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Herder C, Maalmi H, Saatmann N, Zaharia OP, Strassburger K, Burkart V, Norman K, Roden M. Correlates of Skeletal Muscle Mass and Differences Between Novel Subtypes in Recent-Onset Diabetes. J Clin Endocrinol Metab 2024; 109:e1238-e1248. [PMID: 37831076 PMCID: PMC10876398 DOI: 10.1210/clinem/dgad605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 10/04/2023] [Accepted: 10/11/2023] [Indexed: 10/14/2023]
Abstract
CONTEXT Low skeletal muscle mass (SMM) is associated with long-standing diabetes but little is known about SMM in newly diagnosed diabetes. OBJECTIVE We aimed to identify correlates of SMM in recent-onset diabetes and to compare SMM between novel diabetes subtypes. METHODS SMM was normalized to body mass index (SMM/BMI) in 842 participants with known diabetes duration of less than 1 year from the German Diabetes Study (GDS). Cross-sectional associations between clinical variables, 79 biomarkers of inflammation, and SMM/BMI were assessed, and differences in SMM/BMI between novel diabetes subtypes were analyzed with different degrees of adjustment for confounders. RESULTS Male sex and physical activity were positively associated with SMM/BMI, whereas associations of age, BMI, glycated hemoglobin A1c, homeostatic model assessment for β-cell function, and estimated glomerular filtration rate with SMM/BMI were inverse (all P < .05; model r2 = 0.82). Twenty-three biomarkers of inflammation showed correlations with SMM/BMI after adjustment for sex and multiple testing (all P < .0006), but BMI largely explained these correlations. In a sex-adjusted analysis, individuals with severe autoimmune diabetes had a higher SMM/BMI whereas individuals with severe insulin-resistant diabetes and mild obesity-related diabetes had a lower SMM/BMI than all other subtypes combined. However, differences were attenuated after adjustment for the clustering variables. CONCLUSION SMM/BMI differs between diabetes subtypes and may contribute to subtype differences in disease progression. Of note, clinical variables rather than biomarkers of inflammation explain most of the variation in SMM/BMI.
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Affiliation(s)
- Christian Herder
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf 40225, Germany
- German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg 85764, Germany
- Department of Endocrinology and Diabetology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf 40225, Germany
| | - Haifa Maalmi
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf 40225, Germany
- German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg 85764, Germany
| | - Nina Saatmann
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf 40225, Germany
- German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg 85764, Germany
| | - Oana-Patricia Zaharia
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf 40225, Germany
- German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg 85764, Germany
- Department of Endocrinology and Diabetology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf 40225, Germany
| | - Klaus Strassburger
- German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg 85764, Germany
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf 40225, Germany
| | - Volker Burkart
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf 40225, Germany
- German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg 85764, Germany
| | - Kristina Norman
- Department of Geriatrics and Medical Gerontology, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin 13347, Germany
- Department of Nutrition and Gerontology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal 14558, Germany
- Institute of Nutritional Science, University of Potsdam, Nuthetal 14558, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin 10785, Germany
| | - Michael Roden
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf 40225, Germany
- German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg 85764, Germany
- Department of Endocrinology and Diabetology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf 40225, Germany
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Yerrakalva D, Hajna S, Khaw KT, Griffin SJ, Brage S. Prospective associations between changes in physical activity and sedentary time and subsequent lean muscle mass in older English adults: the EPIC-Norfolk cohort study. Int J Behav Nutr Phys Act 2024; 21:10. [PMID: 38279174 PMCID: PMC10811887 DOI: 10.1186/s12966-023-01547-6] [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: 03/23/2023] [Accepted: 12/05/2023] [Indexed: 01/28/2024] Open
Abstract
BACKGROUND The longitudinal associations between physical behaviours and lean muscle mass indices need to be better understood to aid healthy ageing intervention development. METHODS We assessed physical behaviours (total physical activity, moderate-to-vigorous physical activity (MVPA), light physical activity, total sedentary time and prolonged sedentary bout time) for 7 days using hip-worn accelerometers. We also assessed domain-specific physical behaviours (walking, cycling, gardening and housework time) with self-report questionnaires at baseline (2006-2011) and follow-up (2012-2016) in the European Prospective Investigation into Cancer (EPIC)-Norfolk study. We assessed body composition using dual-energy X-ray absorptiometry (DEXA) at follow-up in 1535 participants (≥ 60 years at baseline). From this, we derived appendicular lean muscle mass (ALM) indices (% relative ALM = (ALM/total body weight)*100), body mass index (BMI)-scaled ALM (ALM/BMI, kg/kg/m2) and height-scaled ALM (ALM/height2, kg/m2)). We evaluated the prospective associations of both baseline and change in physical behaviours with follow-up muscle mass indices using multivariable linear regression. RESULTS Over 5.5 years (SD 14.8) follow-up, higher baseline accelerometer-measured physical activity and lower sedentary time were associated with higher subsequent relative ALM and BMI-scaled ALM, but not height-scaled ALM (e.g. 0.02% higher subsequent relative ALM per minute/day of baseline MVPA for men). Greater increases in physical activity and greater declines in sedentary time variables were associated with higher subsequent relative ALM and BMI-scaled ALM, but not height-scaled ALM (e.g. 0.001 kg/kg/m2 subsequent BMI-scaled ALM and 0.04% subsequent relative ALM per min/day/year increases in LPA over follow-up; 0.001 kg/kg/m2 subsequent BMI-scaled ALM and -0.03% subsequent relative ALM per min/day/year less of total sedentary time over follow-up). Greater increases in women's cycling and gardening over follow-up were associated with greater subsequent relative ALM (cycling 0.9% per hour/week/year; gardening 0.2% per hour/week/year) and BMI-scaled ALM (cycling 0.03 kg/kg/m2 per hour/week/year; gardening 0.004 kg/kg/m2 per hour/week/year). CONCLUSION Physical behaviours across all intensities, and in women more specifically cycling and gardening, may help prevent age-related declines in muscle mass.
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Affiliation(s)
- Dharani Yerrakalva
- Department of Public Health and Primary Care, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Samantha Hajna
- Department of Health Sciences, Faculty of Applied Health Sciences, Brock University, St Catharines, ON, Canada
- MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Cambridge, UK
| | - Kay-Tee Khaw
- Department of Public Health and Primary Care, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Simon J Griffin
- Department of Public Health and Primary Care, University of Cambridge School of Clinical Medicine, Cambridge, UK
- MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Cambridge, UK
| | - Soren Brage
- MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Cambridge, UK.
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3
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Zhong J, Xie W, Wang X, Dong X, Mo Y, Liu D, Yao X, Liu B, Deng W, Su Y, Li Y, Wang X. The Prevalence of Sarcopenia among Hunan Province Community-Dwelling Adults Aged 60 Years and Older and Its Relationship with Lifestyle: Diagnostic Criteria from the Asian Working Group for Sarcopenia 2019 Update. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:1562. [PMID: 36363519 PMCID: PMC9699421 DOI: 10.3390/medicina58111562] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 10/13/2022] [Accepted: 10/27/2022] [Indexed: 01/04/2024]
Abstract
Background and Objectives: This study aims to detect the prevalence of sarcopenia in community-dwelling older adults in Hunan Province, discuss factors related to lifestyle, and provide a reliable basis for the prevention and treatment of sarcopenia. Materials and Methods: In this study, a total of 1040 community-dwelling adults ≥ 60 years were examined for sarcopenia using a cluster stratified random sampling method, which was defined using the diagnostic criteria recommended by the Asian Working Group for Sarcopenia (AWGS) from September 2019 to March 2020. Multivariate logistic regression analysis was applied to determine the correlation between sarcopenia and smoking, drinking, nutritional status, physical activity, and sleep quality. Results: A total of 27.1% of the older adults were diagnosed with sarcopenia, with rates of 26.2% in men and 25.2% in women. Multiple logistic regression showed that advanced age (OR = 2.480, 95% CI: 1.730, 3.553), the risk of malnutrition (OR = 2.085, 95% CI: 1.440, 3.019), and malnutrition (OR = 1.212, 95% CI: 0.304, 4.834) were risk factors for sarcopenia. No falls in the previous year (OR = 0.616, 95% CI: 1.885, 1.209), normal weight (OR = 0.228, 95% CI: 0.109, 0.475), overweight (OR = 0.030, 95% CI: 0.013, 0.069), moderate physical activity (OR = 0.593, 95% CI: 0.377, 0.933), or high physical activity (OR = 0.417, 95% CI: 0.230, 0.755) were identified as protective factors for sarcopenia. Conclusions: The prevalence of sarcopenia was high among older adults in the community in Hunan Province. In addition, we found that lifestyle is an important factor in sarcopenia.
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Affiliation(s)
- Jing Zhong
- Deparment of Nephrology, The Third Xiangya Hospital, Central South University, Changsha 410013, China
| | - Wenqing Xie
- Deparment of Orthopedics, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Xiaoqin Wang
- Department of Geriatrics, The Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Xin Dong
- Xiang Ya Nursing School, Central South University, Changsha 410013, China
| | - Yihan Mo
- Xiang Ya Nursing School, Central South University, Changsha 410013, China
| | - Dan Liu
- Xiang Ya Nursing School, Central South University, Changsha 410013, China
| | - Xuemei Yao
- Xiang Ya Nursing School, Central South University, Changsha 410013, China
| | - Beibei Liu
- Xiang Ya Nursing School, Central South University, Changsha 410013, China
| | - Wenyu Deng
- Xiang Ya Nursing School, Central South University, Changsha 410013, China
| | - Yidong Su
- Xiang Ya Nursing School, Central South University, Changsha 410013, China
| | - Yusheng Li
- Deparment of Orthopedics, Xiangya Hospital, Central South University, Changsha 410008, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Xiuhua Wang
- Xiang Ya Nursing School, Central South University, Changsha 410013, China
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Nikolov J, Norman K, Buchmann N, Spranger J, Demuth I, Steinhagen-Thiessen E, Spira D, Mai K. Association between meal-specific daily protein intake and lean mass in older adults: results of the cross-sectional BASE-II study. Am J Clin Nutr 2021; 114:1141-1147. [PMID: 33963728 DOI: 10.1093/ajcn/nqab144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Accepted: 04/06/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Adequate total and meal-specific protein intake is considered an important prerequisite to preserve appendicular lean mass (ALM) in older adults and to prevent sarcopenia. OBJECTIVES We analyzed the meal-specific protein intake across the main meals between participants with normal vs. low ALM to BMI ratio (ALMBMI). METHODS 782 participants [59.6% men; median 69 (IQR: 65, 71) y] of the Berlin Aging Study II have been included in this analysis. ALM was assessed by dual X-ray absorptiometry. Low lean mass was defined as ALMBMI using recommended sex-specific cut-offs. A 5-day nutritional protocol was used to assess total and meal-specific protein intake. RESULTS Median total protein intake was 0.89 (IQR: 0.74, 1.05) g/kg/d body weight (BW) in participants with low ALMBMI and 1.02 (IQR: 0.86, 1.21) g/kg BW in participants with normal ALMBMI (P < 0.001). Daily protein intake at breakfast was similar in both groups [0.23 (95% CI: 0.20, 0.26) vs. 0.24 (95% CI: 0.23, 0.26) g/kg BW; P = 0.245]. Subjects with low ALMBMI reported a lower protein intake at lunch and dinner compared with those with normal ALMBMI [0.29 (95% CI: 0.27, 0.32) vs. 0.35 (95% CI: 0.34, 0.36) g/kg BW; P = 0.001 and 0.32 (95% CI: 0.30, 0.35) vs. 0.36 (95% CI: 0.35, 0.37) g/kg BW; P = 0.027, respectively]. In a stepwise regression model, a higher total protein intake was positively associated with ALMBMI [ß = 0.10 (95% CI: 0.07, 0.13) P < 0.001]. The protein intake at dinner was positively associated with ALMBMI [ß = 0.14 (95% CI: 0.08, 0.19) P < 0.001] irrespective of protein intake at breakfast and lunch. This association disappeared after additional adjustment for total protein intake. CONCLUSION Our data highlight an association of total protein intake and ALMBMI in older adults. Although current data support an association of high ALMBMI with protein intake at dinner in particular, this was not independent from total protein intake and the findings do not allow a conclusion on causality.
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Affiliation(s)
- Jivko Nikolov
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Department of Endocrinology, Diabetes and Metabolism, Berlin Institute of Health, Berlin, Germany.,Department of Geriatrics, Intensive Care Unit, St. Joseph Hospital Berlin Tempelhof, Berlin, Germany
| | - Kristina Norman
- Research Group on Geriatrics, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Department of Nutrition and Gerontology, German Institute of Human Nutrition Potsdam Rehbrücke, Nuthetal, Germany.,University of Potsdam, Institute of Nutritional Science, Nuthetal, Germany
| | - Nikolaus Buchmann
- Department of Cardiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Joachim Spranger
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Department of Endocrinology, Diabetes and Metabolism, Berlin Institute of Health, Berlin, Germany
| | - Ilja Demuth
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Department of Endocrinology, Diabetes and Metabolism, Berlin Institute of Health, Berlin, Germany.,Charité - Universitätsmedizin Berlin, BCRT - Berlin Institute of Health Center for Regenerative Therapies, Berlin, Germany
| | - Elisabeth Steinhagen-Thiessen
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Department of Endocrinology, Diabetes and Metabolism, Berlin Institute of Health, Berlin, Germany
| | - Dominik Spira
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Department of Endocrinology, Diabetes and Metabolism, Berlin Institute of Health, Berlin, Germany
| | - Knut Mai
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Department of Endocrinology, Diabetes and Metabolism, Berlin Institute of Health, Berlin, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Berlin, Germany
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5
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Herpich C, Franz K, Ost M, Otten L, Coleman V, Klaus S, Müller-Werdan U, Norman K. Associations Between Serum GDF15 Concentrations, Muscle Mass, and Strength Show Sex-Specific Differences in Older Hospital Patients. Rejuvenation Res 2020; 24:14-19. [PMID: 32475214 DOI: 10.1089/rej.2020.2308] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Aging is accompanied by a progressive decline of muscle mass and strength and also higher levels of circulating cytokines such as growth differentiation factor 15 (GDF15). Studies evaluating the association of GDF15 with muscle mass and strength are rare. In this analysis, we investigated GDF15 concentrations and their relationship with muscle mass and strength in older men compared with women. GDF15 serum concentrations were measured in 103 (60 years and older) hospital patients and an age-matched control group with an immunosorbent assay. Skeletal muscle mass was determined with the bioelectrical impedance analysis. Grip strength and knee extension strength were assessed and normalized for height. Associations between GDF15 concentrations and muscle mass and strength were evaluated with general linear models. Male patients showed higher levels of GDF15 compared with female patients (p = 0.021). Elevated GDF15 concentrations were associated with lower measures of muscle mass, exclusively in men, after adjustment for age and number of drugs per day. Our results indicate sex differences between associations of GDF15 with muscle mass and strength parameters in a cohort of older hospital patients.
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Affiliation(s)
- Catrin Herpich
- Department of Nutrition and Gerontology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany
| | - Kristina Franz
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt Universität zu Berlin and Berlin Institute of Health, Research Group on Geriatrics, Working Group Nutrition and Body Composition, Berlin, Germany
| | - Mario Ost
- Department of Physiology and Energy Metabolism, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany
| | - Lindsey Otten
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt Universität zu Berlin and Berlin Institute of Health, Research Group on Geriatrics, Working Group Nutrition and Body Composition, Berlin, Germany
| | - Verena Coleman
- Department of Physiology and Energy Metabolism, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany
| | - Susanne Klaus
- Department of Physiology and Energy Metabolism, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany.,University of Potsdam, Institute of Nutritional Science, Nuthetal, Germany
| | - Ursula Müller-Werdan
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt Universität zu Berlin and Berlin Institute of Health, Research Group on Geriatrics, Working Group Nutrition and Body Composition, Berlin, Germany.,Protestant Geriatric Centre Berlin, Berlin, Germany
| | - Kristina Norman
- Department of Nutrition and Gerontology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany.,Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt Universität zu Berlin and Berlin Institute of Health, Research Group on Geriatrics, Working Group Nutrition and Body Composition, Berlin, Germany.,University of Potsdam, Institute of Nutritional Science, Nuthetal, Germany
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Kim HK, Lee MJ, Kim EH, Bae SJ, Choe J, Kim CH, Park JY. Longitudinal Changes of Body Composition Phenotypes and Their Association with Incident Type 2 Diabetes Mellitus during a 5-Year Follow-up in Koreans. Diabetes Metab J 2019; 43:627-639. [PMID: 31237125 PMCID: PMC6834838 DOI: 10.4093/dmj.2018.0141] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 01/11/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND To elucidate longitudinal changes of complex body composition phenotypes and their association with incident type 2 diabetes mellitus. METHODS A total of 17,280 (mean age, 48.1±8.2 years) Korean adults who underwent medical check-ups were included. The mean follow-up duration was 5.5±0.5 years. Body compositions were assessed using a bioelectrical impedance analysis. Four body composition phenotypes were defined using the median of appendicular skeletal muscle mass (ASM) index and fat mass index: low muscle/low fat (LM/LF); high muscle (HM)/LF; LM/high fat (HF); and HM/HF groups. RESULTS Of the individuals in the LM/LF or HM/HF groups, over 60% remained in the same group, and over 30% were moved to the LM/HF group. Most of the LM/HF group remained in this group. In the baseline HM/LF group, approximately 30% stayed in the group, and the remaining individuals transitioned to the three other groups in similar proportions. Incident diabetes was significantly lower in participants who remained in the HM/LF group than those who transitioned to the LM/LF or LM/HF group from the baseline HM/LF group in men. ASM index was significantly associated with a decreased risk for incident diabetes in men regardless of obesity status (adjusted odds ratio [OR], 0.71 per kg/m²; 95% confidence interval [CI], 0.52 to 0.97 in non-obese) (adjusted OR, 0.87; 95% CI, 0.77 to 0.98 in obese) after adjusting for other strong risk factors (e.g., baseline glycosylated hemoglobin and homeostasis model assessment of insulin resistance). CONCLUSION Maintenance of ASM may be protective against the development of type 2 diabetes mellitus in men, regardless of obesity status.
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Affiliation(s)
- Hong Kyu Kim
- Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
| | - Min Jung Lee
- Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Eun Hee Kim
- Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sung Jin Bae
- Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jaewon Choe
- Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chul Hee Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Joong Yeol Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, University of Ulsan College of Medicine, Seoul, Korea
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Shah RV, Yeri AS, Murthy VL, Massaro JM, D'Agostino R, Freedman JE, Long MT, Fox CS, Das S, Benjamin EJ, Vasan RS, O'Donnell CJ, Hoffmann U. Association of Multiorgan Computed Tomographic Phenomap With Adverse Cardiovascular Health Outcomes: The Framingham Heart Study. JAMA Cardiol 2019; 2:1236-1246. [PMID: 28975197 DOI: 10.1001/jamacardio.2017.3145] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Importance Increased ability to quantify anatomical phenotypes across multiple organs provides the opportunity to assess their cumulative ability to identify individuals at greatest susceptibility for adverse outcomes. Objective To apply unsupervised machine learning to define the distribution and prognostic importance of computed tomography-based multiorgan phenotypes associated with adverse health outcomes. Design, Setting, and Participants This asymptomatic community-based cohort study included 2924 Framingham Heart Study participants between July 2002 and April 2005 undergoing computed tomographic imaging of the chest and abdomen. Participants are from the offspring and third-generation cohorts. Exposures Eleven computed tomography-based measures of valvular/vascular calcification, adiposity, and muscle attenuation. Main Outcomes and Measures All-cause mortality and cardiovascular disease (myocardial infarction, stroke, or cardiovascular death). Results The median age of the participants was 50 years (interquartile range, 43-60 years), and 1422 (48.6%) were men. Principal component analysis identified 3 major anatomic axes: (1) global calcification (defined by aortic, thoracic, coronary, and valvular calcification); (2) adiposity (defined by pericardial, visceral, hepatic, and intrathoracic fat); and (3) muscle attenuation that explained 65.7% of the population variation. Principal components showed different evolution with age (continuous increase in global calcification, decrease in muscle attenuation, and U-shaped association with adiposity) but similar patterns in men and women. Using unsupervised clustering approaches in the offspring cohort (n = 1150), we identified a cohort (n = 232; 20.2%) with an unfavorable multiorgan phenotype across all 3 anatomic axes as compared with a favorable multiorgan phenotype. Membership in the unfavorable phenotypic cluster was associated with a greater prevalence of cardiovascular disease risk factors and with increased all-cause mortality (hazard ratio, 2.61; 95% CI, 1.74-3.92; P < .001), independent of coronary artery calcium score, visceral adipose tissue, and 10-year global cardiovascular disease Framingham risk, and it provided improvement in metrics of discrimination and reclassification. Conclusions and Relevance This proof-of-concept analysis demonstrates that unsupervised machine learning, in an asymptomatic community cohort, identifies an unfavorable multiorgan phenotype associated with adverse health outcomes, especially in elderly American adults. Future investigations in larger populations are required not only to validate the present results, but also to harness clinical, biochemical, imaging, and genetic markers to increase our understanding of healthy cardiovascular aging.
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Affiliation(s)
- Ravi V Shah
- Cardiovascular Research Center, Massachusetts General Hospital, Boston
| | - Ashish S Yeri
- Cardiovascular Research Center, Massachusetts General Hospital, Boston
| | | | - Joe M Massaro
- Department of Statistics, Boston University, Boston, Massachusetts
| | - Ralph D'Agostino
- Department of Mathematics and Statistics, Boston University, Boston, Massachusetts
| | | | - Michelle T Long
- Framingham Heart Study, Framingham, Massachusetts.,Section of Gastroenterology, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts
| | - Caroline S Fox
- Framingham Heart Study, Framingham, Massachusetts.,Merck Research Laboratories, Boston, Massachusetts
| | - Saumya Das
- Cardiovascular Research Center, Massachusetts General Hospital, Boston
| | - Emelia J Benjamin
- Framingham Heart Study, Framingham, Massachusetts.,Cardiology and Preventive Medicine and Epidemiology Sections, Boston University School of Medicine, and Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
| | | | - Christopher J O'Donnell
- Cardiology Section, Department of Medicine, Boston VA Healthcare, Boston, Massachusetts.,Associate Editor
| | - Udo Hoffmann
- Department of Radiology, Massachusetts General Hospital, Boston
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8
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Tung HT, Lai CC, Chen KM, Tsai HY. Meridian Cuffing Exercises Improved Functional Fitness and Cardiopulmonary Functioning of Community Older Adults. Clin Nurs Res 2018; 29:37-47. [PMID: 29606011 DOI: 10.1177/1054773818768021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study was aimed to test the effects of a meridian cuffing exercise, the Healthy Beat Acupunch (HBA) regimen, on the functional fitness and cardiopulmonary functioning of community older adults. A single-blind, cluster randomized controlled trial was conducted. We randomly allocated eight community care centers to the intervention or control group and recruited 228 participants who completed the study (intervention: four centers, n = 111; control: four centers, n = 117). The intervention group underwent a 40-min session of HBA regimen 3 times per week for 6 months. Functional fitness and cardiopulmonary functioning were assessed at baseline, 3 months, and 6 months of the intervention. The intervention group demonstrated significantly greater improvements in functional fitness and cardiopulmonary functioning than the control group between baseline and either 3 months or 6 months. We suggest that activities designed to promote health among community older adults include acupunch exercises.
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Affiliation(s)
| | - Chi-Chieh Lai
- Kuo Wu Li Chu Welfare and Charity Foundation, Kaohsiung, Taiwan
| | - Kuei-Min Chen
- Kaohsiung Medical University, Taiwan.,Kaohsiung Medical University Hospital, Taiwan
| | - Han-Ya Tsai
- Ming Shan Tzu-An-Home Assisted Living Facility, Kaohsiung, Taiwan
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König M, Spira D, Demuth I, Steinhagen-Thiessen E, Norman K. Polypharmacy as a Risk Factor for Clinically Relevant Sarcopenia: Results From the Berlin Aging Study II. J Gerontol A Biol Sci Med Sci 2017; 73:117-122. [PMID: 28481965 DOI: 10.1093/gerona/glx074] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 04/18/2017] [Indexed: 01/01/2023] Open
Abstract
Background Sarcopenia affects more than 10% of older adults. Next to age-associated physiologic changes, diseases like diabetes or inflammatory, neurological, malignant and endocrine disorders may contribute to the development of sarcopenia. Likewise, polypharmacy, i.e., multiple drug use, is common among older adults. Although the two conditions frequently co-occur, the association of polypharmacy with sarcopenia has not yet been examined. We investigated the association of polypharmacy and sarcopenia in a large cohort of community-dwelling older adults (60-84 years). Methods Thousand five hundred and two participants from the Berlin Aging Study II were included. Polypharmacy was defined as concurrent use of 5 or more drugs (prescription and nonprescription). Body composition was assessed with dual-energy X-ray absorptiometry, and appendicular lean mass (ALM) was calculated as sum of the four limbs' lean mass. Sarcopenia was defined as low ALM-to-body mass index (BMI)-ratio using validated sex-specific cutoffs. Results Mean age was 68.7 ± 3.7 years, 50.7% were female. The median (interquartile range) number of drugs was 2 (1-4); 21.1% of subjects reported regular use of ≥5 drugs. Subjects with polypharmacy were more often sarcopenic according to the applied ALM/BMI-cutoffs (16.3% vs 6.9%, p < 0.001), with a higher BMI (p < 0.001) and lower ALM/BMI (p < 0.001), but no significant difference in mean ALM. Notably, polypharmacy was also associated with higher rates of reduced gait speed and exhaustion. Even after multivariable adjustment (sex, age, comorbid conditions and physical activity) polypharmacy was consistently associated with a significantly increased likelihood of sarcopenia (odds ratio = 2.24, 95% confidence interval [CI] = 1.33-3.75). Conclusion Polypharmacy is associated with clinically relevant sarcopenia, as assessed by a low ALM/BMI.
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Affiliation(s)
- Maximilian König
- Research Group on Geriatrics, Charité - Universitätsmedizin Berlin, Germany
| | - Dominik Spira
- Research Group on Geriatrics, Charité - Universitätsmedizin Berlin, Germany
| | - Ilja Demuth
- Research Group on Geriatrics, Charité - Universitätsmedizin Berlin, Germany.,Institute of Medical and Human Genetics, Charité - Universitätsmedizin Berlin, Germany
| | - Elisabeth Steinhagen-Thiessen
- Research Group on Geriatrics, Charité - Universitätsmedizin Berlin, Germany.,Lipid Clinic and Lipid Apheresis, Charité - Universitätsmedizin Berlin, Germany
| | - Kristina Norman
- Research Group on Geriatrics, Charité - Universitätsmedizin Berlin, Germany
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10
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Hai S, Wang H, Cao L, Liu P, Zhou J, Yang Y, Dong B. Association between sarcopenia with lifestyle and family function among community-dwelling Chinese aged 60 years and older. BMC Geriatr 2017; 17:187. [PMID: 28821239 PMCID: PMC5563006 DOI: 10.1186/s12877-017-0587-0] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Accepted: 08/14/2017] [Indexed: 02/05/2023] Open
Abstract
Background Sarcopenia is defined as the age-related decline in skeletal muscle mass and function. The risk factors and causes of sarcopenia must be identified to develop prevention and treatment strategies for this syndrome. Our aim was to examine the association between sarcopenia with lifestyle and family function among community-dwelling Chinese people aged 60 years and older. Methods We conducted this study to evaluate sarcopenia among 834 community-dwelling Chinese individuals aged ≥60 years using the Asian Working Group for Sarcopenia (AWGS) criteria. The sociodemographic characteristics, food consumption patterns, habits of smoking, and alcohol consumption of the participants were collected using a general questionnaire, whereas physical activity was assessed using the International Physical Activity Questionnaire (IPAQ; long-form version). Family function was assessed using the Family APGAR scale. In addition, the association of sarcopenia with lifestyle and family function was examined using univariate and multivariate analyses. Results The total prevalence rate of sarcopenia was 10.6%. Female participants with sarcopenia had a lower frequency per week of nut consumption than those without sarcopenia (p < 0.05), whereas, for male participants, the differences in food consumption patterns of those with sarcopenia versus those without sarcopenia were not significant. Among the participants, the mean Family APGAR score was 8 (standard deviation [SD] = 0.92). For both sexes, participants with sarcopenia had lower family function scores than those without sarcopenia. In the multivariate model, after adjustment for all covariates, frequency per week of nut consumption (adjusted OR 0.724, 95% CI 0.532–0.985, P < 0.05) and Family APGAR score (adjusted OR 0.683, 95% CI 0.496–0.940, P = 0.019) were statistically significantly associated with sarcopenia. The relationship between other lifestyle habits and sarcopenia was not significant. Conclusion There was significant association between sarcopenia with intake of nuts and family function. Further studies should evaluate if adequate intake of nuts and a well-functioning family may be effective in lowering the risk of sarcopenia.
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Affiliation(s)
- Shan Hai
- Department of Geriatrics, West China Hospital, Sichuan University, 37 Guoxue Lane, Chengdu, NO, 610041, China
| | - Hui Wang
- Department of Geriatrics, West China Hospital, Sichuan University, 37 Guoxue Lane, Chengdu, NO, 610041, China
| | - Li Cao
- Department of Geriatrics, West China Hospital, Sichuan University, 37 Guoxue Lane, Chengdu, NO, 610041, China
| | - Ping Liu
- Department of Geriatrics, West China Hospital, Sichuan University, 37 Guoxue Lane, Chengdu, NO, 610041, China
| | - Jianghua Zhou
- Department of Geriatrics, West China Hospital, Sichuan University, 37 Guoxue Lane, Chengdu, NO, 610041, China
| | - Ying Yang
- Department of Geriatrics, West China Hospital, Sichuan University, 37 Guoxue Lane, Chengdu, NO, 610041, China
| | - Birong Dong
- Department of Geriatrics, West China Hospital, Sichuan University, 37 Guoxue Lane, Chengdu, NO, 610041, China.
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11
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Hai S, Cao L, Wang H, Zhou J, Liu P, Yang Y, Hao Q, Dong B. Association between sarcopenia and nutritional status and physical activity among community-dwelling Chinese adults aged 60 years and older. Geriatr Gerontol Int 2017; 17:1959-1966. [PMID: 28188973 DOI: 10.1111/ggi.13001] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 11/24/2016] [Accepted: 12/07/2016] [Indexed: 02/05/2023]
Affiliation(s)
- Shan Hai
- Department of Geriatrics, West China Hospital; Sichuan University; Chengdu China
| | - Li Cao
- Department of Geriatrics, West China Hospital; Sichuan University; Chengdu China
| | - Hui Wang
- Department of Geriatrics, West China Hospital; Sichuan University; Chengdu China
| | - Jianghua Zhou
- Department of Geriatrics, West China Hospital; Sichuan University; Chengdu China
| | - Ping Liu
- Department of Geriatrics, West China Hospital; Sichuan University; Chengdu China
| | - Ying Yang
- Department of Geriatrics, West China Hospital; Sichuan University; Chengdu China
| | - Qiukui Hao
- Department of Geriatrics, West China Hospital; Sichuan University; Chengdu China
| | - Birong Dong
- Department of Geriatrics, West China Hospital; Sichuan University; Chengdu China
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12
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Spahillari A, Mukamal KJ, DeFilippi C, Kizer JR, Gottdiener JS, Djoussé L, Lyles MF, Bartz TM, Murthy VL, Shah RV. The association of lean and fat mass with all-cause mortality in older adults: The Cardiovascular Health Study. Nutr Metab Cardiovasc Dis 2016; 26:1039-1047. [PMID: 27484755 PMCID: PMC5079822 DOI: 10.1016/j.numecd.2016.06.011] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Revised: 06/21/2016] [Accepted: 06/22/2016] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND AIMS Understanding contributions of lean and fat tissue to cardiovascular and non-cardiovascular mortality may help clarify areas of prevention in older adults. We aimed to define distributions of lean and fat tissue in older adults and their contributions to cause-specific mortality. METHODS AND RESULTS A total of 1335 participants of the Cardiovascular Health Study (CHS) who underwent dual-energy x-ray absorptiometry (DEXA) scans were included. We used principal components analysis (PCA) to define two independent sources of variation in DEXA-derived body composition, corresponding to principal components composed of lean ("lean PC") and fat ("fat PC") tissue. We used Cox proportional hazards regression using these PCs to investigate the relationship between body composition with cardiovascular and non-cardiovascular mortality. Mean age was 76.2 ± 4.8 years (56% women) with mean body mass index 27.1 ± 4.4 kg/m2. A greater lean PC was associated with lower all-cause (HR = 0.91, 95% CI 0.84-0.98, P = 0.01) and cardiovascular mortality (HR = 0.84, 95% CI 0.74-0.95, P = 0.005). The lowest quartile of the fat PC (least adiposity) was associated with a greater hazard of all-cause mortality (HR = 1.24, 95% CI 1.04-1.48, P = 0.02) relative to fat PCs between the 25th-75th percentile, but the highest quartile did not have a significantly greater hazard (P = 0.70). CONCLUSION Greater lean tissue mass is associated with improved cardiovascular and overall mortality in the elderly. The lowest levels of fat tissue mass are linked with adverse prognosis, but the highest levels show no significant mortality protection. Prevention efforts in the elderly frail may be best targeted toward improvements in lean muscle mass.
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Affiliation(s)
- A Spahillari
- Division of Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
| | - K J Mukamal
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
| | - C DeFilippi
- Division of Cardiovascular Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.
| | - J R Kizer
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, NY, USA.
| | - J S Gottdiener
- Department of Medicine, University of Maryland Medical School, Baltimore, MD, USA.
| | - L Djoussé
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.
| | - M F Lyles
- Department of Medicine, Section on Gerontology and Geriatrics, Wake Forest School of Medicine, Winston-Salem, NC, USA.
| | - T M Bartz
- Department of Biostatistics, University of Washington, Seattle, WA, USA.
| | - V L Murthy
- Frankel Cardiovascular Center and Department of Medicine (Cardiovascular Medicine Division), University of Michigan, Ann Arbor, MI, USA.
| | - R V Shah
- Department of Medicine (Division of Cardiology), Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
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13
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Aggio DA, Sartini C, Papacosta O, Lennon LT, Ash S, Whincup PH, Wannamethee SG, Jefferis BJ. Cross-sectional associations of objectively measured physical activity and sedentary time with sarcopenia and sarcopenic obesity in older men. Prev Med 2016; 91:264-272. [PMID: 27575317 PMCID: PMC5061552 DOI: 10.1016/j.ypmed.2016.08.040] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 08/23/2016] [Accepted: 08/25/2016] [Indexed: 12/21/2022]
Abstract
This study investigated associations between objectively measured physical activity (PA) with sarcopenia and sarcopenic obesity in older British men. Participants were men aged 70-92years (n=1286) recruited from UK Primary Care Centres. Outcomes included (i) sarcopenia, defined as low muscle mass (lowest two fifths of the mid-upper arm muscle circumference distribution) accompanied by low muscular strength (hand grip strength <30kg) or low physical performance (gait speed≤0.8m/s); (ii) severe sarcopenia, required all three conditions; (iii) sarcopenic obesity defined as sarcopenia or severe sarcopenia and a waist circumference of >102cm. Independent variables included time spent in PA intensities measured by GT3x accelerometers, worn during one week in 2010-12. Multinomial regression models were used for cross-sectional analyses relating PA and sarcopenia. In total, 14.2% (n=183) of men had sarcopenia and a further 5.4% (n=70) had severe sarcopenia. 25.3% of sarcopenic or severely sarcopenic men were obese. Each extra 30min per day of moderate-to-vigorous PA (MVPA) was associated with a reduced risk of severe sarcopenia (relative risk [RR] 0.53, 95% confidence interval [CI] 0.30, 0.93) and sarcopenic obesity (RR 0.47 [95% CI 0.27, 0.84]). Light PA (LPA) and sedentary breaks were marginally associated with a reduced risk of sarcopenic obesity. Sedentary time was marginally associated with an increased risk of sarcopenic obesity independent of MVPA (RR 1.18 [95% CI 0.99, 1.40]). MVPA may reduce the risk of severe sarcopenia and sarcopenic obesity among older men. Reducing sedentary time and increasing LPA and sedentary breaks may also protect against sarcopenic obesity.
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Affiliation(s)
- Daniel A Aggio
- UCL Department of Primary Care & Population Health, UCL Medical School, Rowland Hill Street, London NW3 2PF, UK; UCL Physical Activity Research Group, UK.
| | - Claudio Sartini
- UCL Department of Primary Care & Population Health, UCL Medical School, Rowland Hill Street, London NW3 2PF, UK; UCL Physical Activity Research Group, UK
| | - Olia Papacosta
- UCL Department of Primary Care & Population Health, UCL Medical School, Rowland Hill Street, London NW3 2PF, UK
| | - Lucy T Lennon
- UCL Department of Primary Care & Population Health, UCL Medical School, Rowland Hill Street, London NW3 2PF, UK
| | - Sarah Ash
- UCL Department of Primary Care & Population Health, UCL Medical School, Rowland Hill Street, London NW3 2PF, UK
| | - Peter H Whincup
- Population Health Research Institute, St George's University of London, Cranmer Terrace, London. SW17 0RE, UK
| | - S Goya Wannamethee
- UCL Department of Primary Care & Population Health, UCL Medical School, Rowland Hill Street, London NW3 2PF, UK; UCL Physical Activity Research Group, UK
| | - Barbara J Jefferis
- UCL Department of Primary Care & Population Health, UCL Medical School, Rowland Hill Street, London NW3 2PF, UK; UCL Physical Activity Research Group, UK
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14
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Abstract
PURPOSE OF REVIEW Denervation is a hallmark of age-related and other types of muscle wasting. This review focuses on recent insights and current viewpoints regarding the mechanisms and clinical relevance of maintaining the neuromuscular junction to counteract muscle wasting resulting from aging or neural disease/damage. RECENT FINDINGS Activity-dependent regulation of autophagy, the agrin-muscle specific kinase-Lrp4 signaling axis, and sympathetic modulation are principal mechanisms involved in stabilizing the neuromuscular junction. These findings are derived from several animal models and were largely confirmed by human gene expression analysis as well as insights from rare neuromuscular diseases such as amyotrophic lateral sclerosis and congenital myasthenic syndromes. Based on these insights, agrin-derived fragments are currently being evaluated as biomarkers for age-related muscle wasting. Tuning of autophagy, of the agrin pathway, and of sympathetic input are being studied as clinical treatment of muscle wasting disorders. SUMMARY Basic research has revealed that maintenance of neuromuscular junctions and a few signaling pathways are important in the context of age-dependent and other forms of muscle wasting. These findings have recently started to enter clinical practice, but further research needs to substantiate and refine our knowledge.
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Affiliation(s)
- Rüdiger Rudolf
- Interdisciplinary Center for Neuroscience, University of Heidelberg, Germany
- Institute of Molecular and Cell Biology, Mannheim University of Applied Science, Germany
- Institute of Toxicology and Genetics, Karlsruhe Institute of Technology, Germany
| | - Michael R. Deschenes
- Department of Kinesiology and Health Sciences, The College of William and Mary, Williamsburg, VA, USA
| | - Marco Sandri
- Department of Biomedical Science, University of Padua, Italy
- Venetian Institute of Molecular Medicine (VIMM), Padua, Italy
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15
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Nikolov J, Spira D, Aleksandrova K, Otten L, Meyer A, Demuth I, Steinhagen-Thiessen E, Eckardt R, Norman K. Adherence to a Mediterranean-Style Diet and Appendicular Lean Mass in Community-Dwelling Older People: Results From the Berlin Aging Study II. J Gerontol A Biol Sci Med Sci 2015; 71:1315-21. [PMID: 26686229 DOI: 10.1093/gerona/glv218] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Accepted: 11/07/2015] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Selected nutrients or food groups have often been studied with regard to long-term mortality and cardiovascular disease, whereas the relation between diet quality and appendicular lean mass (ALM) has rarely been researched. OBJECTIVE The aim of this study was to explore the association between a Mediterranean-style diet and ALM in community-dwelling older people. METHODS Cross-sectional data from the Berlin Aging Study II were available for 1,509 participants (51% women, 68.2±3.7 years). Nutrient intake was assessed using the European Prospective Investigation into Cancer and Nutrition Food Frequency Questionnaire. Adherence to a Mediterranean-style diet was evaluated with the modified Mediterranean-type diet score (mMedTypeDiet). ALM was determined by dual-energy X-ray absorptiometry and related to body mass index (ALM/BMI). A general linear regression model was carried out to assess the association between mMedTypeDiet score groups and ALM/BMI. RESULTS ALM/BMI was higher in women with a higher adherence to the mMedTypeDiet (0.64±0.1 vs 0.62±0.1 and 0.61±0.1 in low and medium adherence, retrospectively, p = .004). In the risk factor-adjusted general linear regression analysis, a higher adherence to the mMedTypeDiet was associated with higher ALM/BMI in women and better ALM/fat mass ratio when compared to a medium and a low diet quality. No significant associations were seen in men. CONCLUSIONS Higher adherence to a Mediterranean-style diet was associated with a positive effect on ALM/BMI in women.
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Affiliation(s)
| | | | - Krasimira Aleksandrova
- Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbrucke, Nuthetal
| | | | | | - Ilja Demuth
- Charité Research Group on Geriatrics and Institute of Medical and Human Genetics, Charité-Universitätsmedizin, Berlin, Germany
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