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Park SJ, Ji E, Yoo HJ, Kim K, Ji S, Baek JY, Lee JY, Jung HW, Jang IY, Lee E, Hong N, Kim BJ. Circulating lumican as a potential biomarker for osteosarcopenia in older adults. Bone 2024; 179:116959. [PMID: 37956822 DOI: 10.1016/j.bone.2023.116959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/31/2023] [Accepted: 11/07/2023] [Indexed: 11/15/2023]
Abstract
In vitro and animal experiments demonstrated that lumican exerts anabolic effects on bone and muscle by stimulating osteoblastogenesis, suppressing osteoclastogenesis and increasing myogenesis. However, the relationship between circulating lumican and musculoskeletal phenotypes in humans remains unclear. We aimed to analyze the relationship between serum lumican levels and osteosarcopenia in older adults. Blood samples were collected from 134 participants (age: 65 years and older) who underwent comprehensive assessment of bone and muscle phenotypes. Osteoporosis and sarcopenia were diagnosed based on World Health Organization and Asian consensus guidelines, respectively. Osteosarcopenia was defined as the simultaneous presence of osteoporosis and sarcopenia. After adjusting for sex, age, and body mass index, older adults with osteosarcopenia had 20.2 % lower serum lumican levels than those without (P = 0.010). The odds ratio (OR) for osteosarcopenia per standard deviation decrease in serum lumican level was 4.17 (P = 0.003). Consistently, higher serum lumican levels were correlated with higher bone mass at all measured sites (P = 0.004 to 0.045) and higher grip strength (P = 0.023). Furthermore, participants in the lowest tertile (T1) had 7.56-fold higher OR for osteosarcopenia (P = 0.024) than those in the highest lumican tertile (T3). In conclusion, these findings clinically validate previous experimental data showing the musculoskeletal protective effects of lumican and suggest that blood lumican levels could be used as a potential biomarker to assess the risk of not only osteosarcopenia but also osteoporosis or sarcopenia in older adults.
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Affiliation(s)
- So Jeong Park
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Eunhye Ji
- Department of Convergence Medicine, Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Hyun Ju Yoo
- Department of Convergence Medicine, Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Kyunggon Kim
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea; Department of Digital Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Sunghwan Ji
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Ji Yeon Baek
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jin Young Lee
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Hee-Won Jung
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Il-Young Jang
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Eunju Lee
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Namki Hong
- Department of Internal Medicine, Severance Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, South Korea
| | - Beom-Jun Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
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Liu H, He X, Deng XY, Yan JL. Exploring the correlation between serum fibroblast growth factor-21 levels and Sarcopenia: a systematic review and meta-analysis. BMC Musculoskelet Disord 2023; 24:533. [PMID: 37386374 DOI: 10.1186/s12891-023-06641-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 06/15/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND Fibroblast growth factor 21 (FGF-21) plays an important role in the growth and metabolism of skeletal muscle cells. This study aims to systemically review the evidence regarding the relationship between FGF-21 levels and Sarcopenia, as well as the related influential factors. METHODS This review was conducted according to the PRISMA guidelines. We comprehensively searched PubMed, EMBASE, the Web of Science, Scopus, and Chinese Databases (CNKI, Wan Fang, VIP, and CBM) up to 1 May 2023. 3 investigators performed independent literature screening and data extraction of the included literature, and two investigators performed an independent quality assessment of case-control studies using the Joanna Briggs Institute (JBI) tool. Data analysis was performed using Review Manager 5.4 software. For continuous various outcomes, mean difference (MD) or standard mean difference (SMD) with 95% confidence intervals (CIs) was applied for assessment by fixed-effect or random-effect model analysis. The heterogeneity test was performed by the Q-statistic and quantified using I2, and publication bias was evaluated using a funnel plot. RESULTS Five studies with a total of 625 cases were included in the review. Meta-analysis showed lower BMI in the sarcopenia group [MD= -2.88 (95% CI, -3. 49, -2.27); P < 0.00001; I2 = 0%], significantly reduced grip strength in the sarcopenia group compared to the non-sarcopenia group [MD = -7.32(95% CI, -10.42,-4.23); P < 0.00001; I2 = 93%]. No statistically significant differences in serum FGF21 levels were found when comparing the two groups of subjects [SMD = 0.31(95% CI, -0.42, 1.04); P = 0.41; I2 = 94%], and no strong correlation was found between the onset of sarcopenia and serum FGF21 levels. CONCLUSION The diagnosis of sarcopenia is followed by a more significant decrease in muscle mass and strength, but there is a lack of strong evidence to support a direct relationship between elevated organismal FGF21 and sarcopenia, and it is not convincing to use FGF21 as a biological or diagnostic marker for sarcopenia. The currently used diagnostic criteria for sarcopenia and setting of cut-off values for each evaluation parameter no longer seem to match clinical practice.
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Affiliation(s)
- Hao Liu
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
| | - Xia He
- Affiliated Sichuan Provincial Rehabilitation Hospital of the Chengdu University of Traditional Chinese Medicine, Chengdu, 611135, China.
| | - Xiao-Yan Deng
- Tianhui Town Community Health Center, Chengdu, 610081, China
| | - Jing-Lu Yan
- Tianhui Town Community Health Center, Chengdu, 610081, China
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Luo S, Chen X, Hou L, Yue J, Liu X, Xia X, Cao L, Dong B. Cut-off points of the Ishii test to diagnosing severe sarcopenia among multi-ethnic middle-aged to older adults: results from the West China Health and Aging Trend study. Front Med (Lausanne) 2023; 10:1176128. [PMID: 37425295 PMCID: PMC10323675 DOI: 10.3389/fmed.2023.1176128] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 06/06/2023] [Indexed: 07/11/2023] Open
Abstract
Objective This study was designed to establish the cut-off value and diagnostic utility of the Ishii test, which gauges the odds of severe sarcopenia based on the results of an equation based upon age, grip strength, and calf circumference among middle-aged and older adults in Western China. Methods This study incorporated adults ≥ 50 years of age from the West China Health and Aging Trend (WCHAT) study. Severe sarcopenia was defined as per the Asian Working Group for Sarcopenia: 2019 Consensus (AWGS2019) recommendations, with the odds of severe sarcopenia being estimated with the Ishii test score chart. The diagnostic utility of the Ishii test in this patient cohort was assessed by analyzing its sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and the area under the ROC curve (AUC). Results In total, 4,177 individuals ≥ 50 years of age were included in this study including 2668 females (63.9%) and 1,509 males (36.1%). These included 568 (13.6%) participants affected by severe sarcopenia, of whom 237 were male (15.7%) and 331 were female (12.4%). Optimal Ishii test cut-off values established based on Youden's index were ≥ 114 for males and ≥ 120 for females when using the AWGS2019 reference standard. The sensitivity/specificity/PPV/NPV of the Ishii test when screening for severe sarcopenia were 89.45%/77.15%/0.42/0.98 in males and 90.03%/77.05%/0.36/0.98 in females. The AUC values for the Ishii test in males and females were 0.899 (95% CI, 0.883-0.916) and 0.905 (95% CI, 0.892-0.917), respectively. Conclusion These data indicate that the Ishii test offers value as a candidate diagnostic test that can be used to screen for severe sarcopenia, with recommended diagnostic cut-off values of ≥ 114 for males and ≥ 120 for females.
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Affiliation(s)
- Shuyue Luo
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
- Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaoyan Chen
- Zigong Psychiatric Research Center, Zigong Affiliated Hospital of Southwest Medical University, Zigong, China
| | - Lisha Hou
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Jirong Yue
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaolei Liu
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Xin Xia
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Li Cao
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
- Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Birong Dong
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
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Prokopidis K, Giannos P, Reginster JY, Bruyere O, Petrovic M, Cherubini A, Triantafyllidis KK, Kechagias KS, Dionyssiotis Y, Cesari M, Ibrahim K, Scott D, Barbagallo M, Veronese N. Sarcopenia is associated with a greater risk of polypharmacy and number of medications: a systematic review and meta-analysis. J Cachexia Sarcopenia Muscle 2023; 14:671-683. [PMID: 36781175 PMCID: PMC10067503 DOI: 10.1002/jcsm.13190] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 01/10/2023] [Accepted: 01/16/2023] [Indexed: 02/15/2023] Open
Abstract
Polypharmacy in older adults is associated with multiple negative consequences that may affect muscular function, independently from the presence of medical conditions. The aim of this systematic review and meta-analysis was to investigate the association of sarcopenia with polypharmacy and higher number of medications. A systematic literature search of observational studies using PubMed, Web of Science, Scopus and Cochrane Library databases was conducted from inception until June 2022. To determine if sarcopenia is associated with a higher risk of polypharmacy and increased number of medications, a meta-analysis using a random-effects model was used to calculate the pooled effects (CRD42022337539). Twenty-nine studies were included in the systematic review and meta-analysis. Sarcopenia was associated with a higher prevalence of polypharmacy (odds ratio [OR]: 1.65, 95% confidence interval [CI] [1.23, 2.20], I2 = 84%, P < 0.01) and higher number of medications (mean difference: 1.39, 95% CI [0.59, 2.19], I2 = 95%, P < 0.01) compared with individuals without sarcopenia. Using meta-regression, a high variance was observed due to different populations (i.e., community-dwelling, nursing home residents, inpatients, outpatients) for both outcomes of polypharmacy (r = -0.338, SE = 0.1669, 95% CI [-0.67, -0.01], z = -2.03, P = 0.04) and number of medications (r = 0.589, SE = 0.2615, 95% CI [0.08, 1.10], z = 2.25, P = 0.02). This systematic review and meta-analysis reported a significantly increased risk of polypharmacy and higher number of medications in people with sarcopenia compared with individuals without this condition. Future research should clarify whether the specificity and number of medications is a direct contributor in accelerating the progression of muscle wasting and dysfunction contributing to sarcopenia in older adults.
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Affiliation(s)
- Konstantinos Prokopidis
- Department of Musculoskeletal Biology, Institute of Life Course and Medical SciencesUniversity of LiverpoolLiverpoolUK
- Society of Meta‐research and Biomedical InnovationLondonUK
| | - Panagiotis Giannos
- Society of Meta‐research and Biomedical InnovationLondonUK
- Department of Life Sciences, Faculty of Natural SciencesImperial College LondonLondonUK
| | - Jean Yves Reginster
- WHO Collaborating Center for Epidemiology of Musculoskeletal Health and AgingLiègeBelgium
- Division of Public Health, Epidemiology and Health EconomicsUniversity of LiègeLiègeBelgium
| | - Olivier Bruyere
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Center for Public Health Aspects of Musculo‐Skeletal Health and AgeingUniversity of LiègeLiègeBelgium
| | - Mirko Petrovic
- Section of Geriatrics, Department of Internal Medicine and PaediatricsGhent UniversityGhentBelgium
| | - Antonio Cherubini
- Geriatria, Accettazione Geriatrica e Centro di Ricerca per l'Invecchiamento, IRCCS INRCAAnconaItaly
| | - Konstantinos K. Triantafyllidis
- Society of Meta‐research and Biomedical InnovationLondonUK
- Department of Nutrition and DieteticsHomerton University Hospital Foundation TrustLondonUK
| | - Konstantinos S. Kechagias
- Society of Meta‐research and Biomedical InnovationLondonUK
- Department of Metabolism, Digestion and Reproduction, Faculty of MedicineImperial College LondonLondonUK
| | - Yannis Dionyssiotis
- Medical School, Spinal Cord Injury Rehabilitation Clinic, General University Hospital PatrasUniversity of PatrasPatrasGreece
| | - Matteo Cesari
- Department of Clinical Sciences and Community HealthUniversity of MilanMilanItaly
- Geriatric UnitIRCCS Istituti Clinici Scientifici MaugeriMilanItaly
| | - Kinda Ibrahim
- Academic Geriatric Medicine, Faculty of Medicine, University Hospital SouthamptonUniversity of SouthamptonSouthamptonUK
- Applied Research Collaboration Wessex, The National Institute of Health and Care Research (NIHR)University of SouthamptonSouthamptonUK
| | - David Scott
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition SciencesDeakin UniversityBurwoodVictoriaAustralia
- Department of Medicine, School of Clinical Sciences at Monash HealthMonash UniversityClaytonVictoriaAustralia
| | - Mario Barbagallo
- Department of Internal Medicine and GeriatricsUniversity of PalermoPalermoItaly
| | - Nicola Veronese
- Department of Internal Medicine and GeriatricsUniversity of PalermoPalermoItaly
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da Cruz GF, Lunz TM, Rocha de Jesus T, Costa MB, Vidigal CV, Albergaria BH, Marques-Rocha JL, Guandalini VR. Low appendicular skeletal muscle mass index is associated with the anthropometric variables of post-menopausal women. BMC Geriatr 2022; 22:639. [PMID: 35922763 PMCID: PMC9346057 DOI: 10.1186/s12877-022-03313-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 07/18/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Skeletal muscle mass is a central component of body composition and its decline is enhanced during aging. We verified the association between the appendicular skeletal muscle mass index (ASMI) with the anthropometric variables, biochemical variables, and lifestyle of postmenopausal women. METHODS Cross-sectional observational study conducted with postmenopausal women. Sociodemographic, clinical, lifestyle, physical activity level, biochemical, and anthropometric markers were collected. Body composition was assessed by dual-energy densitometry. Multivariate logistic regression analysis was applied. RESULTS One hundred fourteen women aged in average 66.0 ± 5.8 years were evaluated. There was a significant association between ASMI and age (p = 0.004), body mass (p < 0.001), body mass index (BMI) (p < 0.001), adductor pollicis muscle thickness (APMT) (p < 0.001), plasma calcium levels (p = 0.003), calf circumference (CC), and waist circumference (WC) (p < 0.001 for both). Adjusted regression analyses revealed the influence of BMI, CC, and APMT in the 1st tertile of ASMI (p < 0.05), BMI and CC in the 2rd tertile of ASMI. CONCLUSIONS ASMI was associated with BMI and muscle mass reserve indicators such as CC and DAPMT. In clinical practice, this indicates that simple, low-cost measures with good applicability can be used to predict and track the risk of depletion of skeletal muscle mass and consequent sarcopenia.
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Affiliation(s)
- Geise Ferreira da Cruz
- Department of Integrated Health Education, Federal University of Espirito Santo, Vitoria, Marechal Campos, avenue, 1468 - Maruípe, Vitória, Espírito Santo, 29040-090, Brazil
| | - Tatiana Mion Lunz
- Department of Integrated Education, Federal University of Espirito Santo, Marechal Campos, avenue, 1468 - Maruípe, Vitória, Espírito Santo, 29040-090, Brazil
| | - Tatielle Rocha de Jesus
- Department of Integrated Education, Federal University of Espirito Santo, Marechal Campos, avenue, 1468 - Maruípe, Vitória, Espírito Santo, 29040-090, Brazil
| | - Mariana Braga Costa
- Department of Integrated Education, Federal University of Espirito Santo, Marechal Campos, avenue, 1468 - Maruípe, Vitória, Espírito Santo, 29040-090, Brazil
| | - Camila Vilarinho Vidigal
- Department of Integrated Health Education, Federal University of Espirito Santo, Vitoria, Marechal Campos, avenue, 1468 - Maruípe, Vitória, Espírito Santo, 29040-090, Brazil
| | - Ben-Hur Albergaria
- Department of Social Medicine, Federal University of Espirito Santo, Marechal Campos, avenue, 1468 - Maruípe, Vitória, Espírito Santo, 29040-090, Brazil
| | - José Luiz Marques-Rocha
- Department of Integrated Health Education, Federal University of Espirito Santo, Vitoria, Marechal Campos, avenue, 1468 - Maruípe, Vitória, Espírito Santo, 29040-090, Brazil
- Department of Integrated Education, Federal University of Espirito Santo, Marechal Campos, avenue, 1468 - Maruípe, Vitória, Espírito Santo, 29040-090, Brazil
| | - Valdete Regina Guandalini
- Department of Integrated Health Education, Federal University of Espirito Santo, Vitoria, Marechal Campos, avenue, 1468 - Maruípe, Vitória, Espírito Santo, 29040-090, Brazil.
- Department of Integrated Education, Federal University of Espirito Santo, Marechal Campos, avenue, 1468 - Maruípe, Vitória, Espírito Santo, 29040-090, Brazil.
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Ahn SH, Jung HW, Lee E, Baek JY, Jang IY, Park SJ, Lee JY, Choi E, Lee YS, Hong S, Kim BJ. Decreased Serum Level of Sclerostin in Older Adults with Sarcopenia. Endocrinol Metab (Seoul) 2022; 37:487-496. [PMID: 35619214 PMCID: PMC9262689 DOI: 10.3803/enm.2022.1428] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 04/11/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGRUOUND Although muscles and bones interact with each other through various secretory factors, the role of sclerostin, an osteocyte-secreted factor, on muscle metabolism has not been well studied. We investigated the levels of serum sclerostin in Korean older adults with sarcopenia. METHODS Blood samples were collected from 129 participants who underwent evaluation of muscle mass and function in an outpatient geriatric clinic of a teaching hospital. Sarcopenia and related parameters were determined using cutoff values for the Asian population. Serum sclerostin levels were measured using an enzyme-linked immunosorbent assay. RESULTS The mean age of the participants was 69.6 years, and 20 participants (15.5%) were classified as having sarcopenia. After adjusting for age, sex, and body mass index, serum sclerostin levels were significantly lower in participants with sarcopenia, low muscle mass, or weak muscle strength (P=0.003 to 0.045). Serum sclerostin levels were positively associated with skeletal muscle index and grip strength after adjusting for confounders (P=0.001 and P=0.003), whereas sarcopenic phenotype score showed a negative association (P=0.006). These increases in muscle mass and strength were also dose dependent as serum sclerostin levels increased (P for trends=0.003 and P for trends=0.015). Higher serum sclerostin levels were associated with lower odds ratio (ORs) for sarcopenia, low muscle mass, and weak muscle strength after adjusting for confounders (OR, 0.27 to 0.50; P<0.001 to 0.025). CONCLUSION Higher serum sclerostin levels were associated with a lower risk of sarcopenia, low muscle mass, and weak muscle strength in Korean older adults.
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Affiliation(s)
- Seong Hee Ahn
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Inha University Hospital, Inha University College of Medicine, Incheon, Korea
| | - Hee-Won Jung
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Eunju Lee
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ji Yeon Baek
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Il-Young Jang
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - So Jeong Park
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jin Young Lee
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Eunah Choi
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yun Sun Lee
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seongbin Hong
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Inha University Hospital, Inha University College of Medicine, Incheon, Korea
- Corresponding authors: Seongbin Hong Division of Endocrinology and Metabolism, Department of Internal Medicine, Inha University Hospital, Inha University College of Medicine, 27 Inhang-ro, Jung-gu, Incheon 22332, Korea Tel: +82-32-890-3360, Fax: +82-32-883-6578, E-mail:
| | - Beom-Jun Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Beom-Jun Kim Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea Tel: +82-2-3010-5876, Fax: +82-2-3010-6962, E-mail:
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Koo BK. Assessment of Muscle Quantity, Quality and Function. J Obes Metab Syndr 2022; 31:9-16. [PMID: 35318289 PMCID: PMC8987447 DOI: 10.7570/jomes22025] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 03/21/2022] [Accepted: 03/21/2022] [Indexed: 12/25/2022] Open
Abstract
Sarcopenia is a syndrome characterized by loss of skeletal muscle mass and strength that can increase the risk of physical disability, chronic conditions such as diabetes mellitus and cardiovascular diseases, and long-term mortality. Sarcopenia adversely affects not only the elderly population, but also young adults. This review provides updated definitions of sarcopenia and recommendations for the assessment of muscle quantity and quality.
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Affiliation(s)
- Bo Kyung Koo
- Department of Internal Medicine, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
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Mikami K, Endo T, Sawada N, Igarashi G, Kimura M, Hasegawa T, Iino C, Sawada K, Ando M, Sugimura Y, Mikami T, Nakaji S, Matsuzaka M, Sakuraba H, Fukuda S. Association of serum creatinine-to-cystatin C ratio with skeletal muscle mass and strength in nonalcoholic fatty liver disease in the Iwaki Health Promotion Project. J Clin Biochem Nutr 2022; 70:273-282. [PMID: 35692671 PMCID: PMC9130064 DOI: 10.3164/jcbn.21-61] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 09/01/2021] [Indexed: 12/11/2022] Open
Abstract
We evaluated the feasibility of using serum creatinine-to-cystatin C ratio in the assessments of muscle mass and strength in nonalcoholic fatty liver disease. In a community-based cross-sectional study, skeletal muscle mass and handgrip strength were assessed in 641 Japanese adults. Low skeletal muscle mass index and low handgrip strength were defined as indicated in the sarcopenia diagnostic criteria of the Japan Society of Hepatology. Nonalcoholic fatty liver disease was defined as fatty liver on ultrasonography in the absence of other causes of steatosis. The creatinine-to-cystatin C ratio was useful for identifying the participants with low skeletal muscle mass index, with an area under the receiver-operating characteristic curve of 0.84 [95% confidence interval (CI), 0.77–0.91] in men and 0.72 in women (95% CI, 0.65–0.78), and those with low handgrip strength, with an area under the receiver-operating characteristic curve of 0.96 (95% CI, 0.93–0.99) in men and 0.79 (95% CI, 0.66–0.92) in women. Moreover, the creatinine-to-cystatin C ratio correlated with skeletal muscle mass index (r = 0.511, p<0.001) and handgrip strength (r = 0.657, p<0.001), whereas it did not correlate with exacerbation of hepatic steatosis. In this study, creatinine-to-cystatin C ratio correlated with muscle mass and strength in nonalcoholic fatty liver disease regardless of hepatic steatosis.
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Affiliation(s)
- Kenichiro Mikami
- Department of Gastroenterology, Hirosaki University Graduate School of Medicine
| | - Tetsu Endo
- Department of Gastroenterology, Hirosaki University Graduate School of Medicine
| | - Naoya Sawada
- Department of Gastroenterology, Hirosaki University Graduate School of Medicine
| | - Go Igarashi
- Department of Gastroenterology, Hirosaki University Graduate School of Medicine
| | - Masayo Kimura
- Department of Gastroenterology, Hirosaki University Graduate School of Medicine
| | - Takuma Hasegawa
- Department of Gastroenterology, Hirosaki University Graduate School of Medicine
| | - Chikara Iino
- Department of Gastroenterology, Hirosaki University Graduate School of Medicine
| | - Kaori Sawada
- Department of Diet and Health Science, Hirosaki University Graduate School of Medicine
| | - Masataka Ando
- Department of Diet and Health Science, Hirosaki University Graduate School of Medicine
| | - Yoshikuni Sugimura
- Department of Microbial Flora and Health Science, Hirosaki University Graduate School of Medicine
| | - Tatsuya Mikami
- Innovation Center for Health Promotion, Hirosaki University Graduate School of Medicine
| | - Shigeyuki Nakaji
- Department of Social Medicine, Hirosaki University Graduate School of Medicine
| | | | - Hirotake Sakuraba
- Department of Gastroenterology, Hirosaki University Graduate School of Medicine
| | - Shinsaku Fukuda
- Department of Gastroenterology, Hirosaki University Graduate School of Medicine
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Oh G, Lee H, Park CM, Jung HW, Lee E, Jang IY, Guralnik JM, Kim DH. Long-term effect of a 24-week multicomponent intervention on physical performance and frailty in community-dwelling older adults. Age Ageing 2021; 50:2157-2166. [PMID: 34351363 PMCID: PMC8581390 DOI: 10.1093/ageing/afab149] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Indexed: 12/19/2022] Open
Abstract
Introduction Multicomponent interventions improve physical function and frailty in older adults, but their long-term benefit remains uncertain. Methods This prospective non-randomised study was conducted in 383 older Koreans (mean age, 76.8 years; female 72.3%) who were living alone or receiving medical aid. Of these, 187 individuals chose to receive a 24-week intervention that consisted of group exercise, nutritional supplements, depression management, deprescribing and home hazard reduction. The remaining 196 individuals received usual care. We compared the short physical performance battery (SPPB) score (0–12 points), frailty phenotype scale (0–5 points) and deficit-accumulation frailty index (0–1) at baseline, 6, 18 and 30 months. Results After 1:1 propensity score matching (n = 117 per group), the mean SPPB scores for the intervention and comparison groups were 7.6 versus 7.6 at baseline, 10.7 versus 7.1 at 6 months (mean difference, 3.5; 95% confidence interval [CI], 2.8–4.2), 9.1 versus 7.8 at 18 months (1.3; 95% CI, 0.6–2.0) and 8.6 versus 7.5 at 30 months (1.1; 95% CI, 0.4–1.8). The intervention group had lower frailty phenotype scale (1.1 versus 1.8; difference, −0.7; 95% CI −1.0 to −0.3) and frailty index (0.22 versus 0.27; difference, −0.04; −0.06 to −0.02) at 6 months, but similar scores at 18 and 30 months. The 30-month mean institutionalisation-free survival time was 28.5 months in the intervention group versus 23.3 months in the comparison group (difference, 5.2 months; 95% CI, 3.1–7.4). Conclusions The 24-week multicomponent intervention showed sustained improvement in physical function, temporary reduction in frailty and longer institutionalisation-free survival over 30 months.
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Affiliation(s)
- Gahee Oh
- Marcus Institute for Aging Research, Hebrew Senior Life, Boston, MA, USA
| | - Heayon Lee
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Chan Mi Park
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
- Harvard T.H.Chan School of Public Health, Boston, MA 02115, USA
| | - Hee-Won Jung
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Eunju Lee
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Il-Young Jang
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
- PyeongChang Health Center and County Hospital, PyeongChang, Gangwon-Do, Republic of Korea
| | - Jack M Guralnik
- Division of Gerontology, Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Dae Hyun Kim
- Marcus Institute for Aging Research, Hebrew Senior Life, Boston, MA, USA
- Division of Gerontology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
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Park H, Lim J, Baek JY, Lee E, Jung HW, Jang IY. Status of Constipation and Its Association with Sarcopenia in Older Adults: A Population-Based Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111083. [PMID: 34769606 PMCID: PMC8583223 DOI: 10.3390/ijerph182111083] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 10/09/2021] [Accepted: 10/16/2021] [Indexed: 12/16/2022]
Abstract
(1) Background: As the clinical relevance of constipation and sarcopenia is not well studied, we aimed to investigate the association between them in older adults. (2) Methods: A cross-sectional study was conducted on 1278 community-dwelling older adults in South Korea. The Rome IV criteria were used to identify patients with clinically defined constipation, while sarcopenia was defined by the Asian Working Group for Sarcopenia consensus. The cohort was classified into three groups: no constipation, self-reported constipation only, and clinically defined constipation. (3) Results: The presence of constipation was associated with sarcopenia and slow gait speed (p < 0.001). After adjustment for possible covariates, the association with sarcopenia attenuated, while that for slow gait speed persisted. In terms of geriatric parameters, both groups with clinically defined and self-reported constipation had a higher burden of cognitive impairment, IADL disability, and lower QOL scores (p < 0.05) compared with those without constipation. (4) Conclusions: Sarcopenia and slow gait speed associated with constipation in community-dwelling older adults. Individuals with self-reported constipation symptoms alone showed comparable sarcopenic and geriatric burden to those with clinically defined constipation. Clinical suspicion for possible co-existing sarcopenia is warranted in older patients with constipation.
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Affiliation(s)
- Hyungchul Park
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (H.P.); (J.L.)
- Department of Gastroenterology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang 10380, Korea
| | - Jihye Lim
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (H.P.); (J.L.)
| | - Ji Yeon Baek
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (J.Y.B.); (E.L.)
| | - Eunju Lee
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (J.Y.B.); (E.L.)
| | - Hee-Won Jung
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (J.Y.B.); (E.L.)
- Correspondence: (H.-W.J.); (I.-Y.J.); Tel.: +82-2-3010-1852 (H.-W.J.); +82-2-3010-1658 (I.-Y.J.)
| | - Il-Young Jang
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (J.Y.B.); (E.L.)
- Correspondence: (H.-W.J.); (I.-Y.J.); Tel.: +82-2-3010-1852 (H.-W.J.); +82-2-3010-1658 (I.-Y.J.)
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11
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da Cruz GF, Lunz TM, de Jesus TR, Costa MB, Vidigal CV, Albergaria BH, Marques-Rocha JL, Guandalini VR. Influence of the appendicular skeletal muscle mass index on the bone mineral density of postmenopausal women. BMC Musculoskelet Disord 2021; 22:861. [PMID: 34627216 PMCID: PMC8501937 DOI: 10.1186/s12891-021-04748-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 09/28/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The appendicular skeletal muscle mass index (ASMI) is an important risk indicator for osteoporosis because of the anatomical proximity and metabolic connection between muscle and bone mass. The present study investigated the relationship between ASMI and the bone mineral density (BMD) categories of postmenopausal women. METHODS In this cross-sectional study with a probabilistic sample, sociodemographic, lifestyle, menopause time, anthropometric, and physical activity variables were collected. ASMI and BMD were assessed by dual-energy X-ray absorptiometry (DXA). Participants were grouped according to BMD values into normal density, osteopenia, and osteoporosis. Multivariate logistic regression models were applied to verify the influence of ASMI on BMD. Data were analyzed using the SPSS statistical software, version 22. The significance level for all tests was set at 5%. RESULTS Of the 114 women analyzed, most were between 60 and 69.9 years of age (62.3%), on menopause for ≤19.0 (51.8%), self-declared brown race/color (49.1%), had < 4 years of education (41.2%), never smoked (69.0%) or drank alcohol (62.8%). Of these, 52.6% were classified as sufficiently active and 52.2% had regular sun exposure. Women with osteoporosis were older (p = 0.035), on menopause for a longer time (p = 0.011), underweight (p = 0.004), had adequate waist circumference (p = 0.017), and low ASMI values (p = 0.002). There was an association between the 1st tertile of ASMI and osteoporosis. However, after adjustments for age, race/color, and body mass index, the strength of association between BMD and ASMI was not maintained. CONCLUSIONS ASMI was not associated with the BMD of the postmenopausal women evaluated. Total body and muscle mass, in addition to bone mass, should be monitored during menopause treatment. Longitudinal studies must be conducted to elucidate the mechanisms and gaps in this relationship.
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Affiliation(s)
- Geise Ferreira da Cruz
- Postgraduate Program in Nutrition and Health, Federal University of Espirito Santo, Marechal Campos, avenue, 1468 - Maruípe, Vitória, Espírito Santo, CEP: 29040-090, Brazil
| | - Tatiana Mion Lunz
- Department of Integrated Education, Federal University of Espirito Santo, Marechal Campos, avenue, 1468 - Maruípe, Vitória, Espírito Santo, CEP: 29040-090, Brazil
| | - Tatielle Rocha de Jesus
- Department of Integrated Education, Federal University of Espirito Santo, Marechal Campos, avenue, 1468 - Maruípe, Vitória, Espírito Santo, CEP: 29040-090, Brazil
| | - Mariana Braga Costa
- Department of Integrated Education, Federal University of Espirito Santo, Marechal Campos, avenue, 1468 - Maruípe, Vitória, Espírito Santo, CEP: 29040-090, Brazil
| | - Camila Vilarinho Vidigal
- Department of Integrated Education, Federal University of Espirito Santo, Marechal Campos, avenue, 1468 - Maruípe, Vitória, Espírito Santo, CEP: 29040-090, Brazil
| | - Ben-Hur Albergaria
- Department of Social Medicine, Federal University of Espirito Santo, Marechal Campos avenue, 1468 - Maruípe, Vitória, Espírito Santo, CEP: 29040-090, Brazil
| | - Jose Luiz Marques-Rocha
- Postgraduate Program in Nutrition and Health, Federal University of Espirito Santo, Marechal Campos, avenue, 1468 - Maruípe, Vitória, Espírito Santo, CEP: 29040-090, Brazil
- Department of Integrated Education, Federal University of Espirito Santo, Marechal Campos, avenue, 1468 - Maruípe, Vitória, Espírito Santo, CEP: 29040-090, Brazil
| | - Valdete Regina Guandalini
- Postgraduate Program in Nutrition and Health, Federal University of Espirito Santo, Marechal Campos, avenue, 1468 - Maruípe, Vitória, Espírito Santo, CEP: 29040-090, Brazil.
- Department of Integrated Education, Federal University of Espirito Santo, Marechal Campos, avenue, 1468 - Maruípe, Vitória, Espírito Santo, CEP: 29040-090, Brazil.
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Pana A, Sourtzi P, Kalokairinou A, Velonaki VS. Sarcopenia and polypharmacy among older adults: A scoping review of the literature. Arch Gerontol Geriatr 2021; 98:104520. [PMID: 34619629 DOI: 10.1016/j.archger.2021.104520] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 09/01/2021] [Accepted: 09/06/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Sarcopenia and polypharmacy are both prevalent conditions in the geriatric population, leading to poor quality of life and adverse outcomes. OBJECTIVE To explore the evidence on the relationship between sarcopenia and polypharmacy and to summarize the findings and the gaps from the existing literature. METHOD A systematic scoping review was conducted between March and May 2021, with no restriction on publication date, using the Arksey and O'Malley framework and reported according to PRISMA-ScR. Four bibliographic databases, PubMed, Web of Science, Scopus, Proquest One Academic, and four sources of gray literature were searched for studies written in English or Greek. Data were extracted quantitatively and using thematic analysis. RESULTS Of the 397 initially retrieved records, 22 studies were finally included in this review, 20 published articles and 2 posters-presentations. Most of the studies used cross-sectional data. The relationship between sarcopenia and polypharmacy should be interpreted on the basis of the definition of polypharmacy, the diagnostic criteria of sarcopenia used, and the population setting. Sarcopenia or risk for sarcopenia are associated with polypharmacy or the number of medications in community-dwelling older adults, regardless of diagnostic criteria used for sarcopenia. CONCLUSION There is an association between sarcopenia or risk for sarcopenia and polypharmacy or the number of medications in community-dwelling older adults but not among residents of nursing homes or inpatients. Specific widely accepted definitions of polypharmacy and sarcopenia, a consensus on the method of sarcopenia assessment, and prospective studies are needed to identify polypharmacy as a potential risk factor for sarcopenia.
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Affiliation(s)
- Anastasia Pana
- National and Kapodistrian University of Athens, Department of Nursing, Greece; Hellenic Association of Gerontology and Geriatrics, Athens, Greece; General Hospital Asklepieio, Voula, Greece.
| | - Panayota Sourtzi
- National and Kapodistrian University of Athens, Department of Nursing, Greece; Hellenic Association of Gerontology and Geriatrics, Athens, Greece
| | - Athina Kalokairinou
- National and Kapodistrian University of Athens, Department of Nursing, Greece
| | - Venetia Sofia Velonaki
- National and Kapodistrian University of Athens, Department of Nursing, Greece; Hellenic Association of Gerontology and Geriatrics, Athens, Greece
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Lee SA, Jang IY, Park SY, Kim KW, Park DW, Kim HJ, Kim JB, Jung SH, Choo SJ, Chung CH, Kang DH, Lee JW, Kim DH. Benefit of Sarcopenia Screening in Older Patients Undergoing Surgical Aortic Valve Replacement. Ann Thorac Surg 2021; 113:2018-2026. [PMID: 34332995 DOI: 10.1016/j.athoracsur.2021.06.067] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 06/01/2021] [Accepted: 06/18/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Sarcopenia, known as physical frailty, is highly prevalent in older patients and is related to adverse outcomes post-cardiac surgery. However, whether sarcopenia assessment can reclassify an individual patients' risk, which is estimated by Society of Thoracic Surgeons-predicted risk of mortality scores in patients who undergo surgical aortic valve replacement, is unclear. METHODS This retrospective, single center, cohort study comprised 874 patients aged ≥65 years who underwent surgical aortic valve replacement between 2009 and 2016. Total skeletal muscle area was calculated using height-squared and was measured by preoperative computed tomography at the third lumbar vertebra inferior border using machine learning-based analysis. Sex-specific Z-scores were calculated and patients in the lowest Z-score tertile were considered to have sarcopenia. The primary endpoint was 30-day mortality, and secondary endpoints were in-hospital events, 1-year mortality, and long-term mortality. RESULTS Thirty-day mortality, 30-day in-hospital events, and one-year mortality rates were 4.7%, 17.6%, and 8.0%, respectively. As the Z-score decreased, early adverse event odds showed a stepwise increase. Sarcopenia were independently associated with higher 30-day mortality, 30-day in-hospital events, and 1-year mortality. Reclassification analyses showed improvements in the ability to predict early adverse events after adding the Z-scores over and above the Society of Thoracic Surgeons-predicted risk of mortality scores (All, p <0.005). CONCLUSIONS Sarcopenic patients had significantly higher risks of early adverse events and long-term mortality after undergoing surgical aortic valve replacement than non-sarcopenic patients. Sarcopenia determined by preoperative computed tomography can enhance the prediction of postoperative outcome risk.
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Affiliation(s)
- Seung-Ah Lee
- Department of Cardiology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Republic of Korea
| | - Il-Young Jang
- Department of Geriatrics, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Republic of Korea
| | - Seo-Young Park
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Republic of Korea
| | - Kyung-Won Kim
- Department of Radiology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Republic of Korea
| | - Duk-Woo Park
- Department of Cardiology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Republic of Korea
| | - Ho Jin Kim
- Department of Thoracic and Cardiac Surgery, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Republic of Korea
| | - Joon Bum Kim
- Department of Thoracic and Cardiac Surgery, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Republic of Korea
| | - Sung-Ho Jung
- Department of Thoracic and Cardiac Surgery, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Republic of Korea
| | - Suk Jung Choo
- Department of Thoracic and Cardiac Surgery, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Republic of Korea
| | - Cheol-Hyun Chung
- Department of Thoracic and Cardiac Surgery, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Republic of Korea
| | - Duk-Hyun Kang
- Department of Cardiology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Republic of Korea
| | - Jae-Won Lee
- Department of Thoracic and Cardiac Surgery, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Republic of Korea
| | - Dae-Hee Kim
- Department of Cardiology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Republic of Korea.
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Baek JY, Lee E, Jung HW, Jang IY. Geriatrics Fact Sheet in Korea 2021. Ann Geriatr Med Res 2021; 25:65-71. [PMID: 34187140 PMCID: PMC8272996 DOI: 10.4235/agmr.21.0063] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 06/25/2021] [Indexed: 11/01/2022] Open
Abstract
South Korea became an aged society in 2017 and is predicted to become a super-aged society by 2025. Therefore, knowing the trends among older adults and identifying the geriatric burden are crucial for both healthcare professionals and policymakers. We previously summarized the general health and socioeconomic profiles of Korean older adults from the 2017 National Survey of Living Conditions and Welfare Needs of Older Koreans. In this update, we briefly summarized the results of the 2020 National Survey of Living Conditions and Welfare Needs of Older Koreans by categorizing them according to their general aging profile, socioeconomic status, lifestyle, and health status. In addition, we reviewed recent updates in the field of frailty and sarcopenia from population-based community cohorts in Korea. We hope this study will serve as a current reference for nationwide statistical data on common clinical and social parameters used in geriatrics and gerontology.
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Affiliation(s)
- Ji Yeon Baek
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Eunju Lee
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hee-Won Jung
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Il-Young Jang
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Fang L, Zhong S, Ma D, Li C, Hao Y, Gao Y, Zhang L, Shen L. A cross-sectional study: an assessment of low muscle mass and osteoporosis in type 2 diabetes mellitus patients with a high glycated hemoglobin level. Ther Adv Chronic Dis 2021; 12:20406223211026762. [PMID: 34262679 PMCID: PMC8246566 DOI: 10.1177/20406223211026762] [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: 01/10/2021] [Accepted: 06/02/2021] [Indexed: 12/05/2022] Open
Abstract
Background: Low muscle mass and osteoporosis are commonly observed in individuals with type 2 diabetes mellitus (T2DM). We investigated the prevalence of low muscle mass and osteoporosis in patients with T2DM who had high glycated hemoglobin (HbA1c) levels. Methods: We included 187 Chinese patients with T2DM who were aged ⩾50 years and evaluated their body composition using dual-energy X-ray absorptiometry. We measured levels of fasting blood glucose, HbA1c, B collagen-specific sequences (B-CTX), osteocalcin (OC), propeptide of type 1 procollagen (P1NP), and 25-hydroxy vitamin D. Results: Of the total patients, 82 were men and 105 were women. The prevalence rates of low muscle mass, osteopenia, and osteoporosis were 35.8%, 38.0%, and 31.0%, respectively. The prevalence rate of low muscle mass was significantly higher in women with HbA1c levels >9.0% than in those with HbA1c levels <9.0%. The prevalence rates of osteopenia and osteoporosis in men with HbA1c levels >9.0% differed significantly from those with HbA1c levels <9.0%. The appendicular skeletal muscle mass index (ASMI), trunk muscle mass, lumbar spinal bone mineral content (BMC), lumbar spine BMD, femoral BMC, and femoral BMD were significantly decreased, and the serum levels of B-CTX, OC, and P1NP were significantly increased in patients with T2DM who had osteoporosis. The ASMI was associated with osteopenia/osteoporosis in men and women with T2DM. Conclusions: In patients with T2DM, high HbA1c levels were associated with higher prevalence rates of low muscle mass in women and osteoporosis in men, and ASMI was a risk factor of osteoporosis.
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Affiliation(s)
- Lingna Fang
- Department of Endocrinology and Metabolism, Kunshan Hospital Affiliated with Jiangsu University, Qianjin Road 91#, Kunshan, 215300, China
| | - Shao Zhong
- Department of Endocrinology and Metabolism, Kunshan Hospital Affiliated with Jiangsu University, Kunshan, China
| | - Dan Ma
- Department of Endocrinology and Metabolism, Kunshan Hospital Affiliated with Jiangsu University, Kunshan, China
| | - Chong Li
- Department of Orthopaedics, Kunshan Hospital Affiliated with Jiangsu University, Kunshan, China
| | - Yanmin Hao
- Department of Orthopaedics, Kunshan Hospital Affiliated with Jiangsu University, Kunshan, China
| | - Yan Gao
- Department of Orthopaedics, Kunshan Hospital Affiliated with Jiangsu University, Kunshan, China
| | - Li Zhang
- Department of Endocrinology and Metabolism, Kunshan Hospital Affiliated with Jiangsu University, Kunshan, China
| | - Liwen Shen
- Department of Endocrinology and Metabolism, Kunshan Hospital Affiliated with Jiangsu University, Kunshan, China
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Sarcopenia. PAJAR - PAN AMERICAN JOURNAL OF AGING RESEARCH 2021. [DOI: 10.15448/2357-9641.2020.1.40032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Objective: To assess the prevalence of sarcopenia and associated factors among older women from the local community and older women living in Long-Term Care (LTC) institutions.Methods: A cross-sectional study conducted with 423 older women aged 60 or more, from the local community and older women aged 60 or more, living in LTC institutions. Sarcopenia was defined, according to the consensus of the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), including three criteria: low muscle strength (LMS) (<16kg); low muscle mass (LMM) (≤6.75kg/m2) assessed by a skeletal muscle mass index, and low physical performance (LPP) (≤0,8m/s) assessed by gait speed test. Older women who only showed LMS were considered to have pre-sarcopenia, those with LMS associated with LMM were diagnosed with sarcopenia and those who met all three criteria, were diagnosed with severe sarcopenia.Results: Among the community-dwelling older women, the prevalence of sarcopenia was 2.0% (from 60 to 69), 8.6% (from 70 to 79) and 12.9% (80 or more) and among the ones living in LTC Institutions, 3.3% (from 60 to 69), 14.8% (from 70 to 79) and 34.2% (80 or more). After multivariate logistic regression, age and low body mass index (BMI) were associated with sarcopenia in both groups.Conclusion: The prevalence of sarcopenia is higher among LTC older women. However, this is not an independent factor. In addition, regardless of residence, low BMI and advanced age are predictive for sarcopenia.
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Jung HW, Park JH, Kim DA, Jang IY, Park SJ, Lee JY, Lee S, Kim JH, Yi HS, Lee E, Kim BJ. Association between serum FGF21 level and sarcopenia in older adults. Bone 2021; 145:115877. [PMID: 33571698 DOI: 10.1016/j.bone.2021.115877] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 01/22/2021] [Accepted: 02/02/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND With emerging basic research evidence suggesting that fibroblast growth factor (FGF) 21 is a catabolic molecule on muscle metabolism, we aimed to analyze the serum FGF21 level in relation to sarcopenia in older adults. METHODS Blood samples were collected from 125 participants who underwent evaluation for muscle mass and function in an outpatient geriatric clinic of a teaching hospital. Sarcopenia and related components were determined using cutoff values for the Asian population. The serum FGF21 level was measured using enzyme linked immunosorbent assay. RESULTS After controlling for age, sex, and body mass index (BMI), participants with sarcopenia, low muscle mass, and weak muscle strength had 2.3-, 2.0-, and 1.5-fold higher serum FGF21 levels than controls, respectively (p = .033 to <0.001). The serum FGF21 level was positively correlated with sarcopenia phenotype score and inversely correlated with skeletal muscle mass index and grip strength by both crude and multivariate analysis adjusting potential confounders (p = .017 to <0.001). Consistently, higher serum FGF21 level was significantly associated with increased odds for sarcopenia, low muscle mass, and low muscle strength after adjusting for age, sex, and BMI (odds ratio, 1.53-2.61; p = .048 to <0.001). CONCLUSIONS Higher circulating FGF21 was associated with the likelihood of sarcopenia, lower muscle mass, and worse grip strength in older adults, supporting a potential catabolic role of FGF21 on human muscle health.
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Affiliation(s)
- Hee-Won Jung
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, South Korea
| | - Jin Hoon Park
- Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, South Korea
| | - Da Ae Kim
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, South Korea
| | - Il-Young Jang
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, South Korea
| | - So Jeong Park
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, South Korea
| | - Jin Young Lee
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, South Korea
| | - Seungjoo Lee
- Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, South Korea
| | - Jeoung Hee Kim
- Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, South Korea
| | - Hyon-Seung Yi
- Department of Medical Science, Chungnam National University School of Medicine, 99 Daehak-ro, Yuseong-gu, Daejeon, South Korea
| | - Eunju Lee
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, South Korea.
| | - Beom-Jun Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, South Korea.
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Kim DA, Park SJ, Lee JY, Kim JH, Lee S, Lee E, Jang IY, Jung HW, Park JH, Kim BJ. Effect of CCL11 on In Vitro Myogenesis and Its Clinical Relevance for Sarcopenia in Older Adults. Endocrinol Metab (Seoul) 2021; 36:455-465. [PMID: 33849248 PMCID: PMC8090464 DOI: 10.3803/enm.2020.942] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 02/22/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The C-C motif chemokine ligand 11 (CCL11) has been receiving attention as a potential pro-aging factor. Accordingly, it may be involved in muscle metabolism and sarcopenia, a key component of aging phenotypes. To clarify this potential, we investigated the effects of CCL11 on in vitro muscle biology and its clinical relevance for sarcopenia parameters in older adults. METHODS Myogenesis was induced in mouse C2C12 myoblasts with 2% horse serum. Human blood samples were collected from 79 participants who underwent a functional assessment. Thereafter, CCL11 level was measured using a quantikine ELISA kit. Sarcopenia was defined using the Asian-specific guideline. RESULTS Recombinant CCL11 treatment significantly stimulated myogenesis in a dose-dependent manner, and consistently increased the expression of myogenic differentiation markers. Among the C-C chemokine receptors (CCRs), CCR5, not CCR2 and CCR3, was predominantly expressed in muscle cells. Further, the CCR5 inhibitor blocked recombinant CCL11-stimulated myogenesis. In a clinical study, serum CCL11 level was not significantly different according to the status of sarcopenia, low muscle mass, weak muscle strength, and poor physical performance, and was not associated with skeletal muscle index, grip strength, short physical performance battery score, gait speed, and time to complete 5 chair stands, after adjusting for sex, age, and body mass index. CONCLUSION Contrary to expectations, CCL11 exerted beneficial effects on muscle metabolism at least in vitro system. However, its impact on human muscle health was not evident, suggesting that circulating CCL11 may not be a useful biomarker for sarcopenia risk assessment in older adults.
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Affiliation(s)
- Da Ae Kim
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul,
Korea
| | - So Jeong Park
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul,
Korea
| | - Jin Young Lee
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul,
Korea
| | - Jeoung Hee Kim
- Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul,
Korea
| | - Seungjoo Lee
- Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul,
Korea
| | - Eunju Lee
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul,
Korea
| | - Il-Young Jang
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul,
Korea
| | - Hee-Won Jung
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul,
Korea
| | - Jin Hoon Park
- Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul,
Korea
| | - Beom-Jun Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul,
Korea
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19
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Determination of Cutoff Values for the Screening of Osteosarcopenia in Obese Postmenopausal Women. Curr Gerontol Geriatr Res 2021; 2021:6634474. [PMID: 33790963 PMCID: PMC7997768 DOI: 10.1155/2021/6634474] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 02/03/2021] [Accepted: 02/27/2021] [Indexed: 11/30/2022] Open
Abstract
Osteosarcopenic obesity (OSO) describes the concurrent presence of obesity, low bone mass, and low muscle mass in an individual. Currently, no established criteria exist to diagnose OSO. We hypothesized that obese individuals require different cut-points from standard cut-points to define low bone mass and low muscle mass due to their higher weight load. In this study, we determined cutoff values for the screening of osteosarcopenia (OS) in obese postmenopausal Malaysian women based on the measurements of quantitative ultrasound (QUS), bioelectrical impedance analysis (BIA), and functional performance test. Then, we compared the cutoff values derived by 3 different statistical modeling methods, (1) receiver operating characteristic (ROC) curve, (2) lowest quintile of the study population, and (3) 2 standard deviations (SD) below the mean value of a young reference group, and discussed the most suitable method to screen for the presence of OS in obese population. One hundred and forty-one (n = 141) postmenopausal Malaysian women participated in the study. Bone density was assessed using calcaneal quantitative ultrasound. Body composition was assessed using bioelectrical impedance analyzer. Handgrip strength was assessed using a handgrip dynamometer, and physical performance was assessed using a modified Short Physical Performance Battery test. ROC curve was determined to be the most suitable statistical modeling method to derive the cutoffs for the presence of OS in obese population. From the ROC curve method, the final model to estimate the probability of OS in obese postmenopausal women is comprised of five variables: handgrip strength (HGS, with area under the curve (AUC) = 0.698 and threshold ≤ 16.5 kg), skeletal muscle mass index (SMMI, AUC = 0.966 and threshold ≤ 8.2 kg/m2), fat-free mass index (FFMI, AUC = 0.946 and threshold ≤ 15.2 kg/m2), broadband ultrasonic attenuation (BUA, AUC = 0.987 and threshold ≤ 52.85 dB/MHz), and speed of sound (SOS, AUC = 0.991 and threshold ≤ 1492.15 m/s). Portable equipment may be used to screen for OS in obese women. Early identification of OS can help lower the risk of advanced functional impairment that can lead to physical disability in obese postmenopausal women.
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20
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Nga HT, Jang IY, Kim DA, Park SJ, Lee JY, Lee S, Kim JH, Lee E, Park JH, Lee YH, Yi HS, Kim BJ. Serum GDF15 Level Is Independent of Sarcopenia in Older Asian Adults. Gerontology 2021; 67:525-531. [PMID: 33690236 DOI: 10.1159/000513600] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 12/07/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Growth differentiation factor 15 (GDF15), induced by tissue inflammation and mitochondrial stress, has received significant attention as a biomarker of mitochondrial dysfunction and has been implicated in various age-related diseases. However, the association between circulating GDF15 and sarcopenia-associated outcomes in older adults remains to be established. AIM To validate previous experimental data and to investigate the possible role of GDF15 in aging and muscle physiology in humans, this study examined serum GDF15 levels in relation to sarcopenia-related parameters in a cohort of older Asian adults. METHODS Muscle mass and muscle function-related parameters, such as grip strength, gait speed, chair stands, and short physical performance battery score were evaluated by experienced nurses in 125 geriatric participants with or without sarcopenia. Sarcopenia was diagnosed using the Asian-specific cutoff points. Serum GDF15 levels were measured using an enzyme immunoassay kit. RESULTS Serum GDF15 levels were not significantly different according to sarcopenia status, muscle mass, muscle strength, and physical performance and were not associated with the skeletal muscle index, grip strength, gait speed, time to complete 5 chair stands, and short physical performance battery score, regardless of adjustments for sex, age, and BMI. CONCLUSIONS These findings indicate that the definite role of GDF15 on muscle metabolism observed in animal models might not be evident in humans and that elevated GDF15 levels might not predict the risk for sarcopenia, at least in older Asian adults.
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Affiliation(s)
- Ha Thi Nga
- Research Center for Endocrine and Metabolic Diseases, Chungnam National University School of Medicine, Daejeon, Republic of Korea.,Department of Medical Science, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Il-Young Jang
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Da Ae Kim
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - So Jeong Park
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jin Young Lee
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Seungjoo Lee
- Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jeoung Hee Kim
- Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Eunju Lee
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jin Hoon Park
- Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Young-Ho Lee
- Protein Structure Group, Korea Basic Science Institute, Ochang, Cheongju, Republic of Korea
| | - Hyon-Seung Yi
- Research Center for Endocrine and Metabolic Diseases, Chungnam National University School of Medicine, Daejeon, Republic of Korea, .,Department of Medical Science, Chungnam National University School of Medicine, Daejeon, Republic of Korea,
| | - Beom-Jun Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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21
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Lee JC, Song BS, Kang YM, Kim YR, Kang YE, Lee JH, Shong M, Yi HS. Effect of Thyroid-Stimulating Hormone Suppression on Muscle Function After Total Thyroidectomy in Patients With Thyroid Cancer. Front Endocrinol (Lausanne) 2021; 12:769074. [PMID: 34858341 PMCID: PMC8631429 DOI: 10.3389/fendo.2021.769074] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 10/22/2021] [Indexed: 12/30/2022] Open
Abstract
CONTEXT Thyroid-stimulating hormone (TSH) suppression is recommended to reduce tumor recurrence following surgery for differentiated thyroid cancer (DTC). However, prolonged subclinical hyperthyroidism caused by levothyroxine treatment has deleterious effects on various organs. OBJECTIVE To evaluate the relationships of TSH concentration with muscle mass, muscle strength, and physical performance related to sarcopenia in patients with DTC undergoing TSH suppression following surgery. METHODS We studied 134 patients of >60 years who were undergoing TSH suppression therapy following surgery for DTC. We evaluated muscle mass and muscle function-related parameters and diagnosed sarcopenia using the threshold for Asian people. RESULTS The participants were 68.3 ± 7.2 years old and 36/134 (26.9%) were diagnosed with sarcopenia. They were allocated to high-TSH and low-TSH groups using a threshold concentration of 0.40 μU/mL, and grip strength was significantly lower in the low-TSH group. The data were further analyzed according to age and sex, and in the low-TSH group, male participants and those of <70 years were found to have significantly lower grip strength. CONCLUSIONS Low-TSH concentrations is associated with low grip strength, and this is most pronounced in individuals of <70 years of age. Therefore, muscle function should be considered an adverse effect of TSH suppression in patients with DTC who undergo TSH suppression therapy, especially in men of <70 years.
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Affiliation(s)
- Jun Choul Lee
- Research Center for Endocrine and Metabolic Diseases, Chungnam National University School of Medicine, Daejeon, South Korea
| | - Byong-Sop Song
- Department of Core Laboratory of Translational Research, Biomedical Convergence Research Center, Chungnam National University Hospital, Daejeon, South Korea
| | - Young Mi Kang
- Research Center for Endocrine and Metabolic Diseases, Chungnam National University School of Medicine, Daejeon, South Korea
| | - Yu-Ri Kim
- Research Center for Endocrine and Metabolic Diseases, Chungnam National University School of Medicine, Daejeon, South Korea
| | - Yea Eun Kang
- Research Center for Endocrine and Metabolic Diseases, Chungnam National University School of Medicine, Daejeon, South Korea
| | - Ju Hee Lee
- Research Center for Endocrine and Metabolic Diseases, Chungnam National University School of Medicine, Daejeon, South Korea
| | - Minho Shong
- Research Center for Endocrine and Metabolic Diseases, Chungnam National University School of Medicine, Daejeon, South Korea
| | - Hyon-Seung Yi
- Research Center for Endocrine and Metabolic Diseases, Chungnam National University School of Medicine, Daejeon, South Korea
- Department of Core Laboratory of Translational Research, Biomedical Convergence Research Center, Chungnam National University Hospital, Daejeon, South Korea
- *Correspondence: Hyon-Seung Yi,
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22
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Kim HR, Lee H, Seong Y, Lee E, Jung HW, Park YR, Jang IY. Longitudinal trajectory of disability in community-dwelling older adults: An observational cohort study in South Korea. BMC Geriatr 2020; 20:430. [PMID: 33115447 PMCID: PMC7594294 DOI: 10.1186/s12877-020-01834-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Accepted: 10/14/2020] [Indexed: 12/02/2022] Open
Abstract
Background Disability, which is considered a health-related condition, increases care demands and socioeconomic burdens for both families and communities. To confirm the trend of dynamic longitudinal changes in disability, this study aims to explore how disability is divided by the trajectory method, which deals with time-sequenced data. Additionally, this study examines the differences in demographics, geriatric conditions, and time spent at home among the trajectory groups in community-dwelling older adults. Home time is defined as the period during which the patient was not in a hospital or health care facility during their lifetime. Methods Records of 786 community-dwelling older participants were analyzed from the Aging Study of PyeongChang Rural Area, a population-based cohort study that took place over three years. Using 7 domains of activities of daily living and 10 domains of instrumental activities of daily living, participants were grouped into no dependency (0 disabled domain), mild (1 disabled domain), and severe (2 or more disabled domains) disability groups. The longitudinal trajectory group of disability was calculated as a trajectory method. Three distinct trajectory groups were calculated over time: a relatively-stable group (78.5%; n = 617), a gradually-aggravated group (16.0%; n = 126), and a rapidly-deteriorated group (5.5%; n = 43). Results The average age of 786 participants was 73.3 years (SD: 5.8), and the percentage of female was 52.7%. It was found that 78.5% of patients showed relatively no dependence and 5.5% of older adults in a rural area showed severe dependence. Through applying the trajectory method, it was shown that the Short Physical Performance Battery (SPPB) score was 10.2 points in the relatively-stable group and 3.1 points in the rapidly-deteriorating group by the 3rd year. Additionally, by the trajectory method, the rate of decrease in home time was 3.33% in the rapidly-deteriorated group compared to the relatively-stable group. Conclusions This study shows the difference in demographics and geriatric conditions (such as SPPB) through the examination of longitudinal trajectory groups of disability in community-dwelling older adults. Significant differences were also found in the amount of home time among the trajectory groups. Supplementary information Supplementary information accompanies this paper at 10.1186/s12877-020-01834-y.
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Affiliation(s)
- Hae Reong Kim
- Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, South Korea
| | - Heayon Lee
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.,Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Yoonje Seong
- Yonsei University College of Medicine, Seoul, South Korea
| | - Eunju Lee
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Hee-Won Jung
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Yu Rang Park
- Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, South Korea.
| | - Il-Young Jang
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.,Pyeongchang Health Center & Country Hospital, Gangwon-do, South Korea
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23
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Jang IY, Lee S, Kim JH, Lee E, Lee JY, Park SJ, Kim DA, Hamrick MW, Park JH, Kim BJ. Lack of association between circulating apelin level and frailty-related functional parameters in older adults: a cross-sectional study. BMC Geriatr 2020; 20:420. [PMID: 33087053 PMCID: PMC7579806 DOI: 10.1186/s12877-020-01837-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 10/15/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Apelin, an active endogenous peptide, has been recently receiving great attention as a promising target for antiaging intervention, primarily based on results from genetically altered mice. To validate previous experimental data and investigate the possible role of apelin in humans, in this study, we examined serum apelin level in relation to frailty and its associated parameters in a cohort of ambulatory, community-dwelling older adults. METHODS Blood samples were collected from 80 participants who underwent a comprehensive geriatric assessment, and apelin level was measured using an enzyme immunoassay kit. Phenotypic frailty and deficit-accumulation frailty index (FI) were assessed using widely validated approaches, proposed by Fried and Rockwood groups, respectively. RESULTS After adjustment for sex, age, and body mass index, serum apelin level was found to be not significantly different according to phenotypic frailty status (P = 0.550) and not associated with FI, grip strength, gait speed, time to complete 5 chair stands, and muscle mass (P = 0.433 to 0.982). To determine whether the association between serum apelin level and frailty has a threshold effect, we divided the participants into quartiles according to serum apelin level. However, there were no differences in terms of frailty-related parameters and the risk for frailty among the quartile groups (P = 0.248 to 0.741). CONCLUSIONS The serum apelin level was not associated with both phenotypic frailty and functional parameters in older adults, despite its beneficial effects against age-related physiologic decline in animal models. Further large-scale longitudinal studies are necessary to understand the definite role of circulating apelin in frailty risk assessment.
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Affiliation(s)
- Il-Young Jang
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Seungjoo Lee
- Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea
| | - Jeoung Hee Kim
- Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea
| | - Eunju Lee
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jin Young Lee
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - So Jeong Park
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Da Ae Kim
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Mark W Hamrick
- Department of Cell Biology and Anatomy, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Jin Hoon Park
- Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea.
| | - Beom-Jun Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea.
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Lower Serum n-3 Fatty Acid Level in Older Adults with Sarcopenia. Nutrients 2020; 12:nu12102959. [PMID: 32992568 PMCID: PMC7600475 DOI: 10.3390/nu12102959] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 09/21/2020] [Accepted: 09/25/2020] [Indexed: 11/25/2022] Open
Abstract
The n-3 fatty acid (FA) has evoked considerable interest as a modifiable factor for maintenance of muscle health owing to its anti-inflammatory properties. To clarify this possibility, we investigated circulating n-3 FA level, a reliable biomarker of FA status in the body, in relation to sarcopenia in a cohort of Asian older adults. Blood samples were collected from 125 participants who underwent comprehensive assessment of muscle mass and function. Serum FA level was measured by gas chromatography/mass spectrometry. Sarcopenia was diagnosed using the cut-off points specified for the Asian population. After adjusting for sex, age, and body mass index, subjects with sarcopenia and those with low muscle strength had 36.5% and 32.4% lower serum n-3 levels (P = 0.040 and 0.030), respectively, than controls. The odds ratios per standard deviation increment in serum n-3 level for sarcopenia and low muscle strength were 0.29 and 0.40 (P = 0.015 and 0.028), respectively. A higher serum n-3 level was significantly associated with greater muscle strength (P = 0.038). These findings suggest a possible protective effect of n-3 FA on human muscle homeostasis. Further well-designed large-scale longitudinal studies are necessary to understand the definite role of circulating n-3 FA level in sarcopenia risk assessment.
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25
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Jang I, Lee E, Lee H, Park H, Kim S, Kim K, Jung H, Kim DH. Characteristics of sarcopenia by European consensuses and a phenotype score. J Cachexia Sarcopenia Muscle 2020; 11:497-504. [PMID: 31863645 PMCID: PMC7113507 DOI: 10.1002/jcsm.12507] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 09/25/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND We aimed to assess the clinical characteristics of sarcopenia by the original and revised European Working Group on Sarcopenia in Older People (EWGSOP 1 and 2), and to propose a new sarcopenia phenotype score (SPS) to improve relevance of clinical outcomes. METHODS Analyses were performed in 1408 older adults of the Aging Study of PyeongChang Rural Area, a community-based cohort in Korea. For sarcopenia definitions, we used EWGSOP 1, EWGSOP 2, and SPS, a new index counting number of abnormal domains among components of grip strength, gait speed, or muscle mass. Frailty status by the frailty index and the Cardiovascular Health Study frailty score was compared with sarcopenia measures. Prediction ability for composite outcome combining death and institutionalization due to functional decline was assessed among sarcopenia measures. RESULTS Generally, sarcopenia spectrum by both EWGSOP 1 and 2 was associated with worse functional status in parameters of geriatric assessments. However, population who were considered as sarcopenic by EWGSOP 1, but not by EWGSOP 2, showed increased risk of composite outcome and worse frailty status, compared with people who were classified as not sarcopenic by both EWGSOP 1 and 2. With SPS, dose-response relationship was observed with both frailty status and outcome prediction. Prediction for composite outcome was better in SPS than in EWGSOP 2 classification. CONCLUSIONS A new SPS might be used to classify sarcopenic burden in older adults to resolve possible inconsistencies in phenotype correlation and outcome prediction of EWGSOP 2 criteria.
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Affiliation(s)
- Il‐Young Jang
- Department of Internal Medicine, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
- PyeongChang Health Center and County HospitalPyeongChangGangwon‐DoRepublic of Korea
| | - Eunju Lee
- Department of Internal Medicine, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
| | - Heayon Lee
- Department of Internal Medicine, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
| | - Hyungchul Park
- Department of Internal Medicine, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
| | - Sunyoung Kim
- Department of Family MedicineKyung Hee University Medical CenterSeoulRepublic of Korea
| | - Kwang‐il Kim
- Division of Geriatrics, Department of Internal MedicineSeoul National University Bundang HospitalRepublic of Korea
| | - Hee‐Won Jung
- Department of Internal MedicineSeoul National University HospitalSeoulRepublic of Korea
| | - Dae Hyun Kim
- Marcus Institute for Aging ResearchHebrew Senior LifeBostonMAUSA
- Division of Gerontology, Department of MedicineBeth Israel Deaconess Medical CenterBostonMAUSA
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26
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Park YRJ, Sohng KY. [Effects of a Customized Health Promotion Program on Depression, Cognitive Functioning, and Physical Health of Elderly Women Living Alone in Community: A Cluster Randomized Controlled Trial]. J Korean Acad Nurs 2020; 49:515-525. [PMID: 31672946 DOI: 10.4040/jkan.2019.49.5.515] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 05/28/2019] [Accepted: 05/29/2019] [Indexed: 11/09/2022]
Abstract
PURPOSE This study aimed to evaluate the effectiveness of a customized health promotion program (CHPP) on depression, cognitive functioning, and physical health of elderly women living alone in the community. METHODS A randomized comparison of pre-and post-test design was used with 62 participants assigned to either an intervention (n=32 in seven clusters) or a control group (n=30 in seven clusters) in 14 areas of a town. The final sample included 30 intervention participants who completed the CHPP for 10 weeks, and 26 control participants. The intervention group participated in the CHPP weekly; they were provided with instructions about coping with their chronic illnesses, lifestyle modification, risk management, providing emotional support to each other, and floor-seated exercise, which they were encouraged to do three times a week in their homes. RESULTS Significant group differences were found in depression (U=48.50, p<.001), cognitive functioning (U=2.50, p<.001), left arm flexibility (U=251.50, p=.023), right arm flexibility (U=225.00, p=.007), static balance (U=237.00, p=.012), and gait ability (U=190.50, p=.004). However, there were no significant differences in bothgrip strength and muscle mass between the two groups. CONCLUSION The findings indicate that CHPP was overall effective at improving depression, cognitive functioning, and physical functioning of elderly women living alone, and could therefore be considered a positive program for community-dwelling elderly women living alone.
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Affiliation(s)
- Ye Ri Ja Park
- College of Nursing, The Catholic University of Korea, Seoul, Korea
| | - Kyeong Yae Sohng
- College of Nursing, The Catholic University of Korea, Seoul, Korea.
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27
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Chen LK, Woo J, Assantachai P, Auyeung TW, Chou MY, Iijima K, Jang HC, Kang L, Kim M, Kim S, Kojima T, Kuzuya M, Lee JSW, Lee SY, Lee WJ, Lee Y, Liang CK, Lim JY, Lim WS, Peng LN, Sugimoto K, Tanaka T, Won CW, Yamada M, Zhang T, Akishita M, Arai H. Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment. J Am Med Dir Assoc 2020; 21:300-307.e2. [PMID: 32033882 DOI: 10.1016/j.jamda.2019.12.012] [Citation(s) in RCA: 2823] [Impact Index Per Article: 705.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 12/11/2019] [Accepted: 12/12/2019] [Indexed: 12/13/2022]
Abstract
Clinical and research interest in sarcopenia has burgeoned internationally, Asia included. The Asian Working Group for Sarcopenia (AWGS) 2014 consensus defined sarcopenia as "age-related loss of muscle mass, plus low muscle strength, and/or low physical performance" and specified cutoffs for each diagnostic component; research in Asia consequently flourished, prompting this update. AWGS 2019 retains the previous definition of sarcopenia but revises the diagnostic algorithm, protocols, and some criteria: low muscle strength is defined as handgrip strength <28 kg for men and <18 kg for women; criteria for low physical performance are 6-m walk <1.0 m/s, Short Physical Performance Battery score ≤9, or 5-time chair stand test ≥12 seconds. AWGS 2019 retains the original cutoffs for height-adjusted muscle mass: dual-energy X-ray absorptiometry, <7.0 kg/m2 in men and <5.4 kg/m2 in women; and bioimpedance, <7.0 kg/m2 in men and <5.7 kg/m2 in women. In addition, the AWGS 2019 update proposes separate algorithms for community vs hospital settings, which both begin by screening either calf circumference (<34 cm in men, <33 cm in women), SARC-F (≥4), or SARC-CalF (≥11), to facilitate earlier identification of people at risk for sarcopenia. Although skeletal muscle strength and mass are both still considered fundamental to a definitive clinical diagnosis, AWGS 2019 also introduces "possible sarcopenia," defined by either low muscle strength or low physical performance only, specifically for use in primary health care or community-based health promotion, to enable earlier lifestyle interventions. Although defining sarcopenia by body mass index-adjusted muscle mass instead of height-adjusted muscle mass may predict adverse outcomes better, more evidence is needed before changing current recommendations. Lifestyle interventions, especially exercise and nutritional supplementation, prevail as mainstays of treatment. Further research is needed to investigate potential long-term benefits of lifestyle interventions, nutritional supplements, or pharmacotherapy for sarcopenia in Asians.
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Affiliation(s)
- Liang-Kung Chen
- Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan; Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan.
| | - Jean Woo
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong S.A.R., China.
| | - Prasert Assantachai
- Division of Geriatric Medicine, Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Tung-Wai Auyeung
- The S. H. Ho Center for Gerontology and Geriatrics, The Chinese University of Hong Kong, Hong Kong S.A.R, China
| | - Ming-Yueh Chou
- Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan; Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Katsuya Iijima
- Institute of Gerontology, The University of Tokyo, Tokyo, Japan
| | - Hak Chul Jang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Lin Kang
- Department of Geriatrics, Peking Union Medical College Hospital, Beijing, China
| | - Miji Kim
- Department of Biomedical Science and Technology, College of Medicine, East-West Medical Research Institute, Kyung Hee University, Seoul, Korea
| | - Sunyoung Kim
- Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Taro Kojima
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masafumi Kuzuya
- Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Jenny S W Lee
- The S. H. Ho Center for Gerontology and Geriatrics, The Chinese University of Hong Kong, Hong Kong S.A.R, China
| | - Sang Yoon Lee
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea; Department of Rehabilitation Medicine, Seoul National University Boramae Medical Center, Seoul, Korea
| | - Wei-Ju Lee
- Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan; Department of Family Medicine, Taipei Veterans General Hospital Yuanshan Branch, Yilan, Taiwan
| | - Yunhwan Lee
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea
| | - Chih-Kuang Liang
- Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan; Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Jae-Young Lim
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Wee Shiong Lim
- Institute of Geriatrics and Active Aging, Tan Tock Seng Hospital, Singapore
| | - Li-Ning Peng
- Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan; Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ken Sugimoto
- Department of Geriatric Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Tomoki Tanaka
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Chang Won Won
- Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Minoru Yamada
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Teimei Zhang
- Beijing Institute of Geriatrics, Beijing Hospital, Ministry of Health, Beijing, China
| | - Masahiro Akishita
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, Obu, Aichi, Japan.
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Tey SL, Chew STH, How CH, Yalawar M, Baggs G, Chow WL, Cheong M, Ong RHS, Husain FS, Kwan SC, Tan CYL, Low YL, Tan NC, Huynh DTT. Factors associated with muscle mass in community-dwelling older people in Singapore: Findings from the SHIELD study. PLoS One 2019; 14:e0223222. [PMID: 31596873 PMCID: PMC6785067 DOI: 10.1371/journal.pone.0223222] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 09/15/2019] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES Aging is associated with low muscle mass and has been linked to adverse health outcomes. The objectives of this cross-sectional study were: (1) to describe anthropometry, body composition, appendicular skeletal muscle mass index (ASMI; appendicular skeletal muscle mass/height2), and prevalence of low ASMI in older people with normal nutritional status (Malnutrition Universal Screening Tool score = 0); (2) to determine factors associated with ASMI, and odds ratios of having low ASMI. METHODS SHIELD is a study of community-dwelling older people aged 65 years and above in Singapore. ASMI was determined using bioelectrical impedance analysis and low ASMI was defined as <7.0 kg/m2 for males and <5.7 kg/m2 for females (Asian Working Group for Sarcopenia, 2014). RESULTS A total of 400 older people (183 males and 217 females) took part in this study. The overall prevalence of low ASMI was 20.6% (15.5% in males and 24.9% in females). Females had significantly lower ASMI than males (P < 0.0001), age was inversely associated with ASMI (P = 0.0024) while BMI and calf circumference were positively associated with ASMI (both P < 0.0001) in the total cohort. In addition, ASMI was positively associated with bone mass in both genders (both P < 0.0001). After adjusting for covariates, the odds ratios of having low ASMI with every 1 year and 10 years increase in age were 1.13 (95% CI: 1.06, 1.20) and 3.36 (95% CI: 1.82, 6.21) respectively. CONCLUSIONS The high prevalence of low ASMI in community-dwelling older people with normal nutritional status highlights the need for early screening. There was a strong inverse association between age and ASMI while BMI, calf circumference and bone mass were positively associated with ASMI. These findings will give further weight to the importance and development of public health strategies in maintaining and improving muscle health in this population group.
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Affiliation(s)
- Siew Ling Tey
- Abbott Nutrition Research and Development, Asia-Pacific Center, Singapore
| | | | - Choon How How
- Care and Health Integration, Changi General Hospital, Singapore
- SingHealth-Duke NUS Family Medicine Academic Clinical Program, Singapore
| | - Menaka Yalawar
- Statistical Services, Cognizant Technologies Solution Pvt. Ltd., Bangalore, India
| | - Geraldine Baggs
- Abbott Nutrition Research and Development, Columbus, Ohio, United States of America
| | - Wai Leng Chow
- Health Services Research, Changi General Hospital, Singapore
| | - Magdalin Cheong
- Department of Dietetic & Food Services, Changi General Hospital, Singapore
| | | | | | | | | | - Yen Ling Low
- Abbott Nutrition Research and Development, Asia-Pacific Center, Singapore
| | - Ngiap Chuan Tan
- SingHealth-Duke NUS Family Medicine Academic Clinical Program, Singapore
- SingHealth Polyclinics, Singapore
| | - Dieu Thi Thu Huynh
- Abbott Nutrition Research and Development, Asia-Pacific Center, Singapore
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Jang IY, Lee HY, Lee E. Geriatrics Fact Sheet in Korea 2018 From National Statistics. Ann Geriatr Med Res 2019; 23:50-53. [PMID: 32743288 PMCID: PMC7387592 DOI: 10.4235/agmr.19.0013] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 05/08/2019] [Accepted: 05/09/2019] [Indexed: 12/18/2022] Open
Abstract
South Korea is the fastest aging country in the world, having become an aged society in 2017, with over 14% of its population aged 65 years or older. This Korean Geriatrics Fact Sheet 2018 aimed to overview and clarify the current geriatric burden and its trends in South Korea. Using nationwide surveys and public reports from government or related organizations, especially the 2017 Survey of the Living Conditions and Welfare Needs of Korean Older Persons from the Korea Institute for Health and Social Affairs, our committee has summarized the profile, socioeconomic status, health-related lifestyles, geriatric syndromes with major comorbidities, and use of healthcare services in the aging population. We hope that this review will publicize the social burden and seriousness of the aging problem in Korea.
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Affiliation(s)
- Il-Young Jang
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hea Yon Lee
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Eunju Lee
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Crispim Carvalho NN, Baccin Martins VJ, Modesto Filho J, Bandeira F, Fernandes Pimenta FC, de Brito Alves JL. Relationship Between Skeletal Muscle Mass Indexes and Muscular Function, Metabolic Profile and Bone Mineral Density in Women with Recommendation for Bariatric Surgery. Diabetes Metab Syndr Obes 2019; 12:2645-2654. [PMID: 31849508 PMCID: PMC6913321 DOI: 10.2147/dmso.s213643] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Accepted: 07/20/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND AND AIM We evaluated low skeletal muscle mass (LMM) in women prior to bariatric surgery (BS) through different skeletal muscle mass indexes (MMIs) regarding body fat percentage (BFP), handgrip strength (HS), six-minute walk test (6MWT), metabolic profile and bone mineral density (BMD). METHODS Women (n=62) were allocated into two groups according to LMM: obesity with low muscle mass (OLMM) or obesity with normal muscle mass (ONMM). LMM was defined by the appendicular skeletal muscle mass (ASM) adjusted for weight (ASM/wt × 100) and ASM adjusted for body mass index (ASM/BMI), considering the lowest quintile of the indexes studied. RESULTS OLMM was found in 30.5% by ASM/wt × 100 and 20.3% by ASM/BMI. Using the ASM/wt × 100, OLMM group had a high BFP, low HS and BMD in L1-L4, femoral neck (FN) and total femur (TF) when compared with ONMM (p < 0.05). Using ASM/BMI, OLMM group had increased BFP, reduced HS and 6MWT in comparison to ONMM (p < 0.05). Metabolic profile was similar between OLMM and ONMM groups by the two MMIs. MMIs were negatively correlated with BFP (p < 0.05) and positively correlated with HS (p < 0.05), and none of them with 6MWT (p > 0.05). ASM/wt × 100 was positively correlated with all BMD sites assessed (p < 0.05). There was positive correlation between ASM/wt × 100 and ASM/BMI. CONCLUSION OLMM identified by the ASM/wt × 100 and ASM/BMI had higher adiposity and lower HS. Using ASM/BMI, we found that OLMN had a poor physical performance, while the ASM/wt × 100 identified a lower BMD at all sites.
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Affiliation(s)
- Nara Nóbrega Crispim Carvalho
- Department of Nutrition, Health Sciences Center, Federal University of Paraiba, Joao Pessoa, Brazil
- Department of Endocrinology, Lauro Wanderley University Hospital, Federal University of Paraiba, Joao Pessoa, Brazil
- Nara Nóbrega Crispim Carvalho Department of Endocrinology, Lauro Wanderley University Hospital, Federal University of Paraiba, João Pessoa, PB58051-900, BrazilTel/Fax +55 83 9 9368 0937 Email
| | | | - João Modesto Filho
- Department of Endocrinology, Lauro Wanderley University Hospital, Federal University of Paraiba, Joao Pessoa, Brazil
| | - Francisco Bandeira
- Division of Diabetes and Endocrinology of Agamenon Magalhães Hospital, Recife, Brazil
| | | | - José Luiz de Brito Alves
- Department of Nutrition, Health Sciences Center, Federal University of Paraiba, Joao Pessoa, Brazil
- Correspondence: José Luiz de Brito Alves Department of Nutrition, Federal University of Paraiba, Campus I – Jd. Cidade Universitária, João Pessoa, PB58051-900, BrazilTel/Fax +55 81 9 9845 5485 Email
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Carvalho NNC, de Oliveira Junior FA, da Silva G, Baccin Martins VJ, Braga VDA, da Costa-Silva JH, Fernandes Pimenta FC, de Brito Alves JL. Impact of arterial hypertension and type 2 diabetes on cardiac autonomic modulation in obese individuals with recommendation for bariatric surgery. Diabetes Metab Syndr Obes 2019; 12:1503-1511. [PMID: 31686874 PMCID: PMC6709514 DOI: 10.2147/dmso.s204414] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 07/13/2019] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND AND AIM Obese individuals with recommendation for bariatric surgery (BS) exhibit increased cardiovascular risk. The association of obesity with comorbidities, such as arterial hypertension (HTN) and type 2 diabetes mellitus (T2DM) can worsen cardiovascular dysfunction. This study aimed to investigate the effect of HTN on cardiac autonomic function and whether diabetes exacerbates HTN-related impairment of autonomic function in obese subjects. METHODS Samples (n=63) were allocated to three groups: Obese without HTN and T2DM (n=29), Obese with HTN (OHTN, n=17) and OHTN with T2DM (OHTN+T2DM, n=17), in which anthropometric measures, body composition, blood biochemical parameters, blood pressure (BP) and heart rate variability (HRV) were evaluated. RESULTS The age was higher in OHTN+T2DM and OHTN than in obese groups (p<0.05). OHTN+T2DM individuals had increased neck circumference and compromised glycemic profile when compared to obese and OHTN groups (p<0.05). Mean values for standard deviation of RR (SDRR), square root of the mean squared differences of successive RR interval (RMSSD) and number of pairs of successive normal-to-normal beat intervals that differed by 50 ms (pRR50) were significantly lower in OHTN+T2DM and OHTN groups when compared to patients with obesity alone (p<0.05). The low frequency (LF), low frequency/high frequency (LF/HF) ratio were higher in the OHTN+T2DM and OHTN than subjects with obesity alone (p<0.05). Nonlinear parameters SD2 and SD1 were also lower in the OHTN+T2DM when compared to the obese group (p<0.05). However, the SD2/SD1 ratio was higher in the OHTN+T2DM and OHTN groups than the obese group. CONCLUSION T2DM and/or HTN impair the cardiac autonomic function in obese patients. However, the presence of T2DM did not exacerbate the hypertension-related impairment of autonomic function.
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Affiliation(s)
- Nara Nóbrega Crispim Carvalho
- Department of Nutrition, Health Sciences Center, Federal University of Paraiba, João Pessoa, Brazil
- Department of Endocrinology, Lauro Wanderley University Hospital, Federal University of Paraiba, João Pessoa, Brazil
| | | | - Gitana da Silva
- Lauro Wanderley Hospital, Federal University of Paraiba, João Pessoa, Brazil
| | - Vinícius José Baccin Martins
- Department of Physiology and Pathology, Health Sciences Center, Federal University of Paraiba, João Pessoa, Brazil
| | - Valdir de Andrade Braga
- Department of Biotechnology, Center of Biotechnology, Federal University of Paraíba, João Pessoa, Brazil
| | - João Henrique da Costa-Silva
- Department of Physical Education and Sport Sciences, Federal University of Pernambuco, Vitória De Santo Antão, PE, Brazil
| | | | - José Luiz de Brito Alves
- Department of Nutrition, Health Sciences Center, Federal University of Paraiba, João Pessoa, Brazil
- Correspondence: José Luiz de Brito Alves; Nara Nóbrega Crispim CarvalhoDepartment of Nutrition, Federal University of Paraiba, Campus I – Jd. Cidade Universitária, João Pessoa, PBCEP: 58051-900, BrazilTel/fax +55 8 199 845 5485 Email ;
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Jung HW, Kim SW, Kim IY, Lim JY, Park HS, Song W, Yoo HJ, Jang HC, Kim K, Park Y, Park YJ, Yang SJ, Lee HJ, Won CW. Protein Intake Recommendation for Korean Older Adults to Prevent Sarcopenia: Expert Consensus by the Korean Geriatric Society and the Korean Nutrition Society. Ann Geriatr Med Res 2018; 22:167-175. [PMID: 32743269 PMCID: PMC7387625 DOI: 10.4235/agmr.18.0046] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 12/10/2018] [Indexed: 12/24/2022] Open
Abstract
Sarcopenia, a common clinical syndrome in older adults, is defined as decreased muscle mass, strength, and physical performance. Since sarcopenia is associated with the incidence of functional decline, falls, and even mortality in older adults, researchers and health care providers have been keen to accumulate clinical evidence to advocate the screening and prevention of sarcopenia progression in older adults. The factors that may accelerate the loss of muscle mass and function include chronic diseases, inactivity, and deficiency in appropriate nutritional support. Among these, nutritional support is considered an initial step to delay the progression of muscle wasting and improve physical performance in community-dwelling older adults. However, a nationwide study suggested that most Korean older adults do not consume sufficient dietary protein to maintain their muscle mass. Furthermore, considering age-associated anabolic resistance to dietary protein, higher protein intake should be emphasized in older adults than in younger people. To develop a dietary protein recommendation for older adults in Korea, we reviewed the relevant literature, including interventional studies from Korea. From these, we recommend that older adults consume at least 1.2 g of protein per kg of body weight per day (g/kg/day) to delay the progression of muscle wasting. The amount we recommend (1.2 g/kg/day) is 31.4% higher than the previously suggested recommended daily allowance (i.e., 0.91 g/kg/day) for the general population of Korea. Also, evidence to date suggests that the combination of exercise and nutritional support may enhance the beneficial effects of protein intake in older adults in Korea. We found that the current studies are insufficient to build population-based guidelines for older adults, and we call for further researches in Korea.
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Affiliation(s)
- Hee-Won Jung
- Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Korea
| | - Sun-Wook Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Il-Young Kim
- Lee Gil Ya Cancer and Diabetes Institute, Gachon University School of Medicine, Incheon, Korea
| | - Jae-Young Lim
- Rehabilitation Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Seoul National University College of Medicine, Seoul, Korea
| | - Hyoung-Su Park
- Sarcopenia Research Center, Maeil Innovation Center, Maeil Dairies Co., Ltd., Pyeongtaek, Korea
| | - Wook Song
- Institute of Sport Science, Institute on Aging, Seoul National University, Seoul, Korea
| | - Hyung Joon Yoo
- Endocrine Division, Department of Internal Medicine, CM Hospital, Seoul, Korea
| | - Hak-Chul Jang
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Seoul National University College of Medicine, Seoul, Korea
| | - Kirang Kim
- Department of Food Science and Nutrition, Dankook University, Seoul, Korea
| | - Yongsoon Park
- Department of Food and Nutrition, Hanyang University, Seoul, Korea
| | - Yoon Jung Park
- Department of Nutritional Science and Food Management, Ewha Womans University, Seoul, Korea
| | - Soo Jin Yang
- Department of Food and Nutrition, Seoul Women’s University, Seoul, Korea
| | - Hae-Jeung Lee
- Department of Food and Nutrition, Gachon University, Seongnam, Korea
| | - Chang Won Won
- Department of Family Medicine, Kyung Hee University Medical Center, Seoul, Korea
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Jang IY, Kim HR, Lee E, Jung HW, Park H, Cheon SH, Lee YS, Park YR. Impact of a Wearable Device-Based Walking Programs in Rural Older Adults on Physical Activity and Health Outcomes: Cohort Study. JMIR Mhealth Uhealth 2018; 6:e11335. [PMID: 30463838 PMCID: PMC6282012 DOI: 10.2196/11335] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 08/01/2018] [Accepted: 08/01/2018] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Community-dwelling older adults living in rural areas are in a less favorable environment for health care compared with urban older adults. We believe that intermittent coaching through wearable devices can help optimize health care for older adults in medically limited environments. OBJECTIVE We aimed to evaluate whether a wearable device and mobile-based intermittent coaching or self-management could increase physical activity and health outcomes of small groups of older adults in rural areas. METHODS To address the above evaluation goal, we carried out the "Smart Walk" program, a health care model wherein a wearable device is used to promote self-exercise particularly among community-dwelling older adults managed by a community health center. We randomly selected older adults who had enrolled in a population-based, prospective cohort study of aging, the Aging Study of Pyeongchang Rural Area. The "Smart Walk" program was a 13-month program conducted from March 2017 to March 2018 and included 6 months of coaching, 1 month of rest, and 6 months of self-management. We evaluated differences in physical activity and health outcomes according to frailty status and conducted pre- and postanalyses of the Smart Walk program. We also performed intergroup analysis according to adherence of wearable devices. RESULTS We recruited 22 participants (11 robust and 11 prefrail older adults). The two groups were similar in most of the variables, except for age, frailty index, and Short Physical Performance Battery score associated with frailty criteria. After a 6-month coaching program, the prefrail group showed significant improvement in usual gait speed (mean 0.73 [SD 0.11] vs mean 0.96 [SD 0.27], P=.02), International Physical Activity Questionnaire scores in kcal (mean 2790.36 [SD 2224.62] vs mean 7589.72 [SD 4452.52], P=.01), and European Quality of Life-5 Dimensions score (mean 0.84 [SD 0.07] vs mean 0.90 [SD 0.07], P=.02), although no significant improvement was found in the robust group. The average total step count was significantly different and was approximately four times higher in the coaching period than in the self-management period (5,584,295.83 vs 1,289,084.66, P<.001). We found that participants in the "long-self" group who used the wearable device for the longest time showed increased body weight and body mass index by mean 0.65 (SD 1.317) and mean 0.097 (SD 0.513), respectively, compared with the other groups. CONCLUSIONS Our "Smart Walk" program improved physical fitness, anthropometric measurements, and geriatric assessment categories in a small group of older adults in rural areas with limited resources for monitoring. Further validation through various rural public health centers and in a large number of rural older adults is required.
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Affiliation(s)
- Il-Young Jang
- Division of Geriatric Medicine, Department of Internal Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Hae Reong Kim
- Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Eunju Lee
- Division of Geriatric Medicine, Department of Internal Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Hee-Won Jung
- Graduate School of Medical Science And Engineering, Korea Advanced Institute Of Science And Technology, Daejeon, Republic of Korea
| | - Hyelim Park
- Division of Geriatric Medicine, Department of Internal Medicine, Asan Medical Center, Seoul, Republic of Korea.,Pyeongchang Health Center & Country Hospital, Gangwon-do, Republic of Korea
| | - Seon-Hee Cheon
- Pyeongchang Health Center & Country Hospital, Gangwon-do, Republic of Korea
| | - Young Soo Lee
- Division of Geriatric Medicine, Department of Internal Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Yu Rang Park
- Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
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Jang IY, Jung HW, Park H, Lee CK, Yu SS, Lee YS, Lee E, Glynn RJ, Kim DH. A multicomponent frailty intervention for socioeconomically vulnerable older adults: a designed-delay study. Clin Interv Aging 2018; 13:1799-1814. [PMID: 30275687 PMCID: PMC6156114 DOI: 10.2147/cia.s177018] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Purpose The primary aim of this study was to evaluate the effectiveness of a 6-month multicomponent intervention on physical function in socioeconomically vulnerable older adults in rural communities. As secondary aims, we evaluated the effectiveness of the intervention on frailty and other geriatric syndromes, sustained benefit at 12 months, and baseline characteristics associated with poor response. Patients and methods This designed-delay study was conducted in 187 adults (mean age: 77 years; 75% women) who were living alone or on a low income in three rural regions of Korea. A 24-week multicomponent program that consisted of group exercise, nutritional supplementation, depression management, deprescribing medications, and home hazard reduction was implemented with a planned 6-month interval from August 2015 through January 2017. The primary outcome was physical function, measured using the Short Physical Performance Battery (SPPB) score (range: 0–12; minimum clinically important difference ≥1) at 6 months. Secondary outcomes included frailty phenotype, sarcopenia, Mini Nutritional Assessment-Short Form score (range: 0–14), Center for Epidemiologic Studies-Depression Scale score (range: 0–60), and falls. Results At 6 months, the SPPB score increased by 3.18 points (95% CI: 2.89, 3.48) from baseline. The program improved frailty (odds ratio: 0.06; 95% CI: 0.02, 0.16), sarcopenia (odds ratio: 0.32; 95% CI: 0.15, 0.68), Mini Nutritional Assessment-Short Form score by 1.67 points (95% CI: 1.28, 2.06), and Center for Epidemiologic Studies-Depression Scale score by −3.83 points (95% CI: −5.26, −2.39), except for fall (rate ratio: 0.99; 95% CI: 0.69, 1.43). These beneficial effects were sustained at 12 months. Body mass index ≥27 kg/m2 and instrumental activities of daily living disability at baseline were associated with poor improvement in the SPPB score. Conclusion This 24-week multicomponent program had sustained beneficial effects up to 1 year on physical function, frailty, sarcopenia, depressive symptoms, and nutritional status in socioeconomically vulnerable older adults in rural communities. (ClinicalTrials.gov, NCT 02554994)
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Affiliation(s)
- Il-Young Jang
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea, .,PyeongChang Health Center & County Hospital, Pyeongchang, Gangwon-Do, Republic of Korea
| | - Hee-Won Jung
- Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Republic of Korea
| | - Hyelim Park
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea, .,PyeongChang Health Center & County Hospital, Pyeongchang, Gangwon-Do, Republic of Korea
| | - Chang Ki Lee
- Goldman Urology Clinic, Seoul, Republic of Korea
| | - Sang Soo Yu
- PyeongChang Health Center & County Hospital, Pyeongchang, Gangwon-Do, Republic of Korea
| | - Young Soo Lee
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea,
| | - Eunju Lee
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea,
| | - Robert J Glynn
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.,Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Dae Hyun Kim
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.,Division of Gerontology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
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35
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Jang HC. How to Diagnose Sarcopenia in Korean Older Adults? Ann Geriatr Med Res 2018; 22:73-79. [PMID: 32743250 PMCID: PMC7387610 DOI: 10.4235/agmr.2018.22.2.73] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 06/11/2018] [Accepted: 06/12/2018] [Indexed: 02/06/2023] Open
Abstract
In 2017, Korea became an aged society, with the percentage of the population aged ≥65 years accounting for 14% of the total Korean population. The increasing number of older adults and the current health status of Korean older adults had led to increased medical expenditure and social problems. Sarcopenia, defined as the progressive decrease in skeletal muscle mass and strength, develops as a consequence of aging. Sarcopenia is also associated with a risk of adverse health outcomes such as frailty, physical disability, poor quality of life, and death. Thus, sarcopenia is a serious clinical problem among older adults. The International Classification of Diseases, Tenth Revision, Clinical Modification code for sarcopenia, M62.84, became available on October 1, 2016, in the United States. The diagnosis and treatment of sarcopenia urgently requires the establishment of an operational definition for sarcopenia in Korean older adults. In this article, I suggest a screening strategy and diagnostic criteria for sarcopenia in this population.
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Affiliation(s)
- Hak Chul Jang
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
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36
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Yang NP, Hsu NW, Lin CH, Chen HC, Tsao HM, Lo SS, Chou P. Relationship between muscle strength and fall episodes among the elderly: the Yilan study, Taiwan. BMC Geriatr 2018; 18:90. [PMID: 29653515 PMCID: PMC5899404 DOI: 10.1186/s12877-018-0779-2] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Accepted: 04/03/2018] [Indexed: 11/24/2022] Open
Abstract
Background Fall episodes are not unusual among community residents, especially the elderly, and lower muscle strength is an important issue to address in order to prevent falls. Methods A community health survey was conducted in a suburban area of Taiwan, and 1067 older adults were selected for enrollment in the present study. All the enrolled subjects had been visited at their homes; the subjects’ strength of both hands and muscle mass of both legs were measured and well-established questionnaires were finished by certificated paramedic staffs. Results The incidence of fall episodes in the previous 1 year in the Yilan elderly population was 15.1%, and the female predominance was significant. A significantly higher prevalence of cataracts was found in group who experienced a fall in the past year (64% vs. 54.9% in the non-fall group). Mild or more severe dementia was much more prevalent in the group who experienced a recent fall (33.8% vs. 25.7% in the non-fall group). The strength of both hands tested as the physical function was 17.6 ± 8.0 kg in the recent fall group, significantly weaker than that in the non-fall group (20.7 ± 8.7 kg). Multivariate regression analysis revealed a greater weekly exercise duration and greater strength of both hands reduced the occurrence of falls among the whole and the female population. The standardized effect sizes of hand grip strength between both groups, not trivial, were 0.29 and 0.37 for the total population and the female subpopulation respectively. Conclusions Less weekly exercise duration and weaker muscle strength were f ound to be independent risk factors of fall episode(s) in an elderly Taiwanese population, especially in the female sub-population. Muscle strength, measured by average of both hands grip strength, was the most significantly factor of one-year fall episode(s) accessed retrospectively.
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Affiliation(s)
- Nan-Ping Yang
- Community Medicine Research Center & Institute of Public Health, National Yang-Ming University, No.155, Sec.2, Linong Street, Taipei, 112, Taiwan, Republic of China. .,Department of Orthopedics & Surgery, Keelung Hospital, Ministry of Health & Welfare, Keelung, Taiwan.
| | - Nai-Wei Hsu
- Community Medicine Research Center & Institute of Public Health, National Yang-Ming University, No.155, Sec.2, Linong Street, Taipei, 112, Taiwan, Republic of China.,Department of Intern Medicines, National Yang-Ming University Hospital, Yilan, Taiwan
| | - Ching-Heng Lin
- Community Medicine Research Center & Institute of Public Health, National Yang-Ming University, No.155, Sec.2, Linong Street, Taipei, 112, Taiwan, Republic of China.,Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Hsi-Chung Chen
- Community Medicine Research Center & Institute of Public Health, National Yang-Ming University, No.155, Sec.2, Linong Street, Taipei, 112, Taiwan, Republic of China.,Department of Psychiatry & Center of Sleep Disorders, National Taiwan University Hospital, Taipei, Taiwan
| | - Hsuan-Ming Tsao
- Community Medicine Research Center & Institute of Public Health, National Yang-Ming University, No.155, Sec.2, Linong Street, Taipei, 112, Taiwan, Republic of China.,Department of Intern Medicines, National Yang-Ming University Hospital, Yilan, Taiwan
| | - Su-Shun Lo
- Community Medicine Research Center & Institute of Public Health, National Yang-Ming University, No.155, Sec.2, Linong Street, Taipei, 112, Taiwan, Republic of China.,Department of Surgery, National Yang-Ming University Hospital, Yilan, Taiwan
| | - Pesus Chou
- Community Medicine Research Center & Institute of Public Health, National Yang-Ming University, No.155, Sec.2, Linong Street, Taipei, 112, Taiwan, Republic of China.
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