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Xu X, Qian Y, Jin K, Chen J, Fu J, Chen C, Zhu Z. The impact of Helicobacter pylori infection on low skeletal muscle mass risk in Chinese women over 40: a cross-sectional analysis. Front Cell Infect Microbiol 2024; 13:1289909. [PMID: 38235492 PMCID: PMC10791812 DOI: 10.3389/fcimb.2023.1289909] [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: 09/07/2023] [Accepted: 12/08/2023] [Indexed: 01/19/2024] Open
Abstract
Background Sarcopenia can lead to significant personal, social, and economic burdens. The diagnosis of sarcopenia heavily relies on the identification of Low Skeletal Muscle Mass (LSMM), which is an independent predictor of frailty, disability, and increased risk of death among seniors. Women have physiologically lower levels of skeletal muscle mass than men, and female sarcopenia appears to be more influenced by menopause. They also tend to have higher body fat levels than man, which increases the risk of sarcopenia obesity. On another front, it's also recognized that humans are largely prone to Helicobacter pylori (H. pylori) infection, with global prevalence rates often surpassing 50%. Nevertheless, the interconnection between H. pylori infection and LSMM remains relatively unexplored. Hence, our study specifically targeted women as the research population and sought to explore several risk factors for LSMM. Additionally, we delved into the potential correlation between LSMM and H. pylori infection in women, hoping to gain insights into potential preventative measures or treatment options that may enhance the quality of life for women affected by sarcopenia. Methods We conducted a cross-sectional study among women aged over 18 years undergoing physical examination. We performed 13C-urea breath test (UBT) for diagnosis of H. pylori infection and Bioelectrical impedance analysis (BIA) for the assessment of LSMM. Logistic regression models were used to analyze the associations of H. pylori infection with LSMM. Results This study enrolled 1984 Chinese women who were undergoing health check-ups. A univariate logistic regression analysis did not reveal a direct correlation between H. pylori infection and LSMM among this female population (OR=1.149, 95% CI 0.904-1.459, p=0.257). Yet, upon dividing the participants into age-based subgroups, an evident link was observed between H. pylori infection and LSMM in women aged 40 or above (OR=1.381, 95%CI 1.032-1.848, p= 0.030). After adjusting for variables including Age, BMI, TP, ALK, Cre, this relationship remained statistically relevant (OR=1.514, 95%CI 1.085-2.113, p= 0.015). Conclusions Women who are over 40 years old and currently infected with H. pylori have an increased risk of developing LSMM. Therefore, timely treatment for H. pylori eradication is recommended for this group of women to reduce the occurrence of LSMM.
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Affiliation(s)
- Xiaohui Xu
- Department of Medical Care Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yidan Qian
- Department of Medical Care Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Kejia Jin
- Department of Medical Care Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Junpeng Chen
- The First School of Medicine, School of Information and Engineering, Wenzhou Medical University, Wenzhou, China
| | - Jiayue Fu
- The First School of Medicine, School of Information and Engineering, Wenzhou Medical University, Wenzhou, China
| | - Chengshui Chen
- Key Laboratory of Interventional Pulmonology of Zhejiang Province, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- Department of Pulmonary and Critical Care Medicine, Quzhou People’s Hospital, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou, China
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Zaisheng Zhu
- Department of Medical Care Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- Key Laboratory of Interventional Pulmonology of Zhejiang Province, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
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Ulugerger Avci G, Bektan Kanat B, Can G, Suzan V, Unal D, Degirmenci P, Avci S, Yavuzer H, Erdincler DS, Doventas A. The impact of sarcopenia and obesity on mortality of older adults: five years results. Ir J Med Sci 2023; 192:2209-2216. [PMID: 37202585 DOI: 10.1007/s11845-023-03392-9] [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: 02/16/2023] [Accepted: 04/27/2023] [Indexed: 05/20/2023]
Abstract
AIM Sarcopenia and obesity can cause severe physical and metabolic complications. We aimed to investigate the risk of mortality associated with sarcopenia and obesity in older adults. METHOD We designed a retrospective, observational cohort study showing the 5-year mortality of older patients in a tertiary geriatric outpatient clinic. Sociodemographic characteristics, medical history, anthropometric measurements, medications, and comorbidities were recorded. Sarcopenia was evaluated with skeletal muscle mass, handgrip strength, and gait speed. We defined sarcopenic obesity as sarcopenia plus obesity (as a body mass index ≥ 30 kg/m2). We classified the participants into four groups according to whether they were sarcopenic and/or obese: non-sarcopenic non-obese, non-sarcopenic obese, sarcopenic non-obese, and sarcopenic obese. The final overall survival of the patients was obtained from the hospital data system. RESULTS Of the 175 patients, the mean age was 76.1 ± 6.4, and the majority were female (n = 120). Sixty-eight had sarcopenia (39%). The prevalence of obesity was 27%. Thirty-eight patients had died within five years (22%). The mortality rate was significantly higher in the oldest (age 85 and above) and sarcopenic groups (p < 0.001, 0.004, respectively). The mortality rate was highest in the sarcopenic obese group (40.9%). Age (HR: 1.13, 95% CI: 1.07-1.19, p: < 0.001), sarcopenic obesity (HR: 4.85, 95% CI: 1.91-12.31, p: 0.001), sarcopenia (HR: 2.26, 95% CI: 1.15-4.43, p: 0.018) and obesity (HR: 2.15, 95% CI: 1.11-4.17, p: 0.023) were independently associated with mortality at 5 years. The Kaplan-Meier analysis and Log-Rank test showed that sarcopenic obese patients had the highest cumulative mortality incidence rates. CONCLUSION Sarcopenic-obese participants had the highest mortality incidence compared to those without obesity or sarcopenia. In addition, the presence of sarcopenia or obesity alone also had a significant role in mortality risk. So, we should especially focus on maintaining or increasing muscle mass and preventing obesity.
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Affiliation(s)
- Gulru Ulugerger Avci
- Division of Geriatric Medicine, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey.
| | - Bahar Bektan Kanat
- Division of Geriatric Medicine, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Gunay Can
- Department of Public Health, Cerrahpasa Medical Faculty, İstanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Veysel Suzan
- Division of Geriatric Medicine, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Damla Unal
- Division of Geriatric Medicine, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Pelin Degirmenci
- Division of Geriatric Medicine, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Suna Avci
- Division of Geriatric Medicine, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Hakan Yavuzer
- Division of Geriatric Medicine, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Deniz Suna Erdincler
- Division of Geriatric Medicine, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Alper Doventas
- Division of Geriatric Medicine, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
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Lu L, Liu B, Yin F. Alternative skeletal muscle index for sarcopenia diagnosis in elderly patients with type 2 diabetes mellitus: A pilot study. Front Endocrinol (Lausanne) 2023; 14:1083722. [PMID: 36843587 PMCID: PMC9947145 DOI: 10.3389/fendo.2023.1083722] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 01/27/2023] [Indexed: 02/11/2023] Open
Abstract
PURPOSE To determine an alternative skeletal muscle index (a-SMI), easy diagnosis of sarcopenia in elderly patients with type 2 diabetes mellitus (T2DM). PATIENTS AND METHODS This cross-sectional study included 223 inpatients with T2DM (100 males, age range 60-89; 123 females, age range 60-87). Screening for grip strength and gait speed, measuring SMI by dual-energy X-ray absorptiometry (d-SMI) for sarcopenia diagnosis, according to the Asian Working Group for Sarcopenia (AWGS) 2019 consensus. The a-SMI was established by binary logistic regression analysis with positive screening population. To assess the conformance of the new diagnostic approach with the AWGS 2019. RESULTS Sarcopenia was present in 36.3% of the study population. 59 had normal d-SMI and 81 had low d-SMI in screening patients with probable sarcopenia. In univariate analyses for all positive screening population, body mass index (BMI), 25-hydroxyvitamin D (25 - (OH) VitD), high density lipoprotein cholesterol (HDL-C), hypertension (HTN), and gender were correlates of d-SMI. Binary logistic regression analysis revealed that male (B = 2.463, 95%CI: 3.640 ~ 37.883, p = 0.000), HTN (B = 1.404, 95%CI: 1.599 ~ 10.371, p = 0.003), BMI (B = -0.344, 95%CI: 0.598 ~ 0.839, p = 0.000), 25-(OH) VitD (B = -0.058, 95%CI: 0.907 ~ 0.982, p = 0.004) were independent factors for d-SMI detection. Based on the extracted four correlates, the a-SMI was determined. The area under receiver operating characteristic (ROC) curve was 0.842, sensitivity and specificity for the new diagnostic approach were 84.0% and 84.5%. In a statistical measure of agreement between the AWGS 2019 and the new diagnostic approach, the kappa coefficient was 0.669 (p < 0.001). CONCLUSION The a-SMI - based on gender, obesity status, 25-(OH) VitD, and HTN history - can be used in the absence of the d-SMI to supplement the algorithm for sarcopenia diagnosis in elderly patients with T2DM.
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Affiliation(s)
- Lanyu Lu
- Department of Endocrinology and Metabolic Diseases, Hebei Medical University, Shijiazhuang, Hebei, China
| | - Bowei Liu
- Department of Endocrinology, The First Hospital of Qinhuangdao, Qinhuangdao, Hebei, China
- *Correspondence: Bowei Liu,
| | - Fuzai Yin
- Department of Endocrinology, The First Hospital of Qinhuangdao, Qinhuangdao, Hebei, China
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Sarcopenia Is Associated with Metabolic Syndrome in Korean Adults Aged over 50 Years: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031330. [PMID: 35162353 PMCID: PMC8835141 DOI: 10.3390/ijerph19031330] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/20/2022] [Accepted: 01/24/2022] [Indexed: 11/16/2022]
Abstract
This study assessed the association between sarcopenia and metabolic syndrome in Korean adults aged over 50 years. The study obtained data from the Korea National Health and Nutrition Examination Survey (KNHANES, 2008–2011), a cross-sectional and nationally representative survey conducted by the Korean Centers for Disease Control and Prevention. Among the 8363 participants included in this study, the prevalence rate of sarcopenia according to metabolic syndrome was stratified by sex. Crude odds ratios not adjusted for any variables were 1.827 (1.496–2.231) in males, 2.189 (1.818–2.635) in females, and 2.209 (1.766–2.331) in total participants compared with non-sarcopenia. Model 3, which was adjusted for all variables that could affect sarcopenia and metabolic syndrome, showed significant increases in the odds ratios, to 1.957 (1.587–2.413) in males, 1.779 (1.478–2.141) in females, and 1.822 (1.586–2.095) for total participants. The results suggest that the association between sarcopenia and metabolic syndrome is significant in Korean adults.
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Heshmat R, Shafiee G, Ostovar A, Fahimfar N, Maleki Birjandi S, Jabbari M, Sharifi F, Nabipour I, Larijani B. Relationship Between Sarcopenia and Electrocardiographic Abnormalities in Older People: The Bushehr Elderly Health Program. Front Med (Lausanne) 2021; 8:656181. [PMID: 34026788 PMCID: PMC8137975 DOI: 10.3389/fmed.2021.656181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 04/12/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Sarcopenia is characterized by low skeletal muscle mass and function, which is associated with cardiovascular risk factors and may even be related to adverse cardiovascular events and mortality. This study aimed to evaluate whether sarcopenia is related to electrocardiographic (ECG) abnormalities in a large sample of older adults. Methods: We performed a cross-sectional study based on the data collected during the Bushehr Elderly Health (BEH) cohort study. Body composition was measured by dual X-ray absorptiometry (DXA) and muscle strength was measured using a digital dynamometer for each hand of every participant. A person who had low muscle strength, as well as low muscle mass was identified as having sarcopenia. The subjects were classified into three groups according to the Minnesota Code (MC) as major, minor ECG abnormalities and participants with no abnormalities ECG. Results: Of the 2,426 participants, 354 (14.6%) had major ECG abnormalities and 193 (8%) had minor ECG abnormalities. Sarcopenia was associated with an increased risk of major ECG abnormality in all models. After adjustment for confounders of CHD in full model, the OR for major ECG abnormality was 1.47 (95% CI 1.11–1.95) in those with sarcopenia. Low muscle strength and low muscle performance were both with an increased risk of major ECG abnormality in all models. Sarcopenia and low muscle strength increased 28% and 62% risk of any ECG abnormality in the full models [sarcopenia: 1.28(1.01–1.63), low muscle strength: 1.62(1.30–2.03)], respectively. Conclusions: This study showed that sarcopenia and its components are associated with ECG abnormalities in Iranian older people. Although some older adults have higher cardiovascular risk factors, these data showed that further factors such as sarcopenia may be identified as a particular risk factor for future cardiovascular events. Therefore, sarcopenia could be added to the screening of the older population to reduce the risk of cardiovascular events.
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Affiliation(s)
- Ramin Heshmat
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Gita Shafiee
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Afshin Ostovar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Noushin Fahimfar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Saba Maleki Birjandi
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Jabbari
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Sharifi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Iraj Nabipour
- The Persian Gulf Marine Biotechnology Research Center, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Adverse body measurements are superior to sarcopenia-associated measurements in predicting chronic diseases. Sci Rep 2021; 11:7749. [PMID: 33833267 PMCID: PMC8032743 DOI: 10.1038/s41598-021-85316-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 02/26/2021] [Indexed: 11/09/2022] Open
Abstract
Few studies have demonstrated an association of sarcopenia-associated body measurements with chronic diseases through a comprehensive methodology. This study aims to examine the relationship between sarcopenia-associated body measurements and chronic diseases. This is a cohort study. We recruited 316 community dwellers, including 76 patients with sarcopenia and 240 controls, and obtained their body measurements associated with sarcopenia. We collected three-dimensional anthropometric body-surface measurements from 11,158 participants during 2000-2008 and followed up this cohort for 15 years to examine the association of these measurements with the risk of chronic diseases such as hypertension, type 2 diabetes mellitus (T2DM), heart disease, and nephrotic syndrome. Univariate analysis, canonical correlation, and Cox regression analysis were performed to explore the associations. Decreased waist width, upper left arm circumference, and left thigh circumference were significantly associated with sarcopenia. The adverse body measure score (ABMS) was derived by combining significant measurements, namely left upper arm circumference, waist width, and left thigh circumference, and used to predict the risk of hypertension, T2DM, heart diseases, and nephrotic syndrome. A positive association was observed between the ABMS and chronic diseases. Considering the first quartile of the ABMS as a reference, we determined hazard ratios of 2.259, 2.495, 1.332, and 1.595 for hypertension, T2DM, heart disease, and nephrotic syndrome, respectively, in the fourth quartile. Chronic diseases were more strongly associated with the ABMS than with sarcopenia-related body measurements alone. A high ABMS, which includes higher upper arm circumference, higher waist width, and lower thigh circumference, can significantly predict chronic diseases.
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Choi HJ, Ko CY, Chang Y, Kim GS, Choi K, Kim CH. Development and validation of bioimpedance prediction equations for fat-free mass in unilateral male amputees. PeerJ 2021; 9:e10970. [PMID: 33732549 PMCID: PMC7950192 DOI: 10.7717/peerj.10970] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 01/28/2021] [Indexed: 01/07/2023] Open
Abstract
Background Metabolic disease due to increased fat mass is observed in amputees (APTs), thereby restricting their activity. Systemic health management with periodic body composition (BC) testing is essential for healthy living. Bioelectrical impedance analysis (BIA) is a non-invasive and low-cost method to test BC; however, the APTs are classified as being exempted in the BIA. Objective To develop segmental estimated regression equations (sEREs) for determining the fat-free mass (FFM, kg) suitable for APTs and improve the accuracy and validity of the sERE. Methods Seventy-five male APTs participated in this cross-sectional study. Multiple regression analysis was performed to develop highly accurate sEREs of BIA based on independent variables derived from anthropometric measurements, dual-energy X-ray absorptiometry (DXA), and BIA parameters. The difference in validity between the predicted DXA and sum of the segmentally-predicted FFM values by sEREs (Sum_sEREs) values was evaluated using bivariate linear regression analysis and the Bland–Altman plot. Results The coefficient of determination (R2) and total error (TE) between DXA and Sum_sEREs were 71% and 5.4 (kg) in the cross-validation analysis. Conclusions We confirmed the possibility of evaluating the FFM of APTs through the sEREs developed in this study. We also identified several independent variables that should be considered while developing such sEREs. Further studies are required to determine the validity of our sEREs and the most appropriate BIA frequencies for measuring FFM in APTs.
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Affiliation(s)
- Hyuk-Jae Choi
- Department of Medical Convergence Research & Development, Rehabilitation Engineering Research Institute, Incheon, Republic of Korea
| | - Chang-Yong Ko
- Department of Research & Development, Refind Inc, Wonju, Gangwon-do, Republic of Korea
| | - Yunhee Chang
- Department of Medical Convergence Research & Development, Rehabilitation Engineering Research Institute, Incheon, Republic of Korea
| | - Gyoo-Suk Kim
- Department of Medical Convergence Research & Development, Rehabilitation Engineering Research Institute, Incheon, Republic of Korea
| | - Kyungsik Choi
- Department of Healthcare Business Division, Healthmax company, Seoul, Gangnam-gu, Republic of Korea
| | - Chul-Hyun Kim
- Department of Sports Medicine, Soonchunhyang University, Asan, Chungcheongnam-do, Republic of Korea
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Cui M, Gang X, Gao F, Wang G, Xiao X, Li Z, Li X, Ning G, Wang G. Risk Assessment of Sarcopenia in Patients With Type 2 Diabetes Mellitus Using Data Mining Methods. Front Endocrinol (Lausanne) 2020; 11:123. [PMID: 32210921 PMCID: PMC7076070 DOI: 10.3389/fendo.2020.00123] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Accepted: 02/24/2020] [Indexed: 12/22/2022] Open
Abstract
Purpose: Sarcopenia is a geriatric syndrome, and it is closely related to the prevalence of type 2 diabetes mellitus (T2DM). Until now, the diagnosis of sarcopenia requires Dual Energy X-ray Absorptiometry (DXA) scanning. This study aims to make risk assessment of sarcopenia with support vector machine (SVM) and random forest (RF) when DXA is not available. Methods: Firstly, we recruited 132 patients aged over 65 and diagnosed with T2DM in Changchun, China. Clinical data were collected for predicting sarcopenia. Secondly, we selected 3, 5, and 7 features out of over 40 features of patient's data with backward selection, respectively, to train SVM and RF classification models and regression models. Finally, to evaluate the performance of the models, we performed leave one out and 5-fold cross validation. Results: When training the model with 5 features, the sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV) were favorable, and it was better than the models trained with 3 features and 7 features. Area under the receiver operating characteristic (ROC) curve (AUC) were over 0.7, and the mean AUC of SVM models was higher than that of RF. Conclusions: Using SVM and RF to make risk assessment of sarcopenia in the elderly is an option in clinical setting. Only 5 features are needed to input into the software to run the algorithm for a primary assessment. It cannot replace DXA to diagnose sarcopenia, but is a good tool to evaluate sarcopenia.
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Affiliation(s)
- Mengzhao Cui
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, China
| | - Xiaokun Gang
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, China
| | - Fang Gao
- College of Computer Science and Technology, Jilin University, Changchun, China
| | - Gang Wang
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, China
| | - Xianchao Xiao
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, China
| | - Zhuo Li
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, China
| | - Xiongfei Li
- College of Computer Science and Technology, Jilin University, Changchun, China
| | - Guang Ning
- Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health of China, Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Shanghai Institute for Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- *Correspondence: Guang Ning
| | - Guixia Wang
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, China
- Guixia Wang
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Chen YY, Fang WH, Wang CC, Kao TW, Yang HF, Wu CJ, Sun YS, Wang YC, Chen WL. Fat-to-muscle ratio is a useful index for cardiometabolic risks: A population-based observational study. PLoS One 2019; 14:e0214994. [PMID: 30964893 PMCID: PMC6456204 DOI: 10.1371/journal.pone.0214994] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 03/26/2019] [Indexed: 12/14/2022] Open
Abstract
Metabolic disorders are prevalent worldwide and have recently become public health problems recently. Previous studies have proposed different body composition indices for predicting future cardiovascular risks. We hypothesized an association among fat-to-muscle ratio (FMR), metabolic syndrome (MetS), hypertension (HTN), prediabetes, type 2 diabetes mellitus (DM), and cardiovascular risk in an adult population. A total of 66829 eligible subjects composed of 34182 males and 32647 females aged 20 years or older were obtained from health examinations in the Tri-Service General Hospital from 2011 to 2017. The body composition indices included fat and muscle mass measured by bioelectrical impedance analysis. A multivariable regression model was performed in a large population-based cross-sectional study. FMR was significantly associated with MetS, prediabetes, DM and HTN in all models of both genders. Based on quartile analysis, higher FMR had higher predictive ability for adverse health outcomes. The association between different definitions of MetS and the Framingham risk score was analyzed, and FMR-incorporated MetS was more useful for predicting higher Framingham risk scores than traditional definitions. FMR was a useful indicator for the presence of adverse cardiometabolic risks. Compared to traditional definition of MetS, FMR-incorporated MetS had a greater ability to predict incident cardiovascular risks. FMR seemed to be a simple and effective index for the early prevention and management of cardiometabolic events.
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Affiliation(s)
- Yuan-Yuei Chen
- Department of Internal Medicine, Tri-Service General Hospital Songshan Branch, Taipei, Taiwan, Republic of China
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Wen-Hui Fang
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Chung-Ching Wang
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Tung-Wei Kao
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Graduate Institute of Clinical Medical, College of Medicine, National Taiwan University, Taipei, Taiwan, Republic of China
| | - Hui-Fang Yang
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Chen-Jung Wu
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Division of Family Medicine, Department of Community Medicine, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan, Republic of China
| | - Yu-Shan Sun
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Ying-Chuan Wang
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Wei-Liang Chen
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- * E-mail:
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Mesinovic J, Zengin A, De Courten B, Ebeling PR, Scott D. Sarcopenia and type 2 diabetes mellitus: a bidirectional relationship. Diabetes Metab Syndr Obes 2019; 12:1057-1072. [PMID: 31372016 PMCID: PMC6630094 DOI: 10.2147/dmso.s186600] [Citation(s) in RCA: 276] [Impact Index Per Article: 55.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 05/07/2019] [Indexed: 12/05/2022] Open
Abstract
The incidence and prevalence of metabolic and musculoskeletal diseases are increasing. Type 2 diabetes mellitus (T2DM) is characterized by insulin resistance, inflammation, advanced glycation end-product accumulation and increased oxidative stress. These characteristics can negatively affect various aspects of muscle health, including muscle mass, strength, quality and function through impairments in protein metabolism, vascular and mitochondrial dysfunction, and cell death. Sarcopenia is a term used to describe the age-related loss in skeletal muscle mass and function and has been implicated as both a cause and consequence of T2DM. Sarcopenia may contribute to the development and progression of T2DM through altered glucose disposal due to low muscle mass, and also increased localized inflammation, which can arise through inter- and intramuscular adipose tissue accumulation. Lifestyle modifications are important for improving and maintaining mobility and metabolic health in individuals with T2DM and sarcopenia. However, evidence for the most effective and feasible exercise and dietary interventions in this population is lacking. In this review, we discuss the current literature highlighting the bidirectional relationship between T2DM and sarcopenia, highlight current research gaps and treatments, and provide recommendations for future research.
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Affiliation(s)
- Jakub Mesinovic
- Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Melbourne, VIC, Australia
- Correspondence: Jakub MesinovicDepartment of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, 246 Clayton Road, Clayton, Victoria3068, AustraliaTel + 6 138 572 2919Fax + 6 139 594 6495Email
| | - Ayse Zengin
- Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Melbourne, VIC, Australia
| | - Barbora De Courten
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Melbourne, VIC, Australia
| | - Peter R Ebeling
- Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Melbourne, VIC, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), Department of Medicine - Western Health, Melbourne Medical School, The University of Melbourne, St Albans, Melbourne, VIC, Australia
| | - David Scott
- Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Melbourne, VIC, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), Department of Medicine - Western Health, Melbourne Medical School, The University of Melbourne, St Albans, Melbourne, VIC, Australia
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11
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Association between Sarcopenia and Metabolic Syndrome in Middle-Aged and Older Non-Obese Adults: A Systematic Review and Meta-Analysis. Nutrients 2018; 10:nu10030364. [PMID: 29547573 PMCID: PMC5872782 DOI: 10.3390/nu10030364] [Citation(s) in RCA: 90] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Revised: 03/10/2018] [Accepted: 03/14/2018] [Indexed: 12/23/2022] Open
Abstract
The associations between sarcopenia and metabolic syndrome (MetS) in non-obese middle-aged and older adults remain controversial. Thus, this meta-analysis aimed to evaluate the overall prevalence of MetS and the correlations between sarcopenia and MetS in middle-aged and older non-obese adults. We performed a systematic searched strategy using PUBMED, EMBASE and Web of Science databases for relevant observational studies investigating sarcopenia and MetS up to 11 May 2017. The polled prevalence of MetS and odds ratios with 95% confidence intervals (CI), as well as subgroup analyses were calculated using a random effects model. Twelve articles with a total of 35,581 participants were included. The overall prevalence of MetS was 36.45% (95% CI, 28.28–45.48%) in middle-aged and older non-obese adults with sarcopenia. Our analysis demonstrated a positive association between sarcopenia and MetS (OR = 2.01, 95% CI, 1.63–2.47). The subgroup analysis showed that both larger cohort size and the use of dual-energy X-ray absorptiometry to measure body composition can enhance the relationship. Our study revealed that a higher proportion of MetS in middle-aged and older non-obese people with sarcopenia. Moreover, sarcopenia was positively associated with MetS in this population. Further large-scale prospective cohort studies are needed to investigate the causality between sarcopenia and MetS.
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12
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de Souza VA, Oliveira D, Barbosa SR, Corrêa JODA, Colugnati FAB, Mansur HN, Fernandes NMDS, Bastos MG. Sarcopenia in patients with chronic kidney disease not yet on dialysis: Analysis of the prevalence and associated factors. PLoS One 2017; 12:e0176230. [PMID: 28448584 PMCID: PMC5407780 DOI: 10.1371/journal.pone.0176230] [Citation(s) in RCA: 118] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 04/08/2017] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION Sarcopenia is a chronic condition that is associated with aging and characterized by a reduction of muscle mass, strength, and function. Sarcopenia is prevalent in patients with chronic kidney disease (CKD) and associated with increased morbidity and mortality, as well as cardiovascular complications. OBJECTIVES To investigate the prevalence of sarcopenia in patients with CKD not yet on dialysis and its correlation with clinical and laboratory variables and inflammatory markers. METHODS A total of 100 patients of both sexes aged over 18 were evaluated. Sarcopenia was defined using the criteria of the European Working Group on Sarcopenia in Older People (EWGSOP) and of the Foundation for the National Institutes of Health (FNIH) Sarcopenia Project. Sociodemographic and clinical data, activities of daily living, functional capacity, and physical activity were also evaluated. Inflammation was assessed by the serum levels of high-sensitivity C-reactive protein (hsCRP) and interleukin (IL) 4 and 6. RESULTS The prevalence of sarcopenia was 11.9% and 28.7% using the EWGSOP and FNIH criteria, respectively. Sarcopenia was more prevalent in the more advanced stages of CKD (34.5% in stages 2 and 3A; and 65.5% in stages 3B, 4, and 5) and associated with worse performance in activities of daily living (p = 0.049), lower walking speeds (p < 0.001), and higher body mass indexes (BMIs) (p = 0.001) in the non-adjusted model. In addition, patients with sarcopenia had lower functional capacity (p = 0.012) and higher prevalence of physical inactivity (p = 0.041) compared with patients without sarcopenia. After adjustment for confounding variables, sarcopenia was still significantly correlated with walking speed (p = 0.004) and BMI (p = 0.002). HsCRP levels were inversely correlated with appendicular lean mass adjusted for BMI (p = 0.007) and were also positively associated with BMI (p = 0.001). IL4 levels were positively correlated with walking speed (p = 0.007) and lean mass in the lower limbs (p = 0.022). CONCLUSIONS Sarcopenia is common in patients with CKD, particularly in the most advanced stages of the disease. We observed an association between the levels of inflammatory markers and peripheral lean body mass, physical performance, and BMI. This association between sarcopenia and modifiable factors highlights the importance of early diagnosis and the implementation of therapeutic measures to minimize adverse outcomes in patients with CKD not yet on dialysis.
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Affiliation(s)
- Viviane Angelina de Souza
- Department of Clinical Medicine, School of Medicine, Federal University of Juiz de Fora, Juiz de Fora, Brazil
| | - Dílmerson Oliveira
- Department of Anatomy, School of Physical Education, UNIFAMINAS, Muriaé, Brazil
| | - Sérgio Ribeiro Barbosa
- Department of Clinical Medicine, School of Medicine, Federal University of Juiz de Fora, Juiz de Fora, Brazil
| | - José Otávio do Amaral Corrêa
- Department of Pharmaceutical Sciences, School of Pharmacy, Federal University of Juiz de Fora, Juiz de Fora, Brazil
| | | | - Henrique Novais Mansur
- Department of Education, School of Physical Education, Federal Institute of Education, Science and Technology – Southeast of Minas Gerais - Campus Rio Pomba, Rio Pomba, Brazil
| | | | - Marcus Gomes Bastos
- Department of Clinical Medicine, School of Medicine, Federal University of Juiz de Fora, Juiz de Fora, Brazil
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Nooe A, Edwards MK, Addoh O, Loprinzi PD. Convergent validity of the ACC/AHA pooled cohort equations in associating with health-related quality of life among adults in the United States. Health Promot Perspect 2017; 7:42-46. [PMID: 28058241 PMCID: PMC5209650 DOI: 10.15171/hpp.2017.08] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Accepted: 10/01/2016] [Indexed: 01/22/2023] Open
Abstract
Background: The potential convergent validity of the pooled cohort risk (PCR) equations in predicting health-related quality of life (HRQOL) has yet to be evaluated, which was this study's purpose. Methods: Data from the 2001-2011 National Health and Nutrition Examination Survey (NHANES) were used (N = 8978 adults, 40-79 years, free of cardiovascular disease at baseline). Calculation of an individual's 10-year risk of a first atherosclerotic cardiovascular disease (ASCVD) event was determined via the PCR equation. The Centers for Disease Control and Prevention (CDC) HRQOL measure was assessed utilizing 4 questions regarding participants' perceived mental and physical health status from the past 30 days. Results: When adjusting for moderate-to-vigorous physical activity (MVPA), obesity, age, gender and race-ethnicity, an ASCVD score of >20% (vs. <20%) was associated with a 0.53-unit (95% CI: 0.34-0.71) higher HRQOL score. A higher HRQOL score indicates a poorer patient perception of their mental and physical health. Conclusion: The observed association between PCR-determined ASCVD-risk scores and HRQOL provides evidence for the convergent validity of the PCR algorithms, indicating that individuals with a higher risk for a first time ASCVD-event may also have an overall worse HRQOL. As such, employing ASCVD risk reduction efforts may be an important strategy in improving an individual's HRQOL.
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Affiliation(s)
- Allison Nooe
- Center for Health Behavior Research, Physical Activity Epidemiology Laboratory, Department of Health, Exercise Science and Recreation Management, The University of Mississippi, University, MS 38677, USA
| | - Meghan K Edwards
- Center for Health Behavior Research, Physical Activity Epidemiology Laboratory, Department of Health, Exercise Science and Recreation Management, The University of Mississippi, University, MS 38677, USA
| | - Ovuokerie Addoh
- Center for Health Behavior Research, Physical Activity Epidemiology Laboratory, Department of Health, Exercise Science and Recreation Management, The University of Mississippi, University, MS 38677, USA
| | - Paul D Loprinzi
- Jackson Heart Study Vanguard Center of Oxford, Center for Health Behavior Research, Physical Activity Epidemiology Laboratory, Department of Health, Exercise Science and Recreation Management, The University of Mississippi, University, MS 38677, USA
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Sarcopenia is associated with Framingham risk score in the Korean population: Korean National Health and Nutrition Examination Survey (KNHANES) 2010-2011. JOURNAL OF GERIATRIC CARDIOLOGY : JGC 2015; 12:366-72. [PMID: 26346573 PMCID: PMC4554777 DOI: 10.11909/j.issn.1671-5411.2015.04.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/24/2015] [Revised: 03/27/2015] [Accepted: 05/12/2015] [Indexed: 11/21/2022]
Abstract
Background Sarcopenia is a risk factor for metabolic disorders and cardiovascular disease, but the association between sarcopenia and cardiovascular risk factors according to age and obesity status in the general population remains unknown. We thus investigated these associations in the Korean population. Methods We included 8,958 and 8,518 subjects from the fifth Korean National Health and Nutrition Examination Survey (KNHANES) (from 2010 and 2011, respectively). The study was restricted to participants ≥ 20 years old who had completed the health examination survey, including whole body dual-energy X-ray absorptiometry scans. After exclusion, 7,366 subjects (3,188 men, 4,178 women) were included in our final analysis. Age was categorized according to three age groups (20–39, 40–59, and ≥ 60 years), and subjects were categorized according to their sarcopenic and obesity status. Cardiovascular risk was assessed with Framingham risk score (FRS). Results The sarcopenic obese group had a higher FRS than the non-sarcopenic obese group, which had a higher FRS than the non-sarcopenic non-obese group. Age-wise, the 20–39 year-old group showed a non-significant association between sarcopenia and FRS. In the 40–59 year-old group, regardless of obesity status, sarcopenic subjects had a higher FRS than non-sarcopenic subjects. In the ≥ 60 year-old group, sarcopenic subjects had a higher FRS than non-sarcopenic subjects for the non-obese group. Conclusions Sarcopenia was associated with cardiovascular disease and may be an early predictor of its susceptibility in both elderly and middle-aged subjects. Thus, management of sarcopenia is necessary to prevent cardiovascular disease.
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Huang M, Matsushita K, Sang Y, Ballew SH, Astor BC, Coresh J. Association of kidney function and albuminuria with prevalent and incident hypertension: the Atherosclerosis Risk in Communities (ARIC) study. Am J Kidney Dis 2014; 65:58-66. [PMID: 25151408 DOI: 10.1053/j.ajkd.2014.06.025] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Accepted: 06/12/2014] [Indexed: 12/20/2022]
Abstract
BACKGROUND Decreased kidney function and kidney damage may predate hypertension, but only a few studies have investigated both types of markers simultaneously, and these studies have obtained conflicting results. STUDY DESIGN Cross-sectional for prevalent and prospective observational study for incident hypertension. SETTING & PARTICIPANTS 9,593 participants from the ARIC (Atherosclerosis Risk in Communities) Study, aged 53-75 years in 1996-1998. PREDICTORS Several markers of kidney function (estimated glomerular filtration rate using serum creatinine and/or cystatin C and 2 novel markers [β-trace protein and β2-microglobulin]) and 1 marker of kidney damage (urinary albumin-creatinine ratio [ACR]). Every kidney marker was categorized by its quintiles (top quintile as a reference for estimated glomerular filtration rates and bottom quintile for the rest). OUTCOMES Prevalent and incident hypertension. MEASUREMENTS Prevalence ratios and HRs of hypertension based on modified Poisson regression and Cox proportional hazards models, respectively. RESULTS There were 4,378 participants (45.6%) with prevalent hypertension at baseline and 2,175 incident hypertension cases during a median follow-up of 9.8 years. Although all 5 kidney function markers were associated significantly with prevalent hypertension, prevalent hypertension was associated most notably with higher ACR (adjusted prevalence ratio, 1.60 [95% CI, 1.50-1.71] for the highest vs lowest ACR quintile). Similarly, ACR was associated consistently with incident hypertension in all models tested (adjusted HR, 1.28 [95% CI, 1.10-1.49] for top quintile), while kidney function markers demonstrated significant associations in some, but not all, models. Even mildly increased ACR (9.14-14.0mg/g) was associated significantly with incident hypertension. LIMITATIONS Self-reported use of antihypertensive medication for defining incident hypertension, single assessment of kidney markers, and relatively narrow age range. CONCLUSIONS Although all kidney markers were associated with prevalent hypertension, only elevated albuminuria was associated consistently with incident hypertension, suggesting that kidney damage is related more closely to hypertension than moderate reduction in overall kidney function.
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Affiliation(s)
- Minxuan Huang
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | | | - Yingying Sang
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Shoshana H Ballew
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Brad C Astor
- University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Josef Coresh
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
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Han K, Park YM, Kwon HS, Ko SH, Lee SH, Yim HW, Lee WC, Park YG, Kim MK, Park YM. Sarcopenia as a determinant of blood pressure in older Koreans: findings from the Korea National Health and Nutrition Examination Surveys (KNHANES) 2008-2010. PLoS One 2014; 9:e86902. [PMID: 24489804 PMCID: PMC3906091 DOI: 10.1371/journal.pone.0086902] [Citation(s) in RCA: 92] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Accepted: 12/16/2013] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Blood pressure (BP) is directly and causally associated with body size in the general population. Whether muscle mass is an important factor that determines BP remains unclear. OBJECTIVE To investigate whether sarcopenia is associated with hypertension in older Koreans. PARTICIPANTS We surveyed 2,099 males and 2,747 females aged 60 years or older. MEASUREMENTS Sarcopenia was defined as an appendicular skeletal muscle mass divided by body weight (ASM/Wt) that was <1 SD below the gender-specific mean for young adults. Obesity was defined as a body mass index (BMI) ≥ 25 kg/m(2). Subjects were divided into four groups based on presence or absence of obesity or sarcopenia. Hypertension was defined as a systolic BP (SBP) ≥ 140 mmHg, a diastolic BP (DBP) ≥ 90 mmHg, or a self-reported current use of antihypertensive medications. RESULTS The overall prevalence of hypertension in the four groups was as follows 49.7% for non-obese non-sarcopenia, 60.9% for non-obese sarcopenia, 66.2% for obese non-sarcopenia and 74.7% for obese sarcopenia. After adjustment for age, gender, regular activity, current smoking and alcohol use, the odds ratio (OR) for having hypertension was 1.5 (95% confidence interval (CI) = 1.23-1.84) in subjects in the non-obese sarcopenia group, 2.08 (95% CI = 1.68-2.57) in the obese non-sarcopenia group and 3.0 (95% CI = 2.48-3.63) in the obese sarcopenia group, compared with the non-obese non-sarcopenia group (p for trend <0.001). Controlling further for body weight and waist circumference did not change the association between hypertension and sarcopenia. The association between sarcopenia and hypertension was more robust in the subjects with diabetes mellitus. CONCLUSION Body composition beyond BMI has a considerable impact on hypertension in elderly Koreans. Subjects with sarcopenic obesity appear to have a greater risk of hypertension than simply obese or sarcopenia subjects.
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Affiliation(s)
- Kyungdo Han
- Department of Preventive Medicine, The Catholic University of Korea, Seoul, Korea
- Department of Biostatistics, The Catholic University of Korea, Seoul, Korea
| | - Yu-Mi Park
- School of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyuk-Sang Kwon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seung-Hyun Ko
- Division of Endocrinology and Metabolism, Department of Internal Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seung-Hwan Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyeon Woo Yim
- Department of Preventive Medicine, The Catholic University of Korea, Seoul, Korea
| | - Won-Chul Lee
- Department of Preventive Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yong Gyu Park
- Department of Biostatistics, The Catholic University of Korea, Seoul, Korea
| | - Mee Kyoung Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yong-Moon Park
- Department of Preventive Medicine, The Catholic University of Korea, Seoul, Korea
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America
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