. Conclusions A simple nomogram based on five independent factors, namely age, BMI, history of CHD, WBC count, and the severity of luminal stenosis, was developed to assist clinicians in estimating sarcopenia risk among PAD patients. This tool boasts impressive predictive capabilities and broad utility, significantly aiding clinicians in identifying high-risk individuals and enhancing the prognosis of PAD patients.
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Affiliation(s)
- Lu Nie
- Department of Intervention Vascular, Wujin Hospital Affiliated with Jiangsu University, Changzhou, China
- Wujin Clinical College of Xuzhou Medical University, Changzhou, China
| | - Qifan Yang
- Department of Gastroenterology, People's Hospital Affiliated with Jiangsu University, Zhenjiang, China
| | - Qian Song
- Department of Intervention Vascular, Wujin Hospital Affiliated with Jiangsu University, Changzhou, China
- Wujin Clinical College of Xuzhou Medical University, Changzhou, China
| | - Yu Zhou
- Department of Intervention Vascular, Wujin Hospital Affiliated with Jiangsu University, Changzhou, China
- Wujin Clinical College of Xuzhou Medical University, Changzhou, China
| | - Weimiao Zheng
- Department of Intervention Vascular, Wujin Hospital Affiliated with Jiangsu University, Changzhou, China
- Wujin Clinical College of Xuzhou Medical University, Changzhou, China
| | - Qiang Xu
- Department of Intervention Vascular, Wujin Hospital Affiliated with Jiangsu University, Changzhou, China
- Wujin Clinical College of Xuzhou Medical University, Changzhou, China
- Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, Xuzhou Medical University, Xuzhou, Jiangsu, China
- Changzhou Key Laboratory of Molecular Diagnostics and Precision Cancer Medicine, Changzhou, China
- Wujin Institute of Molecular Diagnostics and Precision Cancer Medicine of Jiangsu University, Changzhou, China
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Sutandyo N, Cintakaweni DMW, Setiawan L, Hariani R, Utami N. Association of Body Composition and Handgrip Strength with Interleukin-6 (IL-6) and Vitamin D Level in Cancer Patients. Int J Gen Med 2023; 16:1995-2001. [PMID: 37251283 PMCID: PMC10224722 DOI: 10.2147/ijgm.s388457] [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: 09/30/2022] [Accepted: 04/28/2023] [Indexed: 05/31/2023] Open
Abstract
Introduction Cachexia is prevalent in cancer and is associated with poorer prognosis. We aimed to investigate the association of interleukin-6 (IL-6) and vitamin D levels with cachexia in cancer patients. We also assessed the relationship between body composition profile and cachexia, IL-6, and vitamin D levels. Methods A cross-sectional study was conducted at Dharmais National Cancer Hospital. The study included patients with newly diagnosed biopsy-proven nasopharyngeal cancer, lung cancer, breast cancer, cervical cancer, or non-Hodgkin lymphoma. Blood samples, anthropometrics, and body composition were measured. Results A total of 150 cancer patients were included in the study, with a median age of 52 years, and 64% (n = 96) are female. The prevalence of cachexia was 57%. Cancer patients with cachexia had higher IL-6 levels (P = 0.025). No association between cachexia and vitamin D levels was found (P = 0.787). Patients with cachexia had lower body composition components than those without cachexia (P < 0.05). Vitamin D levels were positively correlated with muscle mass, visceral fat, and handgrip strength (P < 0.05), while no association between IL-6 and body composition was found. Conclusion Cancer-associated cachexia is associated with a higher level of IL-6, lower BMI, lower fat mass index, and lower visceral fat. Vitamin D levels, but not IL-6, are correlated with muscle mass, muscle strength, and visceral fat in cancer patients.
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Affiliation(s)
- Noorwati Sutandyo
- Department of Hematology and Medical Oncology, Dharmais National Cancer Center Hospital, Jakarta, Indonesia
| | | | - Lyana Setiawan
- Department of Integrated Laboratory, Dharmais National Cancer Center Hospital, Jakarta, Indonesia
| | - Ririn Hariani
- Department of Clinical Nutrition, Dharmais National Cancer Center Hospital, Jakarta, Indonesia
| | - Nani Utami
- Department of Clinical Nutrition, Dharmais National Cancer Center Hospital, Jakarta, Indonesia
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Fuentes-Abolafio IJ, Ricci M, Bernal-López MR, Gómez-Huelgas R, Cuesta-Vargas AI, Pérez-Belmonte LM. Biomarkers and the quadriceps femoris muscle architecture assessed by ultrasound in older adults with heart failure with preserved ejection fraction: a cross-sectional study. Aging Clin Exp Res 2022; 34:2493-2504. [PMID: 35939260 PMCID: PMC9637604 DOI: 10.1007/s40520-022-02189-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 06/17/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Sarcopenia is an important comorbidity in patients with heart failure with preserved ejection fraction (HFpEF). The ultrasound (US) assessment has all the advantages of being used in primary care to assess muscle quantity and quality. Some biomarkers could be indicative of muscle mass loss. AIMS To describe the quantitative and qualitative characteristics of the quadriceps femoris assessed by US in older adults with HFpEF and to assess the relationship of the blood and urinary biomarkers, the polypharmacy and comorbidities with US outcomes in older adults with HFpEF. METHODS A cross-sectional study was conducted. 76 older adults with HFpEF were included. The quadriceps femoris muscle thickness (MT, cm), the subcutaneous fat tissue thickness (FT, cm), the muscle echo intensity (MEI) and the subcutaneous fat tissue echo intensity (FEI) were assessed by US in a non-contraction (non-con) and contraction (con) situations. Polypharmacy, comorbidities, blood and urine biomarkers were also collected. RESULTS The carbohydrate antigen 125 (CA-125), the folic acid and the urine creatinine shared the 86.6% variance in the non-con MT, adjusted by age, sex and body mass index (BMI). The folic acid shared the 38.5% of the variance in the con MT, adjusted by age, sex and BMI. The glycosylated haemoglobin explained the 39.6% variance in the non-con MEI, adjusted by age, sex and BMI. The chlorine (Cl-) explained the 40.2% of the variance in the non-con FT, adjusted by age, sex and BMI. The polypharmacy and the folic acid explained the 37.9% of variance in the non-con FEI, while the polypharmacy and the thyrotropin (TSH) shared the 44.4% of variance in the con FEI, both adjusted by age, sex and BMI. No comorbidities, polypharmacy, or blood and urinary biomarkers could explain the con MEI and the con FT variance. CONCLUSIONS Blood and urinary biomarkers obtained in routine analyses could help clinicians detect US outcome changes in older adults with HFpEF and identify a worsening of sarcopenia. TRIAL REGISTRATION NCT03909919. April 10, 2019. Retrospectively registered.
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Affiliation(s)
- Iván José Fuentes-Abolafio
- Grupo de Investigación Clinimetría CTS-631, Departamento de Fisioterapia, Universidad de Málaga, C/Arquitecto Peñalosa, 3, 29071, Málaga, Spain
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA, Plataforma Bionand, Málaga, Spain
| | - Michele Ricci
- Departamento de Medicina Interna, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - María Rosa Bernal-López
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA, Plataforma Bionand, Málaga, Spain
- Departamento de Medicina Interna, Hospital Regional Universitario de Málaga, Málaga, Spain
- CIBER Fisio-Patología de La Obesidad Y La Nutrición, Instituto de Salud Carlos III, Madrid, Spain
| | - Ricardo Gómez-Huelgas
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA, Plataforma Bionand, Málaga, Spain
- Departamento de Medicina Interna, Hospital Regional Universitario de Málaga, Málaga, Spain
- CIBER Fisio-Patología de La Obesidad Y La Nutrición, Instituto de Salud Carlos III, Madrid, Spain
| | - Antonio Ignacio Cuesta-Vargas
- Grupo de Investigación Clinimetría CTS-631, Departamento de Fisioterapia, Universidad de Málaga, C/Arquitecto Peñalosa, 3, 29071, Málaga, Spain.
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA, Plataforma Bionand, Málaga, Spain.
- School of Clinical Sciences, Faculty of Health at the Queensland University of Technology, Brisbane, QLD, Australia.
| | - Luis Miguel Pérez-Belmonte
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA, Plataforma Bionand, Málaga, Spain
- Departamento de Medicina Interna, Hospital Regional Universitario de Málaga, Málaga, Spain
- Unidad de Neurofisiología Cognitiva, Centro de Investigaciones Médico Sanitarias (CIMES), Universidad de Málaga (UMA), Campus de Excelencia Internacional (CEI) Andalucía Tech, Málaga, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain
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Chen L, Arai H, Assantachai P, Akishita M, Chew ST, Dumlao LC, Duque G, Woo J. Roles of nutrition in muscle health of community-dwelling older adults: evidence-based expert consensus from Asian Working Group for Sarcopenia. J Cachexia Sarcopenia Muscle 2022; 13:1653-1672. [PMID: 35307982 PMCID: PMC9178363 DOI: 10.1002/jcsm.12981] [Citation(s) in RCA: 52] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 02/15/2022] [Indexed: 12/29/2022] Open
Abstract
General muscle health declines with age, and in particular, sarcopenia-defined as progressive loss of muscle mass and strength/physical performance-is a growing issue in Asia with a rising population of community-dwelling older adults. Several guidelines have addressed early identification of sarcopenia and management, and although nutrition is central to treatment of sarcopenia, there are currently few guidelines that have examined this specifically in the Asian population. Therefore, the Asian Working Group for Sarcopenia established a special interest group (SIG) comprising seven experts across Asia and one from Australia, to develop an evidence-based expert consensus. A systematic literature search was conducted using MEDLINE on the topic of muscle health, from 2016 (inclusive) to July 2021, in Asia or with relevance to healthy, Asian community-dwelling older adults (≥60 years old). Several key topics were identified: (1) nutritional status: malnutrition and screening; (2) diet and dietary factors; (3) nutritional supplementation; (4) lifestyle interventions plus nutrition; and (5) outcomes and assessment. Clinical questions were developed around these topics, leading to 14 consensus statements. Consensus was achieved using the modified Delphi method with two rounds of voting. Moreover, the consensus addressed the impacts of COVID-19 on nutrition, muscle health, and sarcopenia in Asia. These statements encompass clinical expertise and knowledge across Asia and are aligned with findings in the current literature, to provide a practical framework for addressing muscle health in the community, with the overall aim to encourage and facilitate broader access to equitable care for this target population.
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Affiliation(s)
- Liang‐Kung Chen
- Center for Healthy Longevity and Aging SciencesNational Yang Ming Chiao Tung UniversityTaipeiTaiwan
- Center for Geriatrics and GerontologyTaipei Veterans General HospitalTaipeiTaiwan
- Taipei Municipal Gan‐Dau HospitalTaipeiTaiwan
| | - Hidenori Arai
- National Center for Geriatrics and GerontologyObuJapan
| | | | - Masahiro Akishita
- Department of Geriatric Medicine, Graduate School of MedicineThe University of TokyoTokyoJapan
| | - Samuel T.H. Chew
- Department of Geriatric MedicineChangi General Hospital, SingHealthSingapore
| | | | - Gustavo Duque
- Australian Institute for Musculoskeletal Science (AIMSS)The University of Melbourne and Western HealthMelbourneVictoriaAustralia
| | - Jean Woo
- Chinese University of Hong KongHong Kong
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Choo YJ, Chang MC. Prevalence of Sarcopenia Among the Elderly in Korea: A Meta-Analysis. J Prev Med Public Health 2021; 54:96-102. [PMID: 33845529 PMCID: PMC8046603 DOI: 10.3961/jpmph.21.046] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 02/24/2021] [Indexed: 12/25/2022] Open
Abstract
Objectives Sarcopenia is a common disease in the elderly population that causes disability, poor quality of life, and a high risk of death. In the current study, we conducted a meta-analysis to report basic knowledge about the prevalence of sarcopenia in the elderly in Korea. Methods We searched for articles in the MEDLINE, Cochrane Library, Embase, and Scopus databases published until December 28, 2020. Studies investigating the prevalence of sarcopenia in elderly Koreans aged ≥65 years were included. The methodological quality of the studies was evaluated using the Newcastle-Ottawa scale. Publication bias was evaluated using the Egger test and funnel plots. Results In total, 3 studies and 2922 patients were included in the meta-analysis. All 3 studies used the European Working Group on Sarcopenia in Older People criteria for the diagnosis of sarcopenia. The total prevalence of sarcopenia was 13.1-14.9% in elderly men and 11.4% in elderly women. Conclusions This meta-analysis is the first to estimate the pooled prevalence of sarcopenia in elderly Koreans, and its findings suggest that sarcopenia is common in this population. Therefore, attention should be paid to the prevention and control of sarcopenia.
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Affiliation(s)
- Yoo Jin Choo
- Department of Physical Medicine and Rehabilitation, Yeungnam University College of Medicine, Daegu, Korea
| | - Min Cheol Chang
- Department of Physical Medicine and Rehabilitation, Yeungnam University College of Medicine, Daegu, Korea
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Chen CN, Chen TC, Tsai SC, Hwu CM. Factors associated with relative muscle strength in patients with type 2 diabetes mellitus. Arch Gerontol Geriatr 2021; 95:104384. [PMID: 33740478 DOI: 10.1016/j.archger.2021.104384] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 02/22/2021] [Accepted: 02/24/2021] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Some patients with type 2 diabetes mellitus (T2DM) experience decreased mobility associated with lower relative muscle strength (normalized with muscle mass). This study aimed to identify factors predicting relative muscle strength of patients with T2DM assessed at regular clinical visits. METHODS A total of 144 T2DM patients underwent fasting blood drawing (determining white blood cell count [WBC], diabetic kidney disease [DKD], and glycated hemoglobin [HbA1c]) and the assessment of body composition, diabetic peripheral neuropathy (DPN), activity level, and muscle strength (grip, knee extensor, and ankle plantar flexor strength). One-way ANOVA and multiple regression models were used to identify factors associated with the relative muscle strength. RESULTS Our data showed that age, diabetes duration, fat percentage, WBC, DPN, and DKD were negatively associated with the relative muscle strength. Specifically, a greater WBC was associated with lower relative muscle strength of both distal and proximal muscle groups of extremities after the adjustment of other associated factors. DPN was associated with lower relative strength of the distal muscle groups of extremities. CONCLUSIONS WBC may be used as a marker of inflammation, and greater count, even within the normal range, is negatively associated with the relative muscle strength in patients with T2DM.
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Affiliation(s)
- Chiao-Nan Chen
- Department of Physical Therapy and Assistive Technology, School of Biomedical Science and Engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ting-Chung Chen
- Department of Physical Therapy and Assistive Technology, School of Biomedical Science and Engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Shiow-Chwen Tsai
- Institute of Sports Sciences, University of Taipei, Taipei, Taiwan
| | - Chii-Min Hwu
- Section of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Faculty of Medicine, National Yang Ming Chiao Tung University School of Medicine, Taipei, Taiwan.
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Santiago ECS, Roriz AKC, Ramos LB, Ferreira AJF, Oliveira CC, Gomes-Neto M. Comparison of calorie and nutrient intake among elderly with and without sarcopenia: A systematic review and meta-analysis. Nutr Rev 2021; 79:1338-1352. [PMID: 33616172 DOI: 10.1093/nutrit/nuaa145] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
CONTEXT Sarcopenia, besides having an impact on functional capacity, has been associated with increased hospitalization and mortality, and stands out as an essential cause of disability among older people. OBJECTIVE We conducted a systematic review and meta-analysis of published studies comparing the calories and nutrients ingested by elderly people with and without sarcopenia. DATA SOURCES MEDLINE/PubMed, Scopus, LILACS, Cochrane Library, and Scielo databases were searched. STUDY SELECTION Studies comparing calories and nutrient intake among elderly people diagnosed with sarcopenia and people without sarcopenia were included. DATA ANALYSIS Mean differences and 95% confidence intervals (CIs) were calculated, and heterogeneity was assessed using I2 test. RESULTS A total of 23 studies fulfilled the inclusion criteria. The average number of calories and nutrients ingested were significantly lower in elderly study participants with sarcopenia compared with those without sarcopenia. The meta-analyses showed that the average number of calories ingested (n = 19 studies; mean difference, -156.7 kcal; 95%CI, -194.8 to -118.7) were significantly lower in those with sarcopenia than in elderly participants without sarcopenia. Compared to those without sarcopenia, elderly people with sarcopenia consumed lower amounts of proteins; carbohydrates; saturated fatty acids; vitamins A, B12, C, and D; and minerals such as calcium, magnesium, sodium, and selenium. CONCLUSIONS The evidence so far available suggests a difference in caloric, macronutrient (ie, proteins, carbohydrates, saturated fatty acids), and micronutrient (ie calcium, magnesium, sodium, selenium, and vitamins A, B12, C, and D) intake among the elderly with and without sarcopenia. Additional studies are needed to define the best interventions to improve the consumption of calories and nutrients by the aging population.
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Affiliation(s)
- Emanuelle C S Santiago
- E.C.S. Santiago and M. Gomes-Neto are with the Graduate Program in Medicine and Health, Federal University of Bahia, Salvador, Bahia, Brazil. E.C.S. Santiago, A.K.C. Roriz, L.B. Ramos, A.J.F. Ferreira, C.C. Oliveira, and M. Gomes-Neto are with the Aging-Related Research and Intervention Center, Federal University of Bahia, Salvador, Bahia, Brazil. A.K.C. Roriz and L.B. Ramos are with the Graduate Program in Food, Nutrition and Health, Federal University of Bahia, Salvador, Bahia, Brazil. A.J.F. Ferreira is with the Institute of Public Health, Federal University of Bahia, Salvador, Bahia, Brazil. C.C. Oliveira is with the Department of Nutrition, Federal University of Sergipe, Lagarto, Sergipe, Brazil. M. Gomes-Neto is with the Department of Physiotherapy, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Anna K C Roriz
- E.C.S. Santiago and M. Gomes-Neto are with the Graduate Program in Medicine and Health, Federal University of Bahia, Salvador, Bahia, Brazil. E.C.S. Santiago, A.K.C. Roriz, L.B. Ramos, A.J.F. Ferreira, C.C. Oliveira, and M. Gomes-Neto are with the Aging-Related Research and Intervention Center, Federal University of Bahia, Salvador, Bahia, Brazil. A.K.C. Roriz and L.B. Ramos are with the Graduate Program in Food, Nutrition and Health, Federal University of Bahia, Salvador, Bahia, Brazil. A.J.F. Ferreira is with the Institute of Public Health, Federal University of Bahia, Salvador, Bahia, Brazil. C.C. Oliveira is with the Department of Nutrition, Federal University of Sergipe, Lagarto, Sergipe, Brazil. M. Gomes-Neto is with the Department of Physiotherapy, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Lílian B Ramos
- E.C.S. Santiago and M. Gomes-Neto are with the Graduate Program in Medicine and Health, Federal University of Bahia, Salvador, Bahia, Brazil. E.C.S. Santiago, A.K.C. Roriz, L.B. Ramos, A.J.F. Ferreira, C.C. Oliveira, and M. Gomes-Neto are with the Aging-Related Research and Intervention Center, Federal University of Bahia, Salvador, Bahia, Brazil. A.K.C. Roriz and L.B. Ramos are with the Graduate Program in Food, Nutrition and Health, Federal University of Bahia, Salvador, Bahia, Brazil. A.J.F. Ferreira is with the Institute of Public Health, Federal University of Bahia, Salvador, Bahia, Brazil. C.C. Oliveira is with the Department of Nutrition, Federal University of Sergipe, Lagarto, Sergipe, Brazil. M. Gomes-Neto is with the Department of Physiotherapy, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Andrêa J F Ferreira
- E.C.S. Santiago and M. Gomes-Neto are with the Graduate Program in Medicine and Health, Federal University of Bahia, Salvador, Bahia, Brazil. E.C.S. Santiago, A.K.C. Roriz, L.B. Ramos, A.J.F. Ferreira, C.C. Oliveira, and M. Gomes-Neto are with the Aging-Related Research and Intervention Center, Federal University of Bahia, Salvador, Bahia, Brazil. A.K.C. Roriz and L.B. Ramos are with the Graduate Program in Food, Nutrition and Health, Federal University of Bahia, Salvador, Bahia, Brazil. A.J.F. Ferreira is with the Institute of Public Health, Federal University of Bahia, Salvador, Bahia, Brazil. C.C. Oliveira is with the Department of Nutrition, Federal University of Sergipe, Lagarto, Sergipe, Brazil. M. Gomes-Neto is with the Department of Physiotherapy, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Carolina C Oliveira
- E.C.S. Santiago and M. Gomes-Neto are with the Graduate Program in Medicine and Health, Federal University of Bahia, Salvador, Bahia, Brazil. E.C.S. Santiago, A.K.C. Roriz, L.B. Ramos, A.J.F. Ferreira, C.C. Oliveira, and M. Gomes-Neto are with the Aging-Related Research and Intervention Center, Federal University of Bahia, Salvador, Bahia, Brazil. A.K.C. Roriz and L.B. Ramos are with the Graduate Program in Food, Nutrition and Health, Federal University of Bahia, Salvador, Bahia, Brazil. A.J.F. Ferreira is with the Institute of Public Health, Federal University of Bahia, Salvador, Bahia, Brazil. C.C. Oliveira is with the Department of Nutrition, Federal University of Sergipe, Lagarto, Sergipe, Brazil. M. Gomes-Neto is with the Department of Physiotherapy, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Mansueto Gomes-Neto
- E.C.S. Santiago and M. Gomes-Neto are with the Graduate Program in Medicine and Health, Federal University of Bahia, Salvador, Bahia, Brazil. E.C.S. Santiago, A.K.C. Roriz, L.B. Ramos, A.J.F. Ferreira, C.C. Oliveira, and M. Gomes-Neto are with the Aging-Related Research and Intervention Center, Federal University of Bahia, Salvador, Bahia, Brazil. A.K.C. Roriz and L.B. Ramos are with the Graduate Program in Food, Nutrition and Health, Federal University of Bahia, Salvador, Bahia, Brazil. A.J.F. Ferreira is with the Institute of Public Health, Federal University of Bahia, Salvador, Bahia, Brazil. C.C. Oliveira is with the Department of Nutrition, Federal University of Sergipe, Lagarto, Sergipe, Brazil. M. Gomes-Neto is with the Department of Physiotherapy, Federal University of Bahia, Salvador, Bahia, Brazil
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Chen LK, Woo J, Assantachai P, Auyeung TW, Chou MY, Iijima K, Jang HC, Kang L, Kim M, Kim S, Kojima T, Kuzuya M, Lee JSW, Lee SY, Lee WJ, Lee Y, Liang CK, Lim JY, Lim WS, Peng LN, Sugimoto K, Tanaka T, Won CW, Yamada M, Zhang T, Akishita M, Arai H. Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment. J Am Med Dir Assoc 2020; 21:300-307.e2. [PMID: 32033882 DOI: 10.1016/j.jamda.2019.12.012] [Citation(s) in RCA: 2568] [Impact Index Per Article: 642.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 12/11/2019] [Accepted: 12/12/2019] [Indexed: 12/13/2022]
Abstract
Clinical and research interest in sarcopenia has burgeoned internationally, Asia included. The Asian Working Group for Sarcopenia (AWGS) 2014 consensus defined sarcopenia as "age-related loss of muscle mass, plus low muscle strength, and/or low physical performance" and specified cutoffs for each diagnostic component; research in Asia consequently flourished, prompting this update. AWGS 2019 retains the previous definition of sarcopenia but revises the diagnostic algorithm, protocols, and some criteria: low muscle strength is defined as handgrip strength <28 kg for men and <18 kg for women; criteria for low physical performance are 6-m walk <1.0 m/s, Short Physical Performance Battery score ≤9, or 5-time chair stand test ≥12 seconds. AWGS 2019 retains the original cutoffs for height-adjusted muscle mass: dual-energy X-ray absorptiometry, <7.0 kg/m2 in men and <5.4 kg/m2 in women; and bioimpedance, <7.0 kg/m2 in men and <5.7 kg/m2 in women. In addition, the AWGS 2019 update proposes separate algorithms for community vs hospital settings, which both begin by screening either calf circumference (<34 cm in men, <33 cm in women), SARC-F (≥4), or SARC-CalF (≥11), to facilitate earlier identification of people at risk for sarcopenia. Although skeletal muscle strength and mass are both still considered fundamental to a definitive clinical diagnosis, AWGS 2019 also introduces "possible sarcopenia," defined by either low muscle strength or low physical performance only, specifically for use in primary health care or community-based health promotion, to enable earlier lifestyle interventions. Although defining sarcopenia by body mass index-adjusted muscle mass instead of height-adjusted muscle mass may predict adverse outcomes better, more evidence is needed before changing current recommendations. Lifestyle interventions, especially exercise and nutritional supplementation, prevail as mainstays of treatment. Further research is needed to investigate potential long-term benefits of lifestyle interventions, nutritional supplements, or pharmacotherapy for sarcopenia in Asians.
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Affiliation(s)
- Liang-Kung Chen
- Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan; Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan.
| | - Jean Woo
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong S.A.R., China.
| | - Prasert Assantachai
- Division of Geriatric Medicine, Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Tung-Wai Auyeung
- The S. H. Ho Center for Gerontology and Geriatrics, The Chinese University of Hong Kong, Hong Kong S.A.R, China
| | - Ming-Yueh Chou
- Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan; Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Katsuya Iijima
- Institute of Gerontology, The University of Tokyo, Tokyo, Japan
| | - Hak Chul Jang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Lin Kang
- Department of Geriatrics, Peking Union Medical College Hospital, Beijing, China
| | - Miji Kim
- Department of Biomedical Science and Technology, College of Medicine, East-West Medical Research Institute, Kyung Hee University, Seoul, Korea
| | - Sunyoung Kim
- Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Taro Kojima
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masafumi Kuzuya
- Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Jenny S W Lee
- The S. H. Ho Center for Gerontology and Geriatrics, The Chinese University of Hong Kong, Hong Kong S.A.R, China
| | - Sang Yoon Lee
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea; Department of Rehabilitation Medicine, Seoul National University Boramae Medical Center, Seoul, Korea
| | - Wei-Ju Lee
- Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan; Department of Family Medicine, Taipei Veterans General Hospital Yuanshan Branch, Yilan, Taiwan
| | - Yunhwan Lee
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea
| | - Chih-Kuang Liang
- Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan; Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Jae-Young Lim
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Wee Shiong Lim
- Institute of Geriatrics and Active Aging, Tan Tock Seng Hospital, Singapore
| | - Li-Ning Peng
- Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan; Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ken Sugimoto
- Department of Geriatric Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Tomoki Tanaka
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Chang Won Won
- Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Minoru Yamada
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Teimei Zhang
- Beijing Institute of Geriatrics, Beijing Hospital, Ministry of Health, Beijing, China
| | - Masahiro Akishita
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, Obu, Aichi, Japan.
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Chao CT, Chen YM, Ho FH, Lin KP, Chen JH, Yen CJ. 10-Year Renal Function Trajectories in Community-Dwelling Older Adults: Exploring the Risk Factors for Different Patterns. J Clin Med 2018; 7:jcm7100373. [PMID: 30347853 PMCID: PMC6210637 DOI: 10.3390/jcm7100373] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Revised: 10/15/2018] [Accepted: 10/19/2018] [Indexed: 12/16/2022] Open
Abstract
Longitudinal changes of renal function help inform patients’ clinical courses and improve risk stratification. Rare studies address risk factors predicting changes in estimated glomerular filtration rate (eGFR) over time in older adults, particularly of Chinese ethnicity. We identified prospectively enrolled community-dwelling older adults (≥65 years) receiving annual health examinations between 2005 and 2015 with serum creatinine available continuously in a single institute, and used linear regression to derive individual’s annual eGFR changes, followed by multivariate logistic regression analyses to identify features associated with different eGFR change patterns. Among 500 elderly (71.3 ± 4.2 years), their mean annual eGFR changes were 0.84 ± 1.67 mL/min/1.73 m2/year, with 136 (27.2%) and 238 (47.6%) classified as having downward (annual eGFR change <0 mL/min/1.73 m2/year) and upward eGFR (≥1 mL/min/1.73 m2/year) trajectories, respectively. Multivariate logistic regression showed that higher age (odds ratio (OR) 1.08), worse renal function (OR 13.2), and more severe proteinuria (OR 9.86) or hematuria (OR 3.39) were predictive of a declining eGFR while greater waist circumference (OR 1.06) and higher leukocyte counts (OR 1.21) were predictive of an uprising 10-year eGFR. These findings elucidate important features associated with geriatric renal function variations, which are expected to improve their renal care.
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Affiliation(s)
- Chia-Ter Chao
- Department of Medicine, National Taiwan University Hospital BeiHu Branch, College of Medicine, National Taiwan University, Taipei 10617, Taiwan.
- Geriatric and Community Medicine Research Center, National Taiwan University Hospital BeiHu Branch, Taipei 10617, Taiwan.
| | - Yung-Ming Chen
- Department of Internal Medicine; National Taiwan University, Taipei 10617, Taiwan.
- Department of Geriatrics and Gerontology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei 10617, Taiwan.
| | - Fu-Hui Ho
- Department of Geriatrics and Gerontology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei 10617, Taiwan.
| | - Kun-Pei Lin
- Department of Geriatrics and Gerontology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei 10617, Taiwan.
| | - Jen-Hau Chen
- Department of Geriatrics and Gerontology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei 10617, Taiwan.
| | - Chung-Jen Yen
- Department of Internal Medicine; National Taiwan University, Taipei 10617, Taiwan.
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