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Yamamoto M, Nozoe M, Ikeji R, Seike H, Yoshida Y, Shomoto K. Anorexia assessment using the Simplified Nutritional Appetite Questionnaire and its association with activities of daily living in patients with stroke. Nutrition 2024; 117:112238. [PMID: 37924625 DOI: 10.1016/j.nut.2023.112238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 09/12/2023] [Accepted: 09/21/2023] [Indexed: 11/06/2023]
Abstract
OBJECTIVE This study aimed to validate the assessment of anorexia in patients with acute stroke using the Simplified Nutritional Appetite Questionnaire. METHODS This cross-sectional observational study assessed appetite using the Simplified Nutritional Appetite Questionnaire in patients with acute stroke at discharge from an acute care hospital. Additionally, the relationship between the Simplified Nutritional Appetite Questionnaire and Mini Nutritional Assessment, Mini Nutritional Assessment - Short Form scores, skeletal muscle mass, muscle strength, and activities of daily living measured using the Functional Independence Measures for the motor domain was investigated. A multiple regression analysis was conducted with the Functional Independence Measure for the motor domain as the dependent variable and the Simplified Nutritional Appetite Questionnaire and other confounding factors as explanatory variables to evaluate the association between the Simplified Nutritional Appetite Questionnaire and functional outcomes. RESULTS Among the 234 patients with stroke analyzed in this study, the median Simplified Nutritional Appetite Questionnaire score was 15 (IQR = 13-16) points. The Simplified Nutritional Appetite Questionnaire score significantly correlated with weight change, Functional Independence Measure for the motor domain, nutritional assessment index, and energy and protein intake. However, no significant differences in body mass index, muscle mass, or muscle strength were observed. In the multiple regression analysis adjusted for confounders, the Simplified Nutritional Appetite Questionnaire score (β = 0.106; P = 0.007) was independently associated with the Functional Independence Measure for the motor domain (adjusted R2 = 0.662). CONCLUSIONS This study's results found a significant correlation between Simplified Nutritional Appetite Questionnaire scores and nutritional status as well as an independent association with functional outcomes in patients with stroke. These findings suggest that the Simplified Nutritional Appetite Questionnaire can be a valuable tool for evaluating anorexia in this patient population.
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Affiliation(s)
- Miho Yamamoto
- Department of Rehabilitation Medicine, Nishiyamato Rehabilitation Hospital, Nara, Japan; Graduate School of Health Sciences, Kio University, Nara, Japan
| | - Masafumi Nozoe
- Department of Physical Therapy, Faculty of Rehabilitation, Kansai Medical University, Osaka, Japan.
| | - Rio Ikeji
- Department of Rehabilitation, Itami Kousei Neurosurgical Hospital, Itami, Japan
| | - Haruka Seike
- Department of Rehabilitation, Itami Kousei Neurosurgical Hospital, Itami, Japan
| | - Yosuke Yoshida
- Department of Rehabilitation, Nara Prefecture Seiwa Medical Center, Sango, Japan
| | - Koji Shomoto
- Graduate School of Health Sciences, Kio University, Nara, Japan
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Zheng R, Michaëlsson K, Fall T, Elmståhl S, Lind L. The metabolomic profiling of total fat and fat distribution in a multi-cohort study of women and men. Sci Rep 2023; 13:11129. [PMID: 37429905 DOI: 10.1038/s41598-023-38318-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 07/06/2023] [Indexed: 07/12/2023] Open
Abstract
Currently studies aiming for the comprehensive metabolomics profiling of measured total fat (%) as well as fat distribution in both sexes are lacking. In this work, bioimpedance analysis was applied to measure total fat (%) and fat distribution (trunk to leg ratio). Liquid chromatography-mass spectrometry-based untargeted metabolomics was employed to profile the metabolic signatures of total fat (%) and fat distribution in 3447 participants from three Swedish cohorts (EpiHealth, POEM and PIVUS) using a discovery-replication cross-sectional study design. Total fat (%) and fat distribution were associated with 387 and 120 metabolites in the replication cohort, respectively. Enriched metabolic pathways for both total fat (%) and fat distribution included protein synthesis, branched-chain amino acids biosynthesis and metabolism, glycerophospholipid metabolism and sphingolipid metabolism. Four metabolites were mainly related to fat distribution: glutarylcarnitine (C5-DC), 6-bromotryptophan, 1-stearoyl-2-oleoyl-GPI (18:0/18:1) and pseudouridine. Five metabolites showed different associations with fat distribution in men and women: quinolinate, (12Z)-9,10-dihydroxyoctadec-12-enoate (9,10-DiHOME), two sphingomyelins and metabolonic lactone sulfate. To conclude, total fat (%) and fat distribution were associated with a large number of metabolites, but only a few were exclusively associated with fat distribution and of those metabolites some were associated with sex*fat distribution. Whether these metabolites mediate the undesirable effects of obesity on health outcomes remains to be further investigated.
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Affiliation(s)
- Rui Zheng
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
| | - Karl Michaëlsson
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Tove Fall
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Sölve Elmståhl
- Division of Geriatric Medicine, Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden
| | - Lars Lind
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
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Kose E, Matsumoto A, Yoshimura Y. Association between deprescribing from polypharmacy and functional recovery and home discharge among older patients with sarcopenia after stroke. Nutrition 2023; 111:112040. [PMID: 37141661 DOI: 10.1016/j.nut.2023.112040] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 02/28/2023] [Accepted: 03/18/2023] [Indexed: 05/06/2023]
Abstract
OBJECTIVE Evidence regarding the association between deprescribing from polypharmacy and outcomes in the convalescent rehabilitation setting is rare. The aim of this study was to assess the association between deprescribing from polypharmacy and functional recovery and home discharge in older patients with sarcopenia after stroke. METHODS This retrospective cohort study was conducted at a convalescent rehabilitation hospital from January 2015 to December 2021. Among newly admitted patients in the convalescent rehabilitation ward who had experienced a stroke, patients aged ≥65 y with sarcopenia at admission and who were using at least five medications were included. Sarcopenia was diagnosed according to hand-grip strength and skeletal muscle mass index following the criteria of the Asian Working Group for Sarcopenia 2019. The primary outcome measures were functional independence-measured motor activity (FIM-motor) at discharge and home discharge. Multiple regression analysis was used to determine whether deprescribing from polypharmacy at admission was independently associated with rehabilitation outcomes. RESULTS Among the 264 patients with polypharmacy, 153 patients (mean age, 81.1 y; 46.4% males) were diagnosed with sarcopenia and included in the analysis. Of them, 56 (36.6%) were deprescribed from polypharmacy. Deprescribing from polypharmacy was independently associated with FIM-motor at discharge (β, 0.137; P = 0.017) and home discharge (odds ratio, 1.393; P = 0.002). CONCLUSIONS Because no effective pharmacotherapy for sarcopenia has been established, the novel findings of this study may be useful in the pharmacotherapy for older patients with sarcopenia after stroke. Deprescribing from polypharmacy on admission was positively associated with functional status at discharge and home discharge in older patients with sarcopenia after stroke.
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Affiliation(s)
- Eiji Kose
- Department of Pharmacy, Juntendo University Hospital, Tokyo, Japan
| | - Ayaka Matsumoto
- Department of Pharmacy, Kumamoto Rehabilitation Hospital, Kumamoto, Japan
| | - Yoshihiro Yoshimura
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, Kumamoto, Japan.
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Wang D, Zhou H, Hu Y, Che Y, Ye X, Chen J, Fu J, Xu H. Prediction of body fat increase from food addiction scale in school-aged children and adolescents: A longitudinal cross-lagged study. Front Public Health 2023; 10:1056123. [PMID: 36684883 PMCID: PMC9853519 DOI: 10.3389/fpubh.2022.1056123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 12/08/2022] [Indexed: 01/07/2023] Open
Abstract
Objective Food addiction (FA) is associated with a higher body mass index z-score (BMIZ) in children and adolescents; however, whether these two aspects evolve interdependently remains unknown. This study aimed to address this question using a cross-lagged study. Methods Weight status, including BMIZ, fat content (FC), and visceral fat level (VFL), was determined in 880 children and adolescents (mean age = 14.02 years [range = 8.83-17.52 years]) at two-time points with an interval of 6 months. FA was characterized using the Chinese version of the dimensional Yale Food Addiction Scale for Children 2.0. Furthermore, FC and VFL were measured using direct segmental multi-frequency bioelectrical impedance analysis at each time point. Results Higher FA was associated with increased BMIZ, FC, and VFL (P < 0.05). FA at T0 could predict increased FC at T1 (P < 0.05). The characteristics of females, primary students, and living in urban areas may aggravate the adverse effect of FA on weight status over time and age, particularly the increased VFL in participants aged > 14 years. Conclusion Children and adolescents with a high FA level were at risk for weight gain attributed to increased FC, and the adverse effect could be aggravated with time and age. Novel FA-targeting interventions may help mitigate the risk of getting obesity.
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Affiliation(s)
- Dan Wang
- The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China
| | - Hui Zhou
- Department of Psychology and Behavioral Sciences, Graduate School, Zhejiang University, Hangzhou, Zhejiang, China
| | - Yuzheng Hu
- Department of Psychology and Behavioral Sciences, Graduate School, Zhejiang University, Hangzhou, Zhejiang, China
| | - Yanfen Che
- The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China
| | - Xian Ye
- The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China
| | - Junqing Chen
- The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China
| | - Junfen Fu
- The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China
| | - Hongzhen Xu
- The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China
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Yamasaki Y, Honda Y, Inoue-Umezaki M, Makieda R, Endo Y, Hanayama K, Sakaue H, Teramoto F. The association between sarcopenia and functional outcomes in patients undergoing convalescent rehabilitation. THE JOURNAL OF MEDICAL INVESTIGATION 2023; 70:457-463. [PMID: 37940532 DOI: 10.2152/jmi.70.457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
Sarcopenia is widely believed to be linked to poorer outcomes in inpatient rehabilitation. This study aimed to assess the impact of sarcopenia on functional outcomes and dietary intake during hospitalization in adults undergoing convalescent rehabilitation. We conducted a retrospective cohort analysis at a single rehabilitation institution. The Asian Working Group Consensus Criteria for Sarcopenia was used to diagnose. The Functional Independence Measure (FIM) score was used at hospital discharge to measure the primary functional outcome. Energy and protein intakes during hospitalization were calculated as part of the nutritional assessment. There were 126 patients in the research (median age, 73 yr;54% women). Stroke (n = 73;53.4% sarcopenia) and musculoskeletal disorders (n = 53;56.6% sarcopenia) were among the admission diagnoses. Multiple linear regression analysis revealed that the FIM total score at discharge was modestly associated with sarcopenia only in stroke patients (? = 0.1872, P = 0.09), as well as significantly and independently associated with protein intake during admission only in stroke patients (? = 0.3217, P < 0.05). In hospitalized stroke patients undergoing convalescent therapy, sarcopenia is related to lower functional results. Early identification of sarcopenia and treatment with rehabilitation nutrition should be implemented in this population. J. Med. Invest. 70 : 457-463, August, 2023.
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Affiliation(s)
- Yuki Yamasaki
- Department of Clinical Nutrition, Faculty of Health Science and Technology, Kawasaki University of Medical Welfare, Okayama, Japan
| | - Yui Honda
- Department of Nutrition, Kawasaki Medical School Hospital, Okayama, Japan
| | - Mami Inoue-Umezaki
- Department of Nutrition, Kawasaki Medical School Hospital, Okayama, Japan
| | - Ryoko Makieda
- Department of Nutrition, Kawasaki Medical School Hospital, Okayama, Japan
| | - Yoko Endo
- Department of Clinical Nutrition, Faculty of Health Science and Technology, Kawasaki University of Medical Welfare, Okayama, Japan
- Department of Nutrition, Kawasaki Medical School Hospital, Okayama, Japan
| | - Kozo Hanayama
- Department of Rehabilitation Medicine, Kawasaki Medical School, Okayama, Japan
| | - Hiroshi Sakaue
- Department of Nutrition and Metabolism, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Fusako Teramoto
- Department of Clinical Nutrition, Faculty of Health Science and Technology, Kawasaki University of Medical Welfare, Okayama, Japan
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Polypharmacy and Its Association with Dysphagia and Malnutrition among Stroke Patients with Sarcopenia. Nutrients 2022; 14:nu14204251. [PMID: 36296943 PMCID: PMC9609259 DOI: 10.3390/nu14204251] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 10/06/2022] [Accepted: 10/09/2022] [Indexed: 11/17/2022] Open
Abstract
Evidence on polypharmacy in patients with sarcopenia is lacking. We aimed to examine the association of polypharmacy with swallowing function and nutritional risk in post-stroke patient with sarcopenia. This retrospective cohort study included hospitalized patients diagnosed with sarcopenia who needed convalescent rehabilitation following stroke onset. Study outcomes were the Food Intake Level Scale (FILS) as dysphagia assessment and geriatric nutritional risk index (GNRI) as nutritional status at hospital discharge, respectively. To examine the impact of admission polypharmacy, multivariate linear regression analyses were used to determine whether the number of drugs prescribed at hospital admission was associated with these outcomes. As a result, of the 586 patients enrolled, 257 (mean age 79.3 years, 44.0% male) were diagnosed with sarcopenia and were finally analyzed high admission drug prescription numbers were independently associated with FILS (β = −0.133, p = 0.017) and GNRI (β = −0.145, p = 0.003) at hospital discharge, respectively. Polypharmacy is associated with dysphagia and malnutrition in post-stroke patients with sarcopenia. In addition to the combination of nutritional and exercise therapies, review and optimization of prescription medications may be warranted to treat sarcopenia in order to maximize improvement in outcomes for these patients.
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Potentially inappropriate medications are negatively associated with functional recovery in patients with sarcopenia after stroke. Aging Clin Exp Res 2022; 34:2845-2855. [PMID: 36038811 DOI: 10.1007/s40520-022-02224-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 08/09/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Evidence is scarce for potentially inappropriate medications (PIMs) in rehabilitation medicine. AIM To examine the effect of PIMs on functional recovery in older patients with sarcopenia after stroke. METHODS We conducted a retrospective cohort study in a post-acute rehabilitation hospital. All patients diagnosed with sarcopenia aged ≥ 65 years among all post-stroke patients hospitalized from 2015 to 2020 were included. PIMs were defined based on the 2019 Beers criteria. Sarcopenia was diagnosed using handgrip strength (HG) and skeletal muscle mass index (SMI), according to the criteria of the Asian Working Group for Sarcopenia 2019. The outcomes included functional independence measure motor (FIM-motor), HG, and SMI values at discharge. Multiple linear regression analyses were used to determine whether PIMs used at admission were independently associated with outcomes. RESULTS Of the eligible patients, 361 were 65 years or older, of whom 196 (mean age 81.0 years, 44.4% male) presented with sarcopenia and were included in the analysis. Of these, 131 (66.8%) were prescribed PIMs at admission. The most frequently prescribed PIMs were proton pump inhibitors, antipsychotics, benzodiazepines, and nonsteroidal anti-inflammatory drugs. The number of PIMs on admission was independently associated with FIM-motor (β = - 0.132, P = 0.001) and HG (β = - 0.091, P = 0.048) at discharge, but not with SMI (β = - 0.055, P = 0.256). CONCLUSIONS High admission PIMs prescription numbers are negatively associated with favorable discharge functional status and muscle strength in older patients with sarcopenia after stroke.
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Kose E, Yoshimura Y, Wakabayashi H, Matsumoto A. Use of antipsychotics is negatively associated with muscle strength in older adults with sarcopenia after stroke. J Stroke Cerebrovasc Dis 2022; 31:106587. [PMID: 35793581 DOI: 10.1016/j.jstrokecerebrovasdis.2022.106587] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 05/20/2022] [Accepted: 05/29/2022] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE The use of antipsychotics has been shown to affect activities of daily living during rehabilitation but reports regarding their effects on older patients with sarcopenia are insufficient. We aimed to examine the effect of the use of antipsychotics on muscle strength and muscle mass in older patients with sarcopenia undergoing convalescent rehabilitation after stroke. METHODS This retrospective cohort study was conducted at a rehabilitation hospital between 2015 and 2020. The study outcomes included skeletal muscle mass index and hand grip strength at discharge. Multivariate analyses were used to determine whether the use of antipsychotics at admission and at 4 weeks after admission were independently associated with the study outcomes, after adjusting for potential confounders. RESULTS Of the 619 stroke patients admitted, 196 (mean age 81 years; 44.4% men) had sarcopenia at admission and were included in the final analysis. The median hand grip strength and median skeletal muscle mass index values were 12.5 (5.9-17.9) kg and 5.1 (4.5-6.0) kg/m2, respectively. In the multivariate analyses, the use of antipsychotics at 4 weeks post-admission was independently associated with hand grip strength at discharge (β = -0.125, p = 0.008), which was not the case when used at admission. Furthermore, the use of antipsychotics at admission and at 4 weeks after admission were not significantly associated with the skeletal muscle mass index at discharge. CONCLUSIONS The use of antipsychotics in older patients with sarcopenia after stroke was negatively associated with handgrip strength at discharge.
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Affiliation(s)
- Eiji Kose
- Department of Pharmacy, Teikyo University School of Medicine University Hospital, Tokyo, Japan
| | - Yoshihiro Yoshimura
- Department of Rehabilitation Medicine, Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, 760 Magate, Kikuyo-Town, Kikuchi-County, Kumamoto 869-1106, Japan.
| | - Hidetaka Wakabayashi
- Department of Rehabilitation Medicine, Tokyo Women's Medical University Hospital, Japan
| | - Ayaka Matsumoto
- Department of Pharmacy, Kumamoto Rehabilitation Hospital, Kumamoto, Japan
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Kameyama Y, Ashizawa R, Honda H, Take K, Yoshizawa K, Yoshimoto Y. Sarcopenia affects Functional Independence Measure motor scores in elderly patients with stroke. J Stroke Cerebrovasc Dis 2022; 31:106615. [PMID: 35780719 DOI: 10.1016/j.jstrokecerebrovasdis.2022.106615] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 05/31/2022] [Accepted: 06/20/2022] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES There is no unified view of the relationship between sarcopenia and the activities of daily living (ADL) in stroke patients. This study aimed to determine whether sarcopenia affects the ADL in elderly patients with stroke. MATERIALS AND METHODS This case-control study included 472 stroke patients aged ≥ 65 years who were admitted to the convalescent rehabilitation ward. Sarcopenia was defined as a decrease in both the skeletal muscle mass index and handgrip strength, based on the Asian Working Group for Sarcopenia 2019 criteria cut-off, which was assessed on admission. ADL was assessed using the Functional Independence Measure-motor (FIM-m) score at discharge. The Charlson comorbidity index, Mini Nutritional Assessment-Short Form, Brunnstrom recovery stage of the upper limb, Brunnstrom recovery stage of the lower limb and total amount of rehabilitation during hospitalization were evaluated as confounding factors. To clarify whether sarcopenia affects the ADL in patients with stroke, we conducted a multiple regression analysis with the presence of sarcopenia as the independent variable and FIM-m at discharge as the objective variable. RESULTS The final analysis included 283 patients; among them, 163 (57.6%) patients had sarcopenia at the time of admission to the convalescent rehabilitation ward. In the multiple regression analysis, sarcopenia was independently associated with FIM-m at hospital discharge, even after adjusting for confounders (β = -0.100, p = 0.034). CONCLUSIONS Sarcopenia at admission in elderly patients with stroke affected the FIM-m at discharge, even after adjusting for multiple confounders.
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Affiliation(s)
- Yuto Kameyama
- Department of Rehabilitation, Hamamatsu City Rehabilitation Hospital, Hamamatsu 433-8511, Japan; Division of Rehabilitation Science, Seirei Christopher University Graduate School, Hamamatsu 433-8558, Japan.
| | - Ryota Ashizawa
- Department of Rehabilitation, Seirei Mikatahara General Hospital, Hamamatsu 433-8558, Japan
| | - Hiroya Honda
- Division of Rehabilitation Science, Seirei Christopher University Graduate School, Hamamatsu 433-8558, Japan; Department of Rehabilitation, Hanadaira Care Center, Hamamatsu 431-2211, Japan
| | - Koki Take
- Visiting Nurse Station Takaoka, Seirei Care Center Takaoka, Hamamatsu 433-8117, Japan
| | - Kohei Yoshizawa
- Department of Rehabilitation, Hamamatsu City Rehabilitation Hospital, Hamamatsu 433-8511, Japan; Division of Rehabilitation Science, Seirei Christopher University Graduate School, Hamamatsu 433-8558, Japan
| | - Yoshinobu Yoshimoto
- Division of Rehabilitation Science, Seirei Christopher University Graduate School, Hamamatsu 433-8558, Japan
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Matsumoto A, Yoshimura Y, Nagano F, Bise T, Kido Y, Shimazu S, Shiraishi A. Polypharmacy and potentially inappropriate medications in stroke rehabilitation: prevalence and association with outcomes. Int J Clin Pharm 2022; 44:749-761. [PMID: 35578145 DOI: 10.1007/s11096-022-01416-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 04/18/2022] [Indexed: 12/11/2022]
Abstract
Background Evidence is scarce regarding polypharmacy and potentially inappropriate medications (PIMs) in rehabilitation medicine. Aim To investigate the prevalence of polypharmacy and PIMs and their association with outcomes in stroke rehabilitation. Method A retrospective cohort study was conducted with 849 older inpatients post-stroke. Polypharmacy was defined as six or more medications, and PIMs were defined based on Beers criteria 2019. Study outcomes included functional independence measure (FIM)-motor, FIM-cognitive, energy intake, dysphagia, length of hospital stay, and the rate of home discharge. To consider the effect of pharmacotherapy during rehabilitation, multivariate analyses were used to determine whether the presence of polypharmacy or PIMs at discharge was associated with outcomes. Results After enrollment, 361 patients (mean age 78.3 ± 7.7 years; 49.3% male) were analyzed. Polypharmacy was observed in 43.8% and 62.9% of patients, and any PIMs were observed in 64.8% and 65.4% of patients at admission and discharge, respectively. The most frequently prescribed PIMs included antipsychotics, benzodiazepines, and proton pump inhibitors. Polypharmacy was negatively associated with FIM-motor score (β = - 0.062, P = 0.049), FIM-cognitive score (β = - 0.076, P = 0.014), energy intake (β = - 0.143, P = 0.005), and home discharge (OR: 0.458; 95% CI: 0.248, 0.847; P = 0.013). PIMs were negatively associated with home discharge (OR: 0.375; 95% CI: 0.195, 0.718; P = 0.003). Conclusion Polypharmacy and PIMs are commonly found among older patients undergoing stroke rehabilitation. Moreover, polypharmacy was negatively associated with activities of daily living (ADL) but not with PIMs and ADLs, and both were associated with home discharge.
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Affiliation(s)
- Ayaka Matsumoto
- Department of Pharmacy, Kumamoto Rehabilitation Hospital, Kumamoto, Japan
| | - Yoshihiro Yoshimura
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, 760 Magate, Kikuyo-Town, Kikuchi-County, Kumamoto, 869-1106, Japan.
| | - Fumihiko Nagano
- Department of Rehabilitation, Kumamoto Rehabilitation Hospital, Kumamoto, Japan
| | - Takahiro Bise
- Department of Rehabilitation, Kumamoto Rehabilitation Hospital, Kumamoto, Japan
| | - Yoshifumi Kido
- Department of Rehabilitation, Kumamoto Rehabilitation Hospital, Kumamoto, Japan
| | - Sayuri Shimazu
- Department of Nutritional Management, Kumamoto Rehabilitation Hospital, Kumamoto, Japan
| | - Ai Shiraishi
- Department of Dental Office, Kumamoto Rehabilitation Hospital, Kumamoto, Japan
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Cachexia criteria in chronic illness associated with acute weight loss in patients with stroke. Nutrition 2022; 96:111562. [DOI: 10.1016/j.nut.2021.111562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 10/11/2021] [Accepted: 11/28/2021] [Indexed: 11/22/2022]
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Matsumoto A, Yoshimura Y, Wakabayashi H, Kose E, Nagano F, Bise T, Kido Y, Shimazu S, Shiraishi A. Deprescribing Leads to Improved Energy Intake among Hospitalized Older Sarcopenic Adults with Polypharmacy after Stroke. Nutrients 2022; 14:nu14030443. [PMID: 35276802 PMCID: PMC8838977 DOI: 10.3390/nu14030443] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 01/14/2022] [Accepted: 01/16/2022] [Indexed: 12/15/2022] Open
Abstract
Evidence is scarce regarding the polypharmacy in patients with sarcopenia. The aim of this study was to investigate the effect of deprescribing for polypharmacy on the improvement of nutritional intake and sarcopenia in older patients with sarcopenia. A retrospective cohort study was conducted with hospitalized older patients with sarcopenia undergoing rehabilitation after stroke. Study outcomes included energy intake, protein intake, handgrip strength (HG) and skeletal muscle mass index (SMI) at hospital discharge. To consider the effects of deprescribing for polypharmacy, we used multivariate analyses to examine whether the change in the number of medications during hospitalization was associated with outcomes. Of 361 patients after enrollment, 91 (mean age 81.0 years, 48.4% male) presented with sarcopenia and polypharmacy and were eligible for analysis. The change in the number of medications was independently associated with energy intake (β = −0.237, p = 0.009) and protein intake (β = −0.242, p = 0.047) at discharge, and was not statistically significantly associated with HG (β = −0.018, p = 0.768) and SMI (β = 0.083, p = 0.265) at discharge, respectively. Deprescribing was associated with improved nutritional intake in older sarcopenic patients with polypharmacy undergoing stroke rehabilitation.
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Affiliation(s)
- Ayaka Matsumoto
- Department of Pharmacy, Kumamoto Rehabilitation Hospital, Kumamoto 869-1106, Japan;
| | - Yoshihiro Yoshimura
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, Kumamoto 869-1106, Japan
- Correspondence: ; Tel.: +81-96-232-3111
| | - Hidetaka Wakabayashi
- Department of Rehabilitation Medicine, Tokyo Women’s Medical University Hospital, Tokyo 162-8666, Japan;
| | - Eiji Kose
- Department of Pharmacy, Teikyo University School of Medicine University Hospital, Tokyo 173-8606, Japan;
| | - Fumihiko Nagano
- Department of Rehabilitation, Kumamoto Rehabilitation Hospital, Kumamoto 869-1106, Japan; (F.N.); (T.B.); (Y.K.)
| | - Takahiro Bise
- Department of Rehabilitation, Kumamoto Rehabilitation Hospital, Kumamoto 869-1106, Japan; (F.N.); (T.B.); (Y.K.)
| | - Yoshifumi Kido
- Department of Rehabilitation, Kumamoto Rehabilitation Hospital, Kumamoto 869-1106, Japan; (F.N.); (T.B.); (Y.K.)
| | - Sayuri Shimazu
- Department of Nutritional Management, Kumamoto Rehabilitation Hospital, Kumamoto 869-1106, Japan;
| | - Ai Shiraishi
- Department of Dental Office, Kumamoto Rehabilitation Hospital, Kumamoto 869-1106, Japan;
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Obesity and myosteatosis: the two characteristics of dynapenia in patients with cirrhosis. Eur J Gastroenterol Hepatol 2021; 33:e916-e921. [PMID: 35048658 DOI: 10.1097/meg.0000000000002303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
OBJECTIVE In patients with liver cirrhosis, the clinical characteristics of dynapenia, a condition in which skeletal muscle mass is maintained but muscle strength is reduced, are not yet known. This study aimed to clarify the characteristics of dynapenia and its impact on quality of life (QOL) in patients with liver cirrhosis. METHODS We retrospectively analyzed 116 patients with cirrhosis. Based on grip strength and skeletal muscle mass measured by the bioelectrical impedance analysis method, patients were divided into four groups: normal muscle status, dynapenia, pre-sarcopenia (a condition involving only low muscle mass), and sarcopenia. The characteristics of dynapenia and its influence on QOL were examined. RESULTS Fourteen patients had dynapenia. Liver function did not differ among the four groups. In patients with dynapenia, BMI was highest and computed tomography attenuation of skeletal muscle at the third lumbar spine vertebra was lowest among the four groups. The percentage of patients with both BMI ≥25 kg/m2 and myosteatosis was significantly higher in patients with dynapenia [9/14 (64.3%)] than in those with sarcopenia [2/23 (8.7%), P = 0.004] and pre-sarcopenia [0/18 (0%), P < 0.001] and tended to be higher than those with normal muscle status [16/61 (26.2%), P = 0.065]. The physical QOL in patients with dynapenia was as low as that in those with sarcopenia and significantly lower than that in those with normal muscle status. CONCLUSION Cirrhotic patients with dynapenia had high BMI and myosteatosis, and impaired physical QOL.
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Inoue T, Maeda K, Shimizu A, Nagano A, Ueshima J, Sato K, Murotani K. Calf circumference value for sarcopenia screening among older adults with stroke. Arch Gerontol Geriatr 2020; 93:104290. [PMID: 33171328 DOI: 10.1016/j.archger.2020.104290] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 09/29/2020] [Accepted: 10/26/2020] [Indexed: 11/16/2022]
Abstract
PURPOSE The Asia Working Group for Sarcopenia 2019 (AWGS) recommended using the calf circumference (CC) cut-off values to facilitate the case-finding of sarcopenia. However, the validity of the proposed cut-offs has not been examined in older patients with stroke. This study investigated the validity of the AWGS-recommended CC cut-off values for identifying sarcopenia among older patients with stroke. MATERIALS AND METHODS This cross-sectional study enrolled consecutive patients with stroke, aged 65 years and older, admitted to a convalescent rehabilitation ward. Sarcopenia was diagnosed based on the AWGS 2019 criteria. We drew a receiving operating characteristic curve to assess the ability of CC to predict sarcopenia diagnosis. Subsequently, we estimated the sensitivity, specificity, accuracy, F-value, and Matthews correlation coefficient (MCC) of the considered cut-off values. RESULTS We enrolled 256 patients (43 % women) (mean age, 76.6 ± 7.5 years). The prevalence of sarcopenia was 63.7 %. Among men who presented with CC < 34 cm (the AWGS-recommended cut-off value), sensitivity and specificity were 85 % and 66 %, respectively. Concurrently, estimates of accuracy, F-value, and MCC were the highest at cut-off value <34 cm. Among women, at <33 cm of the AWGS-recommended cut-off value, the sensitivity and specificity were 91 % and 28 %, respectively. At cut-off value <32 cm, sensitivity was maintained at 80 %, while specificity increased to 56 %; suggesting that this cut-off value might be a useful indicator for the case-finding of sarcopenia. CONCLUSIONS The AWGS-recommended CC cut-off values are valid. The predictive characteristics of sarcopenia differed among men and women with stroke.
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Affiliation(s)
- Tatsuro Inoue
- Department of Physical Therapy, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata City, 950-3198, Japan
| | - Keisuke Maeda
- Department of Geriatric Medicine, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi, 474-8511, Japan; Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan.
| | - Akio Shimizu
- Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan; Department of Nutrition, Hamamatsu City Rehabilitation Hospital, 1-6-1 Wagokita, Naka-ku, Hamamatsu, Shizuoka, 433-8127, Japan
| | - Ayano Nagano
- Department of Nursing, Nishinomiya Kyoritsu Neurosurgical Hospital, 11-1 Imazuyamanaka-cho, Nishinomiya, Hyogo, 663-8211, Japan
| | - Junko Ueshima
- Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan; Department of Clinical Nutrition and Food Service, NTT Medical Center Tokyo, 5-9-22 Higashi-Gotanda, Shinagawa-ku, Tokyo, 141-8625, Japan
| | - Keisuke Sato
- Okinawa Chuzan Clinical Research Center, Chuzan Hospital, 6-2-1, Matsumoto, Okinawa, Okinawa, 904-2151, Japan
| | - Kenta Murotani
- Biostatistics Center, Kurume University, Asahi Machi, 67, Kurume, Fukuoka, 830-0011, Japan
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Yoshimura Y, Wakabayashi H, Nagano F, Bise T, Shimazu S, Kudo M, Shiraishi A. Sarcopenic Obesity Is Associated With Activities of Daily Living and Home Discharge in Post-Acute Rehabilitation. J Am Med Dir Assoc 2020; 21:1475-1480. [DOI: 10.1016/j.jamda.2020.03.029] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 03/23/2020] [Accepted: 03/30/2020] [Indexed: 12/11/2022]
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Impact of Sarcopenia on Simultaneous Pancreas and Kidney Transplantation Outcomes: A Retrospective Observational Cohort Study. Transplant Direct 2020; 6:e610. [PMID: 33062843 PMCID: PMC7523826 DOI: 10.1097/txd.0000000000001053] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 07/20/2020] [Accepted: 07/22/2020] [Indexed: 01/06/2023] Open
Abstract
Supplemental Digital Content is available in the text. Sarcopenia has been identified as a predictive variable for surgical outcomes. We hypothesized that sarcopenia could be a key measure to identify frail patients and potentially predict poorer outcomes among recipients of simultaneous pancreas and kidney (SPK) transplants.
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Namba M, Hiramatsu A, Aikata H, Kodama K, Uchikawa S, Ohya K, Morio K, Fujino H, Nakahara T, Murakami E, Yamauchi M, Kawaoka T, Tsuge M, Imamura M, Chayama K. Management of refractory ascites attenuates muscle mass reduction and improves survival in patients with decompensated cirrhosis. J Gastroenterol 2020; 55:217-226. [PMID: 31485782 DOI: 10.1007/s00535-019-01623-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 08/26/2019] [Indexed: 02/04/2023]
Abstract
BACKGROUND This study investigated time-course changes in skeletal muscle volume per year with tolvaptan in patients with refractory ascites that was unresponsive to loop diuretics and aldosterone antagonists. METHODS This retrospective study included 42 patients who received tolvaptan for refractory ascites and/or hepatic edema and underwent computed tomography (CT) before and ≥ 3 months after initiating tolvaptan. The time-course changes in skeletal muscle index per year [ΔSMI (%)] was calculated as follows: ΔSMI (%) = (SMI at final CT scan - SMI at initial CT scan)/SMI at initial CT scan × 100/years between CT scans. RESULTS Eligible patients were 23 men and 19 women of median age of 71 years (range 21-94 years). The median follow-up period was 22.7 (range 3.5-54.6) months. ΔSMI (%) was significantly higher in the responders group than in the nonresponder group. Multivariate analysis showed the response to tolvaptan was an independent and significant factor associated with an increase in muscle mass [odds ratio (OR) 20.364; 95% CI 2.327-178.97; P = 0.006]. Overall survival with tolvaptan was significantly higher in the responder group than in the nonresponder group. Multivariate analysis showed that the response to tolvaptan treatment was a significant contributor to good prognosis (OR 3.884; 95% CI 1.264-11.931; P = 0.018). A significant negative correlation was observed between the dosage of furosemide and ΔSMI (%) (P = 0.014). CONCLUSIONS Treatment of refractory ascites with tolvaptan may attenuate the progression of sarcopenia and improve the prognosis in patients with decompensated cirrhosis.
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Affiliation(s)
- Maiko Namba
- Department of Gastroenterology and Metabolism, Hiroshima University Hospital, 1-2-3 Kasumi, Minamiku, Hiroshima, 734-8551, Japan
| | - Akira Hiramatsu
- Department of Gastroenterology and Metabolism, Hiroshima University Hospital, 1-2-3 Kasumi, Minamiku, Hiroshima, 734-8551, Japan.
| | - Hiroshi Aikata
- Department of Gastroenterology and Metabolism, Hiroshima University Hospital, 1-2-3 Kasumi, Minamiku, Hiroshima, 734-8551, Japan
| | - Kenichiro Kodama
- Department of Gastroenterology and Metabolism, Hiroshima University Hospital, 1-2-3 Kasumi, Minamiku, Hiroshima, 734-8551, Japan
| | - Shinsuke Uchikawa
- Department of Gastroenterology and Metabolism, Hiroshima University Hospital, 1-2-3 Kasumi, Minamiku, Hiroshima, 734-8551, Japan
| | - Kazuki Ohya
- Department of Gastroenterology and Metabolism, Hiroshima University Hospital, 1-2-3 Kasumi, Minamiku, Hiroshima, 734-8551, Japan
| | - Kei Morio
- Department of Gastroenterology and Metabolism, Hiroshima University Hospital, 1-2-3 Kasumi, Minamiku, Hiroshima, 734-8551, Japan
| | - Hatsue Fujino
- Department of Gastroenterology and Metabolism, Hiroshima University Hospital, 1-2-3 Kasumi, Minamiku, Hiroshima, 734-8551, Japan
| | - Takashi Nakahara
- Department of Gastroenterology and Metabolism, Hiroshima University Hospital, 1-2-3 Kasumi, Minamiku, Hiroshima, 734-8551, Japan
| | - Eisuke Murakami
- Department of Gastroenterology and Metabolism, Hiroshima University Hospital, 1-2-3 Kasumi, Minamiku, Hiroshima, 734-8551, Japan
| | - Masami Yamauchi
- Department of Gastroenterology and Metabolism, Hiroshima University Hospital, 1-2-3 Kasumi, Minamiku, Hiroshima, 734-8551, Japan
| | - Tomokazu Kawaoka
- Department of Gastroenterology and Metabolism, Hiroshima University Hospital, 1-2-3 Kasumi, Minamiku, Hiroshima, 734-8551, Japan
| | - Masataka Tsuge
- Department of Gastroenterology and Metabolism, Hiroshima University Hospital, 1-2-3 Kasumi, Minamiku, Hiroshima, 734-8551, Japan
| | - Michio Imamura
- Department of Gastroenterology and Metabolism, Hiroshima University Hospital, 1-2-3 Kasumi, Minamiku, Hiroshima, 734-8551, Japan
| | - Kazuaki Chayama
- Department of Gastroenterology and Metabolism, Hiroshima University Hospital, 1-2-3 Kasumi, Minamiku, Hiroshima, 734-8551, Japan
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Agreement Between Body Composition Assessed by Bioelectrical Impedance Analysis and Doubly Labeled Water in Obese Women Submitted to Bariatric Surgery : Body Composition, BIA, and DLW. Obes Surg 2019; 29:183-189. [PMID: 30232726 DOI: 10.1007/s11695-018-3505-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Bariatric surgery has a significant influence on body composition (BC), which should be monitored. However, there is a need to recommend low-cost practical methods, with good estimation of BC for class III obese and/or bariatric patients. OBJECTIVE The aim of this study was to determine accuracy and agreement between BC assessed by direct segmental multifrequency bioelectrical impedance analysis (DSM-BIA) and doubly labeled water (DLW) as reference method. MATERIAL AND METHODS Twenty class III obese women (age 29.3 ± 5.1 years; body mass index 44.8 ± 2.4 kg/m2) underwent Roux-en-Y gastric bypass surgery. BC (fat mass [FM], fat-free mass [FFM], and total body water [TBW]) was assessed by InBody 230 and DLW in the following periods: before and 6 and 12 months after surgery. Accuracy between the methods was evaluated by the bias and root mean square error. Pearson's correlation, concordance correlation coefficient (CCC), and Bland-Altman method were used to evaluate agreement between the methods. RESULTS Correlations were significant (p < 0.001) and CCC was good/excellent between both methods for the evaluation of FM (r = 0.84-0.92, CCC = 0.84-0.95), FFM (r = 0.73-0.90, CCC = 0.68-0.80), and TBW (r = 0.76-0.91, CCC = 0.72-0.81) before and after bariatric surgery. In addition, no significant bias was observed between DSM-BIA and DLW for FM (mean error [ME] = - 1.40 to 0.06 kg), FFM (ME = 0.91-1.86 kg), and TBW (ME = 0.71-1.24 kg) measurements. CONCLUSION The DSM-BIA was able to estimate the BC of class III obese women submitted to bariatric surgery with values consistent with those of the DLW method.
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Lee MJ, Kim EH, Bae SJ, Kim GA, Park SW, Choe J, Jung CH, Lee WJ, Kim HK. Age-Related Decrease in Skeletal Muscle Mass Is an Independent Risk Factor for Incident Nonalcoholic Fatty Liver Disease: A 10-Year Retrospective Cohort Study. Gut Liver 2019; 13:67-76. [PMID: 30037166 PMCID: PMC6347003 DOI: 10.5009/gnl18070] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 05/02/2018] [Accepted: 06/08/2018] [Indexed: 12/23/2022] Open
Abstract
Background/Aims Sarcopenia has emerged as an important risk factor for nonalcoholic fatty liver disease (NAFLD). Although aging is the main cause of sarcopenia, the longitudinal association between age-related body composition changes and NAFLD development has not been fully investigated. Thus, we evaluated whether age-related increased fat mass or decreased muscle mass is an independent risk factor for incident NAFLD. Methods We conducted a retrospective cohort study involving 4,398 initially NAFLD-free subjects who underwent routine health examinations during 2004 to 2005 and returned for a follow-up during 2014 to 2015. Their body composition was measured by bioelectrical impedance analysis, and fatty liver was diagnosed by abdominal ultrasonography. Results At the 10-year follow-up, 591 out of 4,398 participants (13.4%) had developed NAFLD. In men and women, both increased fat mass and decreased appendicular skeletal muscle mass (ASM) with aging were significantly associated with incident NAFLD after adjustment. A subgroup analysis according to the baseline obesity status showed that increased fat mass was significantly associated with incident NAFLD in obese and nonobese subjects. However, decreased ASM was significantly associated with incident NAFLD in nonobese but not in obese subjects. According to ΔASM tertiles (decrease of ASM), the odds ratios for incident NAFLD in nonobese subjects were 1.38 (95% confidence interval [CI], 1.04 to 1.84) for the second tertile and 1.81 (95% CI, 1.34 to 2.45) for the third tertile after adjustment (p=0.001). Conclusions A progressive increase in fat mass and a loss of ASM with aging were significantly associated with incident NAFLD. This association was more prominent in nonobese subjects.
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Affiliation(s)
- 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
| | - Gi-Ae Kim
- Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sung Won Park
- 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
| | - Chang Hee Jung
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Woo Je Lee
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hong-Kyu Kim
- Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Yoshimura Y, Wakabayashi H, Bise T, Nagano F, Shimazu S, Shiraishi A, Yamaga M, Koga H. Sarcopenia is associated with worse recovery of physical function and dysphagia and a lower rate of home discharge in Japanese hospitalized adults undergoing convalescent rehabilitation. Nutrition 2019; 61:111-118. [DOI: 10.1016/j.nut.2018.11.005] [Citation(s) in RCA: 103] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 09/27/2018] [Accepted: 11/19/2018] [Indexed: 01/06/2023]
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Tamai Y, Iwasa M, Kawasaki Y, Yoshizawa N, Ogura S, Sugimoto R, Eguchi A, Yamamoto N, Sugimoto K, Hasegawa H, Takei Y. Ratio between estimated glomerular filtration rates of creatinine and cystatin C predicts overall survival in patients with hepatocellular carcinoma. Hepatol Res 2019; 49:153-163. [PMID: 30005446 DOI: 10.1111/hepr.13230] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 06/20/2018] [Accepted: 07/06/2018] [Indexed: 01/05/2023]
Abstract
AIM Hepatocellular carcinoma (HCC) patients with sarcopenia have a poor survival, but there are no predictive markers for survival relating to muscle mass and liver function. Therefore, we investigated whether the ratio between estimated glomerular filtration rates of serum creatinine (Scre) and serum cystatin C (Scys) (eGFRcre/eGFRcys) can be used as a predictive marker of survival in HCC patients. METHODS First, the correlation between Scre/Scys ratio and muscle mass was examined in 50 patients with chronic liver disease. Second, a change in Scre/Scys ratio relating to liver function was investigated in cirrhotic rats. Finally, the relationship between the eGFRcre/eGFRcys ratio and survival was assessed in 86 HCC patients. RESULTS The Scre/Scys ratio was correlated with skeletal muscle mass index (r = 0.331, P = 0.019) and psoas muscle area index (r = 0.397, P = 0.004) in chronic liver disease patients. In cirrhotic rats, Scre and Scre/Scys ratio were decreased corresponding with liver function. Thirty-five of 86 HCC patients died within the average follow-up period of 35 months. The patients with an eGFRcre/eGFRcys ratio <1.26 had significantly longer rates of survival compared to patients with an eGFRcre/eGFRcys ratio ≥1.26 (28.8 vs. 18.5 months, P = 0.001). Using multivariate Cox regression analyses, the patient-related eGFRcre/eGFRcys ratio (hazard ratio [HR], 4.178; P = 0.007), as well as the tumor-related factors α-fetoprotein (HR, 1.000; P < 0.001) and Barcelona Clinic Liver Cancer stage (HR, 2.589; P < 0.001), were independent predictors of survival. CONCLUSION The Scre/Scys ratio is associated with muscle mass and liver function. Furthermore, the eGFRcre/eGFRcys ratio could serve as a useful predictive marker for survival of HCC.
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Affiliation(s)
- Yasuyuki Tamai
- Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Motoh Iwasa
- Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Yuya Kawasaki
- Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Naohiko Yoshizawa
- Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Suguru Ogura
- Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Ryosuke Sugimoto
- Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Akiko Eguchi
- Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Norihiko Yamamoto
- Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Kazushi Sugimoto
- Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Hiroshi Hasegawa
- Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Yoshiyuki Takei
- Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine, Tsu, Japan
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Moriwaki M, Wakabayashi H, Sakata K, Domen K. The Effect of Branched Chain Amino Acids-Enriched Nutritional Supplements on Activities of Daily Living and Muscle Mass in Inpatients with Gait Impairments: A Randomized Controlled Trial. J Nutr Health Aging 2019; 23:348-353. [PMID: 30932133 DOI: 10.1007/s12603-019-1172-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To investigate the effects of continuous intervention with branched chain amino acids-enriched nutritional supplements from the acute phase to convalescent rehabilitation wards in inpatients with gait impairments. DESIGN Open-label, randomized, parallel-group comparison study (UMIN Clinical Trials Registry ID: UMIN000018640). SETTING Acute care and convalescent rehabilitation wards. PARTICIPANTS We studied 80 patients undergoing stand/gait training. INTERVENTIONS Participants in the intervention group (RJ group) received nutritional supplements (jelly foods comprising 2500 mg BCAA and 20 IU vitamin D) twice a day until hospital discharge. MEASUREMENTS The primary outcome was the motor components of the Functional Independence Measure (FIM-m), and the secondary outcome was skeletal muscle mass index. RESULTS Analyses were conducted on 55 patients who were able to perform stand/gait training continuously from the acute until the recovery phases. FIM-m was significantly elevated in the RJ group and the control group , but no difference was noted between the two groups. Only the RJ group showed a significant increase in skeletal muscle mass index, and the amount of variation was significantly different between the two groups (the control group decreased an average of 2.2% and the RJ group increased an average of 4.3%; P = 0.014). A significant decrease in body weight was found only in the control group (P = 0.084). CONCLUSIONS Nutritional interventions using branched chain amino acids (BCAA)-enriched nutritional supplements demonstrated no significant difference in activities of daily living; however, an increase in skeletal muscle mass was noted. Skeletal muscle mass and body weight differed significantly between the two groups, and BCAA-enriched nutritional supplements intake in acute and convalescent rehabilitation wards may be effective for the prevention of malnutrition and sarcopenia.
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Affiliation(s)
- M Moriwaki
- Misa Moriwaki MD, Department of Rehabilitation Medicine, Midorigaoka Hospital, 3-13-1 Makami-cho, Takatsuki, Osaka, Japan 569-1121, Tel.: +81-72-681-5717, Fax: +81-72-681-5796, E-mail:
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Yoshimura Y, Wakabayashi H, Bise T, Tanoue M. Prevalence of sarcopenia and its association with activities of daily living and dysphagia in convalescent rehabilitation ward inpatients. Clin Nutr 2018; 37:2022-2028. [DOI: 10.1016/j.clnu.2017.09.009] [Citation(s) in RCA: 107] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 09/05/2017] [Accepted: 09/10/2017] [Indexed: 01/24/2023]
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Tanaka M, Masuda S, Yamakage H, Inoue T, Ohue-Kitano R, Yokota S, Kusakabe T, Wada H, Sanada K, Ishii K, Hasegawa K, Shimatsu A, Satoh-Asahara N. Role of serum myostatin in the association between hyperinsulinemia and muscle atrophy in Japanese obese patients. Diabetes Res Clin Pract 2018; 142:195-202. [PMID: 29859272 DOI: 10.1016/j.diabres.2018.05.041] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 04/16/2018] [Accepted: 05/24/2018] [Indexed: 12/18/2022]
Abstract
AIMS The protein myostatin is a member of the transforming growth factor β superfamily. This is mainly expressed in skeletal muscle and negatively regulates skeletal muscle growth. The present study aimed to elucidate the associations among circulating myostatin level, skeletal muscle mass, and metabolic profiles in Japanese obese patients. METHODS Japanese obese outpatients (n = 74) were enrolled. We measured clinical parameters, quantified serum myostatin levels, and examined their associations in a cross-sectional manner. RESULTS Both total skeletal muscle mass and serum myostatin level were higher in males than in females. Among 74 patients, serum myostatin level was positively correlated with skeletal muscle mass and serum immunoreactive insulin (IRI) level [correlation coefficient (r) = 0.294, P = 0.011; r = 0.262, P = 0.024, respectively]. Furthermore, multivariate linear regression analysis revealed that serum myostatin level was positively correlated with IRI after adjusting for gender and skeletal muscle mass (β-coefficient = 0.230, P = 0.029, R2 = 0.236). CONCLUSIONS In obese patients, serum myostatin level was elevated in conjunction with an increase in IRI level independent of skeletal muscle mass. This may imply possible novel pathological implications of serum myostatin in muscle mass and metabolism in obese patients with hyperinsulinemia.
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Affiliation(s)
- Masashi Tanaka
- Department of Endocrinology, Metabolism, and Hypertension Research, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, 1-1 Fukakusa Mukaihata-cho, Fushimi-ku, Kyoto 612-8555, Japan; Department of Physical Therapy, Health Science University, 7187 Kodachi, Fujikawaguchiko-machi, Yamanashi 401-0380, Japan
| | - Shinya Masuda
- Department of Endocrinology, Metabolism, and Hypertension Research, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, 1-1 Fukakusa Mukaihata-cho, Fushimi-ku, Kyoto 612-8555, Japan
| | - Hajime Yamakage
- Department of Endocrinology, Metabolism, and Hypertension Research, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, 1-1 Fukakusa Mukaihata-cho, Fushimi-ku, Kyoto 612-8555, Japan
| | - Takayuki Inoue
- Department of Endocrinology, Metabolism, and Hypertension Research, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, 1-1 Fukakusa Mukaihata-cho, Fushimi-ku, Kyoto 612-8555, Japan
| | - Ryuji Ohue-Kitano
- Department of Endocrinology, Metabolism, and Hypertension Research, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, 1-1 Fukakusa Mukaihata-cho, Fushimi-ku, Kyoto 612-8555, Japan
| | - Shigefumi Yokota
- Department of Endocrinology, Metabolism, and Hypertension Research, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, 1-1 Fukakusa Mukaihata-cho, Fushimi-ku, Kyoto 612-8555, Japan
| | - Toru Kusakabe
- Department of Endocrinology, Metabolism, and Hypertension Research, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, 1-1 Fukakusa Mukaihata-cho, Fushimi-ku, Kyoto 612-8555, Japan
| | - Hiromichi Wada
- Department of Translational Research, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, 1-1 Fukakusa Mukaihata-cho, Fushimi-ku, Kyoto 612-8555, Japan
| | - Kiyoshi Sanada
- College of Sport and Health Science, Ritsumeikan University, 1-1-1 Noji-higashi, Kusatsu, Shiga 525-8577, Japan
| | - Kojiro Ishii
- Faculty of Health and Sports Science, Doshisha University, 1-3 Tatara-Miyakodani, Kyo-Tanabe, Kyoto 610-0394, Japan
| | - Koji Hasegawa
- Department of Translational Research, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, 1-1 Fukakusa Mukaihata-cho, Fushimi-ku, Kyoto 612-8555, Japan
| | - Akira Shimatsu
- Clinical Research Institute, National Hospital Organization Kyoto Medical Center, 1-1 Mukaihata-cho, Fukakusa, Fushimi-ku, Kyoto 612-8555, Japan
| | - Noriko Satoh-Asahara
- Department of Endocrinology, Metabolism, and Hypertension Research, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, 1-1 Fukakusa Mukaihata-cho, Fushimi-ku, Kyoto 612-8555, Japan.
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Yoshimura Y, Bise T, Shimazu S, Tanoue M, Tomioka Y, Araki M, Nishino T, Kuzuhara A, Takatsuki F. Effects of a leucine-enriched amino acid supplement on muscle mass, muscle strength, and physical function in post-stroke patients with sarcopenia: A randomized controlled trial. Nutrition 2018; 58:1-6. [PMID: 30273819 DOI: 10.1016/j.nut.2018.05.028] [Citation(s) in RCA: 88] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2017] [Revised: 03/01/2018] [Accepted: 05/11/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVES The aim of this study was to investigate the effects of a leucine-enriched amino acid supplement on muscle mass, muscle strength, and physical function in post-stroke patients with sarcopenia. METHODS We conducted an eight-wk, two-parallel group intervention, randomized controlled, blinded outcome assessment among 44 post-stroke older patients with sarcopenia. Sarcopenia was defined as a loss of skeletal muscle mass and decreased muscle strength according to the Asian Working Group for Sarcopenia criteria. The intervention group (n = 21) received a leucine-enriched amino acid supplement; the control group (n = 23) did not. Both groups performed low-intensity resistance training in addition to a post-stroke rehabilitation program. A primary outcome of physical function by using the motor domain of Functional Independence Measure (FIM), and secondary outcomes of appendicular muscle mass (skeletal muscle mass index [SMI]) measured via bioelectrical impedance analysis and muscle strength as handgrip strength were measured at baseline and at the end of the intervention. RESULTS The FIM score increased significantly in both groups over time (P < 0.01), with significantly greater improvement in the intervention group than in the control group (P < 0.045). Handgrip strength also increased significantly over time (P <0.05), with significantly greater improvement in the intervention group (P < 0.01). The SMI increased significantly in the intervention group but not in the control group over time, with significantly greater improvement in the intervention group (median estimated difference, 0.50 kg/m2; 95% confidence interval, 0.01-2.11). CONCLUSIONS We demonstrated that an eight-wk intervention consisting of a leucine-enriched amino acid supplementation and low-intensity resistance training increased muscle mass, strength, and physical function in post-stroke patients with sarcopenia.
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Affiliation(s)
- Yoshihiro Yoshimura
- Department of Rehabilitation Medicine, Kumamoto Rehabilitation Hospital, Kumamoto, Japan.
| | - Takahiro Bise
- Department of Rehabilitation, Kumamoto Rehabilitation Hospital, Kumamoto, Japan
| | - Sayuri Shimazu
- Department of Nutritional Management, Kumamoto Rehabilitation Hospital, Kumamoto, Japan
| | - Maiko Tanoue
- Department of Rehabilitation, Kumamoto Rehabilitation Hospital, Kumamoto, Japan
| | - Yuko Tomioka
- Department of Rehabilitation, Kumamoto Rehabilitation Hospital, Kumamoto, Japan
| | - Mai Araki
- Department of Rehabilitation, Kumamoto Rehabilitation Hospital, Kumamoto, Japan
| | - Takafumi Nishino
- Department of Rehabilitation, Kumamoto Rehabilitation Hospital, Kumamoto, Japan
| | - Aomi Kuzuhara
- Department of Rehabilitation, Kumamoto Rehabilitation Hospital, Kumamoto, Japan
| | - Fumihiko Takatsuki
- Department of Consumer Foods & Seasonings, Food Products Division, Ajinomoto Co., Inc., Tokyo, Japan
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26
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Sugimoto R, Iwasa M, Hara N, Tamai Y, Yoshikawa K, Ogura S, Tanaka H, Eguchi A, Yamamoto N, Kobayashi Y, Hasegawa H, Takei Y. Changes in liver function and body composition by direct-acting antiviral therapy for hepatitis C virus infection. Hepatol Res 2018; 48:337-344. [PMID: 29115717 DOI: 10.1111/hepr.12999] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 11/02/2017] [Accepted: 11/04/2017] [Indexed: 12/13/2022]
Abstract
AIM Management of low skeletal muscle mass (LSM) is a very important topic as LSM affects patient mortality in liver diseases. Changes in body composition are unexplored in chronic hepatitis C virus (HCV) patients, including those with liver cirrhosis, who receive direct-acting antiviral (DAA) therapy. Body composition measurements and liver function tests were carried out before and after DAA therapy. METHODS Blood examination, visceral fat area (VFA) and extremity skeletal muscle mass were measured using the multifrequency bioelectrical impedance analysis method: (i) at 24 weeks before DAA therapy; (ii) at the start of DAA therapy; (iii) at the end of DAA therapy; (iv) at 24 weeks after DAA therapy; and (v) at 48 weeks after DAA therapy. RESULTS Serum albumin (Alb) levels were significantly increased at 48 weeks post DAA therapy, especially in patients with LSM. Skeletal muscle mass index (SMI) was significantly increased after DAA therapy (at 24 weeks and 48 weeks post DAA therapy) in patients with LSM (P < 0.05). An increase in SMI was associated with an increase in body weight or a decrease in VFA. CONCLUSIONS We continuously measured body composition in HCV-infected patients who received DAA therapy and found that skeletal muscle mass was significantly increased, associated with an elevation of serum Alb levels and/or body weight or reduction in VFA, but only in patients who presented with LSM before DAA therapy.
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Affiliation(s)
- Ryosuke Sugimoto
- Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Motoh Iwasa
- Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Nagisa Hara
- Nutrition Unit, Mie University Hospital, Tsu, Japan
| | - Yasuyuki Tamai
- Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Kyoko Yoshikawa
- Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Suguru Ogura
- Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Hideaki Tanaka
- Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Akiko Eguchi
- Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Norihiko Yamamoto
- Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Yoshinao Kobayashi
- Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Hiroshi Hasegawa
- Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Yoshiyuki Takei
- Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine, Tsu, Japan
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27
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Kaido T, Hamaguchi Y, Uemoto S. Sarcopenia plays a crucial role in liver transplantation. Hepatobiliary Surg Nutr 2017; 6:434-436. [PMID: 29312984 DOI: 10.21037/hbsn.2017.08.05] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Toshimi Kaido
- Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yuhei Hamaguchi
- Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shinji Uemoto
- Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Maeda K, Shamoto H, Wakabayashi H, Akagi J. Sarcopenia Is Highly Prevalent in Older Medical Patients With Mobility Limitation. Nutr Clin Pract 2016; 32:110-115. [DOI: 10.1177/0884533616680355] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Affiliation(s)
- Keisuke Maeda
- Department of Nutrition and Dysphagia Rehabilitation, Tamana Regional Health Medical Center, Kumamoto, Japan
| | - Hiroshi Shamoto
- Department of Neurosurgery, Minamisoma Municipal General Hospital, Fukushima, Japan
| | - Hidetaka Wakabayashi
- Department of Rehabilitation Medicine, Yokohama City University Medical Center, Yokohama, Japan
| | - Junji Akagi
- Department of Surgery, Tamana Regional Health Medical Center, Kumamoto, Japan
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29
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Krzymińska-Siemaszko R, Czepulis N, Lewandowicz M, Zasadzka E, Suwalska A, Witowski J, Wieczorowska-Tobis K. The Effect of a 12-Week Omega-3 Supplementation on Body Composition, Muscle Strength and Physical Performance in Elderly Individuals with Decreased Muscle Mass. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:10558-74. [PMID: 26343698 PMCID: PMC4586628 DOI: 10.3390/ijerph120910558] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2015] [Revised: 06/18/2015] [Accepted: 08/24/2015] [Indexed: 01/19/2023]
Abstract
The aim of the study was to assess the effect of a polyunsaturated omega-3 fatty acids (PUFA) supplementation on the parameters of body composition, muscle strength and physical performance in elderly people with decreased muscle mass (DMM). Fifty three elderly people with an ALM index (the ratio of appendicular lean mass to squared height) either below (-2SD: low muscle mass-LMM) or between (-1SD and -2SD: the risk of LMM-rLMM) the ALM index for the young Polish reference population were randomly assigned to PUFA-treated groups (LMM-PUFA, rLMM-PUFA) or control groups (LMM-control, rLMM-control). PUFA-treated groups received capsules containing 1.3 g of PUFA and 10 mg of vitamin E, while the control groups received 11 mg of vitamin E daily for 12 weeks. Body composition (BIA analysis), muscle strength (hand grip measured with dynamometer) and physical performance (Timed Up and Go test-TUG) were assessed before and after supplementation. No statistically significant differences were observed either in muscle mass or in the hand grip and TUG in any group. The post-pre difference (mean ± SD) in ALM index was as follows (kg/m²): LMM-PUFA: 0.00 ± 0.30, rLMM-PUFA: 0.00 ± 0.22, LMM-control: 0.03 ± 0.36, rLMM-control: -0.03 ± 0.20. In our study, a 12 week supplementation of PUFA did not affect the evaluated parameters in elderly individuals with DMM.
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Affiliation(s)
| | - Natasza Czepulis
- Department of Pathophysiology, Poznan University of Medical Sciences, Poznan 60-806, Poland.
| | - Marta Lewandowicz
- Department of Human Nutrition and Hygiene, Poznan University of Life Sciences, Poznan 60-624, Poland.
| | - Ewa Zasadzka
- Department of Geriatric and Gerontology, Poznan University of Medical Sciences, Poznan 60-781, Poland.
| | - Aleksandra Suwalska
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan 60-572, Poland.
| | - Janusz Witowski
- Department of Pathophysiology, Poznan University of Medical Sciences, Poznan 60-806, Poland.
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30
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Ida S, Watanabe M, Yoshida N, Baba Y, Umezaki N, Harada K, Karashima R, Imamura Y, Iwagami S, Baba H. Sarcopenia is a Predictor of Postoperative Respiratory Complications in Patients with Esophageal Cancer. Ann Surg Oncol 2015; 22:4432-7. [PMID: 25862583 DOI: 10.1245/s10434-015-4559-3] [Citation(s) in RCA: 135] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Indexed: 12/16/2022]
Abstract
BACKGROUND Depletion of skeletal muscle mass (sarcopenia) indicates a poor prognosis for patients with several kinds of cancer, but it remains unclear whether esophageal squamous cell carcinoma (ESCC) is among these cancers. The aim of this study was to clarify the relationship between sarcopenia and postoperative outcome in patients with ESCC treated by esophagectomy. METHODS Skeletal muscle mass was assessed in 138 patients who underwent esophagectomy from August 2009 to May 2014. A multifrequency bioelectrical impedance analysis (InBody 720; Biospace, Tokyo, Japan) was used to assess skeletal muscle mass just before surgery. Postoperative complications were graded according to the Clavien-Dindo classification, and univariate and multivariate analyses were performed for postoperative respiratory complications. RESULTS Sarcopenia was determined in 61 patients (44.2 %). Preoperative pulmonary function was significantly lower and the rate of respiratory complications significantly higher in the sarcopenia group than in the non-sarcopenia group (p < 0.01). For other complications, the differences were not significant. Multivariate analysis showed that sarcopenia [odds ratio (OR) 5.82; p = 0.0001] and longer operation time (OR 3.09; p = 0.04) were risk factors for the occurrence of respiratory complications. CONCLUSIONS Sarcopenia may be a predictor of pulmonary complications after esophagectomy. Further analysis is needed to clarify whether nutritional intervention improves skeletal muscle mass and thus contributes to reducing postoperative respiratory complications in sarcopenic patients.
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Affiliation(s)
- Satoshi Ida
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.,Department of Gastroenterological Surgery, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Masayuki Watanabe
- Department of Gastroenterological Surgery, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Naoya Yoshida
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Yoshifumi Baba
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Naoki Umezaki
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Kazuto Harada
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Ryuichi Karashima
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Yu Imamura
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Shiro Iwagami
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Hideo Baba
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
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31
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Krzymińska-Siemaszko R, Czepulis N, Suwalska A, Dworak LB, Fryzowicz A, Madej-Dziechciarow B, Wieczorowska-Tobis K. The significance of body mass index in calculating the cut-off points for low muscle mass in the elderly: methodological issues. BIOMED RESEARCH INTERNATIONAL 2014; 2014:450396. [PMID: 25506592 PMCID: PMC4260439 DOI: 10.1155/2014/450396] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Revised: 09/22/2014] [Accepted: 10/06/2014] [Indexed: 12/25/2022]
Abstract
OBJECTIVES Cut-off points (COPs) for appendicular lean mass (ALM) index, essential to define low muscle mass (LMM) in the elderly, have never been officially defined for Poland. The aim of the study was to establish them. Additionally, the significance of body mass index (BMI) for correctly defining the COPs in a young, healthy reference group was assessed. METHODS The study was composed of reference group (n = 1113) and the elderly group (n = 200). In all subjects, body composition was assessed by bioimpedance analysis, and ALM index was calculated. Next, COPs (kg/m(2)) were set up for the whole reference group and for particular subgroups with different BMIs separately. They were used to diagnose sarcopenia in the elderly. RESULTS COP for all young females was 5.37 (COP-F), while it was equal to 5.52 (COP-F2) when only those with a recommended BMI (18.50-24.99 kg/m(2)) were taken into consideration. For males, it was 7.32 and 7.29, respectively. Only 7% of elderly females had LMM based on COP-F and 15% had LMM based on COP-F2 (P < 0.05); for males, the percentages were 18% and 16%, respectively. CONCLUSIONS COPs for LMM for Poland are 5.52 kg/m(2) (females) and 7.29 kg/m(2) (males). The reference group BMI is an important factor in establishing COPs for low muscle mass.
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Affiliation(s)
- Roma Krzymińska-Siemaszko
- Department of Palliative Medicine, Poznan University of Medical Sciences, Osiedle Rusa 25a, 61-245 Poznan, Poland
| | - Natasza Czepulis
- Department of Pathophysiology, Poznan University of Medical Sciences, 8 Rokietnicka Street, 60-806 Poznan, Poland
| | - Aleksandra Suwalska
- Department of Adult Psychiatry, Poznan University of Medical Sciences, 27/33 Szpitalna Street, 60-572 Poznan, Poland
| | - Lechoslaw B. Dworak
- Department of Bionics, University of Arts, Aleje Marcinkowskiego 29, 60-967 Poznan, Poland
- Department of Physiotherapy and Biological Renovation, Stanislaw Wojciechowski Higher Vocational State School, 4 Nowy Swiat Street, 62-800 Kalisz, Poland
- Department of Biomechanics, University School of Physical Education, 27/39 Krolowej Jadwigi Street, 61-871 Poznan, Poland
| | - Anna Fryzowicz
- Department of Biomechanics, University School of Physical Education, 27/39 Krolowej Jadwigi Street, 61-871 Poznan, Poland
| | - Beata Madej-Dziechciarow
- Department of Physiotherapy and Biological Renovation, Stanislaw Wojciechowski Higher Vocational State School, 4 Nowy Swiat Street, 62-800 Kalisz, Poland
| | - Katarzyna Wieczorowska-Tobis
- Department of Palliative Medicine, Poznan University of Medical Sciences, Osiedle Rusa 25a, 61-245 Poznan, Poland
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