Exercise and Nutrition Impact on Osteoporosis and Sarcopenia-The Incidence of Osteosarcopenia: A Narrative Review

Exploring the link between Di-2-ethylhexyl phthalate (DEHP) exposure and muscle mass: A systematic investigation utilizing NHANES data analysis, network toxicology and molecular docking approaches

Sarcopenia is a syndrome characterized by a progressive, widespread decline in muscle mass and strength. DEHP, a plasticizer involved in daily life and widely used, has been found in various everyday items and causes developmental dysregulation, reproductive impairments, tumorigenesis, and transgenerational disease. However, much remains to be discovered regarding the association between exposure to this environmental toxin and sarcopenia, as well as the toxic targets and molecular mechanisms. This research elucidated the relationship between contact with DEHP and the development of sarcopenia by integrating NHANES data analysis, network toxicology, and molecular docking. 3199 adults were enrolled, and multiple linear regressions were performed to reveal a significant negative correlation between lnDEHP and ALMBMI. Eighty-eight targets associated with DEHP and sarcopenia were identified. Subsequent STRING and Cytoscape screening stressed 20 key targets, including CASP3, BCL2, MMP9, BCL2L1, APP, and CTSS. GO and KEGG enrichment analyses revealed that these targets are involved in ligand-receptor interactions, apoptosis, and calcium signaling pathways. Molecular docking simulations using CB-dock confirmed the high-affinity binding interactions between DEHP and these key targets. This study validated the relationship between DEHP exposure and muscle mass. Further, it provided a theoretical basis for investigating the molecular mechanisms of DEHP exposure-induced skeletal muscle toxicity.

Mechanisms, assessment, and exercise interventions for skeletal muscle dysfunction post-chemotherapy in breast cancer: from inflammation factors to clinical practice

Chemotherapy remains a central component of breast cancer treatment, significantly improving patient survival rates. However, its toxic side effects, along with cancer-related paraneoplastic syndromes, can lead to the loss of skeletal muscle mass and function, impairing physical abilities and increasing the risk of complications during treatment. Chemotherapeutic agents directly impact skeletal muscle cells by promoting protein degradation, inhibiting protein synthesis, and triggering systemic inflammation, all of which contribute to muscle atrophy. Additionally, these drugs can interfere with the proliferation and differentiation of stem cells, such as satellite cells, disrupting muscle regeneration and repair while inducing abnormal differentiation of intermuscular tissue, thereby worsening muscle wasting. These effects not only reduce the effectiveness of chemotherapy but also negatively affect patients' quality of life and disease prognosis. Recent studies have emphasized the role of exercise as an effective non-pharmacological strategy for preventing muscle loss and preserving muscle mass in cancer patients. This review examines the clinical manifestations of muscle dysfunction following breast cancer chemotherapy, the potential mechanisms underlying these changes, and the evidence supporting exercise as a therapeutic approach for improving muscle function.

Impact of Hospitalization on Sarcopenia, NADPH-Oxidase 2, Oxidative Stress, and Low-Grade Endotoxemia in Elderly Patients

BACKGROUND

Hospitalization in older adults often worsens sarcopenia due to prolonged bed rest, poor nutrition, and inactivity. This study examined how hospitalization impacts muscle mass, focusing on oxidative stress and gut-derived endotoxemia.

METHODS

Thirty-one hospitalized older adults were compared with 31 outpatients. Ultrasound was used to measure the thickness of the rectus femoris (RF), intercostal, and diaphragmatic muscles at admission and discharge. Serum levels of LPS, zonulin, sNOX2-dp, and H2O2 were also assessed.

RESULTS

Hospitalized patients had higher serum levels of sNOX2-dp, H2O2, LPS, and zonulin than outpatients. In hospitalized patients, significant increases were observed at discharge compared to admission levels in sNOX2-dp (20.9 ± 6.5 to 23.8 ± 7.5 pg/mL; p = 0.004), H2O2 (24.4 ± 9.8 to 32.8 ± 14.5 µM; p = 0.01), LPS (30.4 ± 12.6 to 43.3 ± 16.35 pg/mL; p < 0.001), and zonulin (2.06 ± 1.23 to 2.95 ± 1.33 ng/mL; p < 0.001). Ultrasound data revealed a reduction in RF muscle thickness (-35%) (0.58 ± 0.29 to 0.38 ± 0.31 cm, p < 0.001), intercostal muscle thickness (-28%) (0.22 ± 0.08 to 0.16 ± 0.06 cm, p < 0.001), and diaphragmatic muscle thickness (-26%) (0.19 ± 0.06 to 0.14 ± 0.04 cm, p < 0.001) at discharge compared to admission. Additionally, muscle strength, measured using the hand-grip test, showed a 25% reduction. Regression analysis revealed correlations between RF muscle loss and increases in sNOX2-dp and H2O2, as well as between NOX2, H2O2, and LPS with zonulin.

CONCLUSIONS

Hospitalization in older adult patients elevates NOX2 blood levels, correlating with reduced muscle mass. Increased low-grade endotoxemia may trigger NOX2 activation, generating oxidative stress that accelerates muscle degeneration and can lead to sarcopenia.

A 7T MRI Study of Fibular Bone Thickness and Density: Impact of Age, Sex and Body Weight, and Correlation with Bone Marrow Expansion and Muscle Fat Infiltration

Background: Reduced bone mass and density, hallmark features of osteopenia and osteoporosis, significantly increase the risk of fractures, falls, and loss of mobility, especially in post-menopausal women and the elderly. Methods: This quantitative 7T MRI study examines the features of fibular bone thinning and bone mineral density loss (BMD) in 107 individuals (43F/64M) across various ages, body mass indices (BMIs), and ethnicities. Results: Women had significantly lower cross-sectional bone wall thickness (BT) and bone tissue area (BA), along with greater BMD loss compared to men in those over age 50 (n = 77), but not in the younger group (n = 30). The bone g-factor, defined as the ratio of inner-to-outer bone diameters, increased with bone thinning, bone marrow expansion (BME), and muscle fat infiltration (MFI) but was independent of subcutaneous fat thickness (SFT). Bone thinning and BMD loss both tend to increase with BME and MFI. Additionally, bone density decrease correlated with bone mass loss, with a stronger association observed with BT than BA. Conclusions: These findings offer insights into the effects of aging and sex on skeletomuscular health, with implications for strategies to mitigate bone loss in osteoporosis and osteosarcopenia.

Association between lipid ratios and sarcopenia and the mediating roles of inflammatory biomarkers in a cross-sectional study from NHANES 2011-2018

Sarcopenia, which leads to reduced quality of life and increased medical burden, is challenging to diagnose in a timely manner. Lipid metabolism plays a role in sarcopenia, and this study explored the associations between blood lipid profile parameters and sarcopenia. Using data from the National Health and Nutrition Examination Survey 2011-2018, we conducted weighted multivariate logistic regression to investigate the associations between lipid ratios and sarcopenia, including non-high-density lipoprotein cholesterol (non-HDL-C) to HDL-C, triglyceride (TG) to HDL-C, low-density lipoprotein cholesterol (LDL-C) to HDL-C, and remnant cholesterol (RC) to HDL-C ratios. We performed subgroup analyses to assess interactions with other covariates and used mediation models to evaluate the mediating roles of inflammatory biomarkers. We included a total of 9500 non-sarcopenic and 849 sarcopenic participants aged 18-59 years. While we observed modest correlations between individual lipid components and sarcopenia, we obtained significant positive associations for lipid ratios. Specifically, non-HDL/HDL-C (OR = 1.09; 95% CI 1.03-1.15; P = 0.003), TG/HDL-C (OR = 1.02; 95% CI 1.02-1.04; P = 0.014), LDL/HDL-C (OR = 1.27; 95% CI 1.11-1.45; P < 0.001), and RC/HDL-C ratios (OR = 1.55; 95% CI 1.16-2.07; P = 0.004) showed strong associations with sarcopenia. These associations were more pronounced in younger participants, those with lower family economic status, and those without self-reported diabetes. Furthermore, there were significant mediation effects of inflammatory biomarkers on the association between non-HDL/HDL-C, LDL/HDL-C, and RC/HDL-C and sarcopenia risk, with proportions ranging from 2.90 to 6.36%. In conclusion, our study demonstrated the positive associations between lipid ratios and sarcopenia in middle-aged adults, suggesting the potential of these lipid ratios for improving sarcopenia case identification. Further research is required to explore the underlying mechanisms.

A sarcopenia prediction model based on the calf maximum muscle circumference measured by ultrasound

BACKGROUND

The correlation between calf circumference（CC）and sarcopenia has been demonstrated, but the correlation between calf maximum muscle circumference (CMMC) measured by ultrasound and sarcopenia has not been reported. We aims to construct a predictive model for sarcopenia based on CMMC in hospitalized older patients.

METHODS

This was a retrospective controlled study of patients > 60 years of age hospitalized in the geriatric department of Hunan Provincial People's Hospital. The patients were thoroughly evaluated by questionnaires, laboratory, and ultrasound examinations, including measuring muscle thickness and calf muscle maximum circumference using ultrasound. Patients were categorized into sarcopenia and non-sarcopenia groups according to the consensus for diagnosis of sarcopenia recommended by the Asian Working Group on Sarcopenia 2019 (AWGS2). Independent predictors of sarcopenia were identified by univariate and multivariate logistic regression analyses, and a predictive model was developed and simplified. The prediction performance of the models was assessed using sensitivity, specificity, and area under the curve (AUC) and compared with independent predictors.

RESULTS

We found that patient age, albumin level (ALB), brachioradialis muscle thickness (BRMT), gastrocnemius lateral head muscle thickness (Glh MT), and calf maximum muscle circumference (CMMC) were independent predictors of sarcopenia in hospitalized older patients. The prediction model was established and simplified to Logistic P = -4.5 + 1.4 × age + 1.3 × ALB + 1.6 × BR MT + 3.7 × CMMC + 1.8 × Glh MT, and the best cut-off value of the model was 0.485. The sensitivity, specificity, and AUC of the model were 0.884 (0.807-0.962), 0.837 (0.762-0.911), and 0.927 (0.890-0.963), respectively. The kappa coefficient between this model and the diagnostic criteria recommended by AWGS2 was 0.709.

CONCLUSION

We constructed a sarcopenia prediction model with five variables: age, ALB level, BR MT, Glh MT, and CMMC. The model could quickly predict sarcopenia in older hospitalized patients.

A nomogram to predict sarcopenia in middle-aged and older women: a nationally representative survey in China

Background

Sarcopenia is a disease characterized by losing muscle mass, strength, and function with age. Studies have shown that sarcopenia is generally higher in women than in men. Therefore, this study used the 2015 China Health and Retirement Longitudinal Study (CHARLS) data to explore further the risk factors associated with sarcopenia in middle-aged and older Chinese women.

Methods

In this study, data from the 2015 CHARLS database were analyzed, comprising 7,805 eligible participants. Participants were categorized into either the sarcopenia group (n = 2,160) or the non-sarcopenia group (n = 5,645) based on the presence or absence of sarcopenia. Through the utilization of logistic regression analysis, multiple risk factors were identified. Additionally, the predictive value of these risk factors was assessed by applying receiver operating characteristic (ROC) curve analysis. Subsequently, a visual nomogram prediction model was developed by incorporating the identified risk factors into R4.1.2 software.

Results

Age, area, education, marriage, waist circumference, stroke, body pain, depression, and region may be closely related to Chinese women with sarcopenia. In addition, this study integrated these sarcopenia-related variables into a comprehensive index, and ROC analysis results showed that the AUC of the composite index was 0.738.

Conclusions

This study found that sarcopenia in Chinese women may be closely related to age, waist, education, marriage, area, stroke, physical pain, depression, and region. In addition, this study constructs a nomogram to help clinicians better screen potential female patients with sarcopenia.

Comparison of changes in skeletal muscle mass after stroke categorized by the severity of motor dysfunction: a retrospective study

[Purpose] To compare changes in skeletal muscle mass after stroke based on the severity of motor dysfunction. [Participants and Methods] This study included 17 patients who had experienced a stroke. Patients were classified into two groups based on lower limb Brunnstrom stages, i.e., those with stages III and IV (moderate motor dysfunction group; n=9), and those with stages V and VI (mild motor dysfunction group; n=8). Muscle mass was measured at the following time points: within 3 days of stroke onset; at 2 weeks ± 2 days after stroke onset; at 4 weeks ± 2 days after stroke onset; at 8 weeks ± 2 days after stroke onset, and muscle mass indices, i.e., the skeletal muscle mass index (SMI), paralyzed lower limb muscle mass, and non-paralyzed lower limb muscle mass were evaluated. Changes in these muscle mass indices between stroke onset and at 2, 4, and 8 weeks after stroke, i.e., ΔSMI, Δparalyzed lower limb muscle mass, and Δnon-paralyzed lower limb muscle mass, were calculated and the changes in each index over time were compared between the two groups. [Results] The analyses did not reveal any significant intergroup differences. [Conclusion] Even in cases of severe paralysis, appropriate nutritional and exercise therapies may help maintain the muscle mass.

Nutritional Habits in Crohn's Disease Onset and Management

Crohn's disease (CD)'s activation factors are still unclear. However, they are reported to involve an interaction between genetic susceptibility and unhealthy lifestyle factors like smoking, alcohol consumption, low physical activity, low BMI (<18.5 kg/m2), and probably unbalanced nutritional habits. Therefore, the aim of the present review is to demonstrate the possible effects of different nutritional habits, before the occurrence of the disease, as crucial factors for the inception of CD activation. The structure of the present narrative review was conducted following the instructions of the "Review Academy of Nutrition and Dietetics Checklist". It is well established that the consumption of specific foods and drinks, such as spicy and fatty foods, raw vegetables and fruits, dairy products, carbonated beverages, and coffee or tea, can provoke the exacerbation of CD symptoms. On the other hand, Mediterranean-oriented diets seem to provide an inverse association with the incidence of CD. Moreover, patients seem to have the knowledge to select foods that contribute to the remission of their symptoms. However, it is not clearly reported whether the onset of CD activation is due to lifelong unbalanced nutritional habits and their subsequent effect on gut microbiota secretion, which seems to be the gold standard for CD's investigation. Therefore, more future studies should record, examine, and compare the nutritional habits between patients with CD (immediately after the disease's diagnosis) and healthy populations in a lifelong manner, in order to reveal the possible influence of foods on CD onset.

The Dietary Inflammatory Index and Sarcopenia in Older Adults in Four Chinese Provinces: A Cross-Sectional Study

Background: Sarcopenia associated with aging severely affects the quality of life of the elderly; diets have been shown to elicit an inflammatory response in the body, and diets that promote inflammation may lead to damage to muscles. The Dietary Inflammatory Index (DII) has been developed to quantify the inflammatory potential of individual diets. Therefore, this study aimed to investigate the association between the DII, sarcopenia and its components in elderly Chinese people. Methods: In this study, data were obtained from the China Nutrition Improvement Strategies and Applications for the Elderly Research Programme. An assessment of sarcopenia was carried out according to the Asian Working Group on Sarcopenia's (AWGS2019) criteria. The DII was calculated using food intake data obtained using the FFQ method, and then the quartile method was used to categorize the subjects into four groups. Multifactor logistic regression was conducted to examine the associations between DII, sarcopenia and its components. Results: This study included 993 subjects over the age of 65, and the prevalence of sarcopenia was 20.2%. The mean DII score of the study population was 0.99 ± 0.1. After adjusting for the confounders age, gender, marital status, and educational level, the risk of sarcopenia was 1.66 times higher in group Q4 than in group Q1 (p-trend < 0.05). However, this relationship is not statistically significant when other more confounding factors are added. Nevertheless, when further analyzing the relationship between DII and sarcopenia components, it was found that after adjusting the model, a higher DII was associated with a risk of muscle strength loss (OR = 1.65, p-trend < 0.05). Conclusions: Higher DII scores increase the risk of muscle strength loss in older adults. By guiding older adults to adopt a more anti-inflammatory diet, muscle health can be improved in terms of increased muscle strength. Further cohort or interventional studies are necessary to validate our findings.

Effects of aquatic exercise compared with land-based exercise on the body composition and function of older adults with sarcopenia: protocol for a randomised controlled trial

INTRODUCTION

Sarcopenia is a condition that occurs more frequently in older adults. Although many types of exercise have been used in the treatment of sarcopenia, few studies have been conducted on different interventional environments for sarcopenia. The purpose of this study is to investigate the effects of aquatic exercise and land-based exercise on the body composition and function of participants with sarcopenia.

METHODS AND ANALYSIS

This randomised, controlled, single-blinded trial will enrol 45 participants (≥ 65 years) following the diagnostic criteria set by the Asian Working Group for Sarcopenia 2019. Participants will be randomised and assigned to one of three groups (aquatic exercise group, land-based exercise group and control group). Assessments will be conducted four times: initially (before intervention), after 8 weeks (intermediate), after 16 weeks (final) and 16 weeks after the end of intervention (follow-up). The primary outcomes are appendicular skeletal muscle index and handgrip strength, while the secondary outcomes include the Short Physical Performance Battery, 6-minute walk test and the Chinese version of the 36-item short-form of health-related quality of life.

ETHICS AND DISSEMINATION

Ethics approval was obtained from the Ethics Committee of Chengdu Sport University, with permission number CDSUEC2023-125. This study has been registered with the Chinese Clinical Trial Registry (ChiCTR2300077457). All participants will provide written informed consent.

TRIAL REGISTRATION NUMBER

Chinese Clinical Trial Registry ChiCTR2300077457.

Effects of population aging on quality of life and disease burden: a population-based study

BACKGROUND

As population aging intensifies, it becomes increasingly important to elucidate the casual relationship between aging and changes in population health. Therefore, our study proposed to develop a systematic attribution framework to comprehensively evaluate the health impacts of population aging.

METHODS

We used health-adjusted life expectancy (HALE) to measure quality of life and disability-adjusted life years (DALY) to quantify the burden of disease for the population of Guangzhou. The HALE and DALY projections were generated using both the Bayesian age-period-cohort models and the population prediction models. Changes in HALE and DALY between 2010-2020 and 2020-2030 were decomposed to isolate the effects of population aging. Three scenarios were analyzed  to examine the relative relationship between disease burden and population aging. In Scenarios 1 and 2, the disease burden rates in 2030 were assumed to  either remain at 2020 levels or follow historical trends. In Scenario 3, it was assumed that the absolute numbers of years of life lost (YLL) and years lived with disability (YLD) in 2030 would remain unchanged from the 2020 levels.

RESULTS

Between 2010 and 2020, 56.24% [69.73%] of the increase in male [female, values in brackets] HALE was attributable to the mortality effects in the population aged 60 and over, while - 3.74% [- 9.29%] was attributable to the disability effects. The increase in DALY caused by changes in age structure accounted for 72.01% [46.68%] of the total increase in DALY. From 2020 to 2030, 61.43% [69.05%] of the increase in HALE is projected to result from the mortality effects in the population aged 60 and over, while - 3.88% [4.73%] will be attributable to the disability effects. The increase in DALY due to changes in age structure is expected to account for 102.93% [100.99%] of the total increase in DALY. In Scenario 1, YLL are projected to increase by 45.0% [54.7%], and YLD by 31.8% [33.8%], compared to 2020. In Scenario 2, YLL in 2030 is expected to decrease by - 2.9% [- 1.3%], while YLD will increase by 12.7% [14.7%] compared to 2020. In Scenario 3, the expected YLL rates and YLD rates in 2030 would need to be reduced by 15.3% [15.4%] and 15.4% [15.6%], respectively, compared to 2020.

CONCLUSIONS

The disability effects among the elderly population hinder improvements in quality of life, while changes in age structure are the primary driver of disease burden accumulation. To mitigate the excess disease burden caused by population aging, it is essential to achieve a reduction of more than 15% in the disease burden by 2030 compared to 2020. Our proposed attribution framework evaluates the health impacts of population aging across two dimensions: quality of life and disease burden. This framework enables comparisons of these effects over time and across different regions.

Bone Adaptations to a Whole Body Vibration Protocol in Murine Models of Different Ages: A Preliminary Study on Structural Changes and Biomarker Evaluation

Background/Objectives: Whole body vibration (WBV) is a valuable tool to mitigate physiological adaptations related to age and inactivity. Although significant benefits have been found at the musculoskeletal level, including increased bone mass and reduced muscle atrophy, the underlying biological mechanisms remain largely unknown. Therefore, our study aimed to evaluate the effects of vibratory training on bone tissue in murine models of different age groups by investigating the structural and distribution changes in some crucial biomarkers involved in musculoskeletal homeostasis. Methods: Specifically, 4-, 12-, and 24-month-old mice were trained with a WBV protocol characterized by three series of 2 min and 30 s, interspersed with a recovery period of the same duration, on a 3-weekly frequency for 3 months. At the end of the training, histological and morphometric analyses were conducted, in association with immunohistochemical analysis to investigate changes in the distribution of fibronectin type III domain-containing protein 5 (FNDC5), NADPH oxidase 4 (NOX4), and sirtuin 1 (SIRT1). Results: Our preliminary results showed that WBV improves musculoskeletal health by preserving bone architecture and promoting up-regulation of FNDC5 and SIRT1 and down-regulation of NOX4. Conclusions: Our study confirms vibratory training as a viable alternative to counter musculoskeletal decline in elderly and/or sedentary subjects. Further investigations should be conducted to deepen knowledge in this field and explore the role of other molecular mediators in physiological adaptations to vibration.

Association between serum uric acid, hyperuricemia and low muscle mass in middle-aged and elderly adults: A national health and nutrition examination study

BACKGROUNDS

Recent research suggests that uric acid, as a metabolite with antioxidant properties, may affect muscle function and health. However, the association between serum uric acid (SUA) and low muscle mass remains relatively obscure. This study focuses on the association between SUA and low muscle mass in a middle-aged and elderly population in the United States.

METHODS

Utilizing data from the National Health and Nutrition Examination Survey (NHANES), a total of 12,106 patients aged ≥45 years, possessing complete analytical data, were incorporated. Low muscle mass in our study is defined as indices below 0.789 for males and 0.512 for females, according to the FNIH Biomarkers Consortium. Gender stratified analyses were conducted employing a multivariate weighted logistic regression model. When examining serum uric acid (SUA) levels, the SUA dataset was stratified into deciles, and odds ratios (ORs) were calculated across distinct subgroups of males and females. A restricted cubic spline (RCS) method was employed to investigate the potential nonlinear association between SUA levels and low muscle mass. A series of subgroup analyses stratified by demographic variables and clinical experience were conducted.

RESULTS

A total of 2,185 participants (18.05%) were identified with low muscle mass, comprising 1,121 males and 1,064 females. Females with low muscle mass had higher SUA levels and an increased incidence of hyperuricemia compared to those without low muscle mass. In females, a fully adjusted multivariable weighted regression model revealed a positive association between hyperuricemia and low muscle mass (OR, 1.43; 95% CI, 1.06 to 1.92; P = 0.021). No significant association was observed in males. Additionally, RCS curves indicated a J-shaped relationship between increasing SUA levels and the risk of low muscle mass in females, and an inverse J-shaped relationship in males.

CONCLUSIONS

This study reveals a significant positive correlation between hyperuricemia and the risk of low muscle mass in middle-aged and older women in the United States, whereas the relationship between SUA levels and low muscle mass did not attain statistical significance. In the male cohort, neither SUA levels nor hyperuricemia demonstrated a significant association with low muscle mass.

Association of triglyceride glucose-related obesity indices with sarcopenia among U.S. adults: a cross-sectional study from the National Health and Nutrition Examination Survey

The triglyceride glucose (TyG) index-related obesity indices have been proposed as reliable indicators of insulin resistance. This study aims to investigate the association between TyG index-related obesity indices and sarcopenia as well as their potential as a tool for screening sarcopenic patients. A cross-sectional study was conducted involving 7,161 participants aged 18 and above from the National Health and Nutrition Examination Survey. TyG index and TyG index-related obesity indices, including triglyceride glucose-body mass index (TyG-BMI), triglyceride glucose-waist circumference (TyG-WC), and triglyceride glucose-waist-to-height ratio (TyG-WHtR) were determined using standard formulas. The ratio of appendicular skeletal muscle mass to BMI were used to assess sarcopenia. The relationship between the TyG index as well as TyG index-related obesity indices and sarcopenia was investigated using restricted cubic spline analysis and multivariate logistic regression analysis. The diagnostic value of the TyG index and TyG index -related obesity indices for sarcopenia was compared using the receiver operating characteristic (ROC) curve. In the fully adjusted regression model, a positive correlation was observed between the TyG-WHtR index and sarcopenia (for each one-unit increase in TyG-WHtR index: OR = 3.57, 95% CI: 2.71-4.71, P < 0.001). Additionally, regression analyses demonstrated TyG-WHtR as a significant predictor of sarcopenia with the highest odds ratio, reaching 12.50 (95% CI: 6.13-25.70, P < 0.001) for the upper fourth quartile (Q4) compared to the first quartile, followed by followed by TyG-BMI (Q4: 3.34; 95% CI: 1.92-5.80, P < 0.001) and TyG-WC (Q4: 1.95; 95% CI: 1.04-3.68, P < 0.001). The RCS curve fitting analysis indicated a U-shaped relationship between TyG-WHtR and the diagnosis of sarcopenia, with an inflection point at 4.02. Furthermore, in the ROC analysis, the AUC for the diagnosis of sarcopenia was largest for TyG-WHtR (0.79, P < 0.001). The TyG ndex-related obesity indices, especially TyG-WHtR, have been shown to be more effective in identifying sarcopenia patients than TyG alone.

Predicting Osteoporosis in Elderly Cancer Patients Using the Modified Glasgow Prognostic Index

IntroductionOsteoporosis increases fracture risk and mortality, and cancer treatments worsen bone loss. Although mGPS is a common inflammatory-nutritional marker in oncology, its role in predicting osteoporosis is unknown.MethodsThis cross-sectional retrospective study analyzed 93 cancer patients aged ≥50 who underwent dual-energy X-ray absorptiometry (DXA) scans within a year of the first chemotherapy allocation. The results were categorized into groups regarding T-score as normal (T ≥ -1.0), osteopenia (-2.5 < T < -1.0), and osteoporosis (T ≤ -2). Patients were categorized based on mGPS and body mass index (BMI), and regression analysis was performed to identify predictors of osteoporosis in the lumbar spine, femur neck, and total femur.ResultsAmong the patients, 61.3% were female, the median age was 61 years, 41.9% had osteoporosis in the lumbar spine, and 49.5% had osteopenia in the femoral neck. A significant association was observed between BMI and osteoporosis, with higher BMI linked to lower osteoporosis prevalence, particularly in the femur regions (P < .03). There were no significant associations between bone density in the lumbar spine/femoral neck/total femur and age, gender, disease stage, type of chemotherapy, or BMI (all P values >.05). A significant association between mGPS and bone density was observed in the lumbar spine (P = .001) and femur total (P < .001). In the lumbar spine, patients with an mGPS score of 0 had the highest proportion of normal bone density (71.4%), while those with an mGPS score of 2 had a higher prevalence of osteoporosis (55.6%) (P = .001). In the femur total, 46.7% of patients with an mGPS score of 2 were classified with osteoporosis, compared to only 8.5% of those with an mGPS score of 0 (P < 001). Patients with an mGPS score of 2 were over six times more likely to have osteoporosis in the lumbar spine (OR = 6.25,P = 0.027). In the femur total, an mGPS score of 2 also significantly predicted osteoporosis (OR = 5.472, P = .013).ConclusionmGPS is a cost-effective and reliable tool for predicting osteoporosis in elderly cancer patients, enabling early interventions. Integrating it into routine assessments could enhance patient outcomes by addressing osteoporosis risk.

Host-specific effects of Eubacterium species on Rg3-mediated modulation of osteosarcopenia in a genetically diverse mouse population

BACKGROUND

Osteosarcopenia, characterized by the simultaneous loss of bone and muscle mass, is a serious health problem in the aging population. This study investigated the interplay between host genetics, gut microbiota, and musculoskeletal health in a mouse model of osteosarcopenia, exploring the therapeutic potential of gut microbiota modulation.

METHODS

We examined the effects of Rg3, a phytochemical, on osteosarcopenia and its interactions with host genetics and gut microbiota in six founder strains of the Collaborative Cross (CC) population. Subsequently, we evaluated the therapeutic potential of Eubacterium nodatum (EN) and Eubacterium ventriosum (EV), two gut microbes identified as significant correlates of Rg3-mediated osteosarcopenia improvement, in selected C57BL/6 J (B6) and 129S1/SvImJ (129S1) mouse strains.

RESULTS

Rg3 treatment altered gut microbiota composition aligned with osteosarcopenia phenotypes, which response varied depending on host genetics. This finding enabled the identification of two microbes in the Eubacterium genus, potential mediator of Rg3 effect on osteosarcopenia. Oral administration of EN and EV differentially impacted bone density, muscle mass, exercise performance, and related gene expression in a mouse strain-specific manner. In 129S1 mice, EN and EV significantly improved these parameters, effectively reversing osteosarcopenic phenotypes. Mechanistic investigations revealed that these effects were mediated through the modulation of osteoblast differentiation and protein degradation pathways. In contrast, EN and EV did not significantly improve osteosarcopenic phenotypes in B6 mice, although they did modulate mitochondrial biogenesis and microbial diversity.

CONCLUSIONS

Our findings underscore the complex interplay between host genetics and the gut microbiota in osteosarcopenia and emphasize the need for personalized treatment strategies. EN and EV exhibit strain-specific therapeutic effects, suggesting that tailoring microbial interventions to individual genetic backgrounds may be crucial for optimizing treatment outcomes. Video Abstract.

Exercise with weight vest plus chicken protein supplementation delayed muscle and bone loss in older female adults

PURPOSE

This study examined the effects of moderate-to-heavy exercise training combined with weighted vest and chicken protein supplementation in older adult females.

METHODS

Fifty-two female participants, 60-79 yearsold, were randomly divided into three groups: control (non-exercise) (CON), exercise with weighted vest (WV), and exercise with weighted vest and protein supplementation (3 g of protein daily; WVP).A ll participants performed brisk walking and strengthening exercises for 50 min/day, three times/week, for 8 weeks. Muscle mass, bone mineral content, T-score, and physical performance were measured.

RESULTS

The WVP group demonstrated a substantial increase in thoracic spine bone mineral content (8.4 ± 7.7 g, p = 0.001), and total body lean mass (0.2 ± 1.0 kg) compared with that in the other two groups. The CON and WV groups showed a decrease in thoracic spine bone mineral content (CON= -1.8 ± 1.8, WV= -3.9 ± 0.1 g) and total body lean mass (CON= -0.7 ± 0.9, WV= -0.8 ± 0.9 kg) compared with those in the WVP group. The WVP and WV groups had increased T-score (WVP= 0.01 ± 0.16, WV= 0.02 ± 0.18) when compared with that of the CON group (-0.19 ± 0.12). Both the WV and WVP groups displayed improved physical performance compared with that of the CON group.

CONCLUSION

Combined exercise with either a weighted vest or protein supplementation proved to be effective in protecting against trunk bone and muscle mass loss, and improving physical fitness in older female adults.

Trends and hotspots in research on osteoporosis and nutrition from 2004 to 2024: a bibliometric analysis

BACKGROUND

The intricate association between nutrition and osteoporosis has garnered increasing attention, and approximately 3000 articles have been published in the past 20 years. However, there are currently very few comprehensive reviews on the development of this field. It is very necessary to retrospectively analyze the related articles and summarize the research hotspots, depth, and directions.

OBJECTIVES

This study aimed to quantitatively analyze, visually review and comment on the articles published in the field of osteoporosis and nutrition based on the bibliometric methods, providing new insights for future research.

METHODS

The related articles published from 2004 to 2024 were retrieved from the Web of Science Core Collection (WOSCC). CiteSpace 6.1R2 software was used to conduct collaborative network analysis of annual publication volume, author patterns, country/region contributions, institutional affiliations, journal publications, highly cited literature, and keyword clustering.

RESULTS

A total of 2138 articles were assessed, revealing a consistent upward trend in published works in this domain, with the majority originating from the United States (564 papers). Seoul National University was identified as the most prolific institution (56 papers). Geng Bin was the most prolific author. Research hotspots included bone density, postmenopausal women, vitamin D, hip fractures, etc. Research subjects included physical activity, sarcopenia, calcium intake, machine learning, etc. Recent research trends indicate that cross-sectional study was more and the quality of life, muscle, and zinc are receiving attention in studies.

CONCLUSIONS

Future research should continue to explore better methods for measuring bone density, investigating indicators for predicting fracture risk, exploring the relationship between various nutrients and substances with osteoporosis at a deeper level, and bolstering management strategies for male osteoporosis. Researchers should conduct longitudinal or interventional studies, and further improving the overall quality of life of patients with osteoporosis.

The ZJU index is associated with the risk of sarcopenia in American adults aged 20-59: a cross-sectional study

BACKGROUND

The ZJU index is an innovative computational method which integrates BMI, FBG, TG, and ALT to AST ratio. It strongly correlates with measures of lipid metabolism and glucose intolerance. No researches have yet explored the relationship between the ZJU index and sarcopenia.

METHODS

We analyzed NHANES data from 2011 to 2018, dividing the ZJU index into quartiles. The association was investigated by adjusting for confounders using multivariable linear and logistic regression analysis. Results were visualized through RCS regression and threshold effect analyses. We conducted various subgroup and sensitivity analyses and plotted ROC curves to assess prediction efficacy, with the AUC as the measure of accuracy.

RESULTS

As the ZJU index increases, the prevalence of sarcopenia also rises. Following the control of potential confounders via logistic regression analysis, our research identified a distinct relationship between the ZJU index and sarcopenia, which was statistically significant (P < 0.001), with higher ZJU index values associated with increased risk (OR = 12.40, 95% CI: 8.46-18.17). Interaction analysis suggests that the relationship between the ZJU index and the risk of developing sarcopenia varies significantly between males and females across different ZJU index levels. ROC analysis for the ZJU index shows an AUC of 0.749.

CONCLUSIONS

The ZJU index significantly correlates with a heightened risk of sarcopenia in Americans, suggesting its potential as a predictive marker for sarcopenia.

Low geriatric nutritional risk index is associated with osteosarcopenia in older patients with type 2 diabetes mellitus

BACKGROUND

The association between the geriatric nutritional risk index (GNRI) and osteosarcopenia in older adults with type 2 diabetes mellitus (T2DM) is not clear.

METHODS

A total of 573 individuals with T2DM were included in this cross-sectional study. Osteosarcopenia was defined as the presence of both osteoporosis and sarcopenia. Appendicular skeletal muscle mass and bone mineral density (BMD) was measured by dual energy X-ray absorptiometry to diagnose sarcopenia and osteoporosis. Multivariate analyses were used to assess the association between Geriatric Nutritional Risk Index (GNRI) and osteosarcopenia.

RESULTS

The patients were divided into four groups: robust (n = 367), osteoporosis alone (n = 154), sarcopenia alone (n = 29), and osteosarcopenia (n = 23). The GNRI was the lowest in osteosarcopenia group and was positively correlated with skeletal muscle index (SMI) (r = 0.122, p = 0.004), grip strength (r = 0.154, p < 0.001), gait speed (r = 0.123, p = 0.004), and BMD of lumbar spine 2-4, femoral neck, and total hip (r = 0.137, p = 0.002; r = 0.096, p = 0.028; r = 0.086, p = 0.049, respectively). In the logistic regression model low GNRI was significantly associated with an increased risk of osteosarcopenia (adjusted OR, 4.164; 95% CI, 1.283-13.514, p = 0.018). Age provided a discriminatory effect of osteosarcopenia with an area under the curve (AUC) of 0.764. When GNRI values were added to the model, the value of the ROC curve was further improved, with an AUC of 0.842.

CONCLUSION

Low GNRI was associated with an increased risk of osteosarcopenia in older adults with T2DM. Comprehensive clinical evaluation of nutritional status by a simple tool such as GNRI might be helpful for early identification of those at high risk for osteosarcopenia in older diabetic individuals.

Association between advanced lung cancer inflammation index and osteoporosis in patients with type 2 diabetes mellitus: evidence from NHANES

Background

Previous studies have shown a significantly increased prevalence of osteoporosis (OP) in patients with type 2 diabetes mellitus (T2DM), which is closely associated with inflammation and nutrition. This study aimed to investigate the relationship between the advanced lung cancer inflammation index (ALI) and OP in patients with T2DM.

Methods

This cross-sectional analysis was conducted based on data from middle-aged and older adults aged 50 years and older with T2DM from the National Health and Nutrition Examination Survey (NHANES).Weighted multivariable logistic regression and linear regression were utilized to investigate the correlation between the ALI and OP with femur bone mineral density (BMD) in individuals with T2DM. Restricted cubic splines (RCS) were employed to assess potential nonlinear relationships, and receiver operating characteristic (ROC) curves were used to evaluate diagnostic accuracy.

Results

A total of 1596 patients with T2DM were included in this study, among whom 736 had OP. After adjusting for covariates, the multivariable logistic regression model showed that compared to participants in the fourth quartile of log2-transformed ALI, those in the first quartile had an increased prevalence of OP in T2DM (OR = 1.95, 95% CI=1.28-2.96, p < 0.01). The multivariable linear regression model indicated that a low log2-transformed ALI is associated with a low femur BMD.RCS demonstrated a linear dose-response relationship between the ALI index and OP in T2DM (p = 0.686), with the area under the ROC curve being 0.57 (95% CI: 0.54-0.60, p < 0.001), and the optimal cutoff value was 6.04.

Conclusion

Our findings indicate that low levels of ALI are independently associated with an increased prevalence of OP in middle-aged and older adults with T2DM in the United States. ALI may serve as a potential biomarker for assessing the prevalence of OP in middle-aged and older adults with T2DM.

Insufficient Muscle Development Level Associated with Serum Zinc, Manganese and Cobalt Levels in Children Aged 6 to 9 Years in Shenzhen, China

Some trace elements have been found to be associated with muscle mass and muscle function; however, evidence in children is limited, and it remains unclear which trace elements are more relevant. We aimed to explore the association of levels of individual and combined essential trace elements and muscle development level (MDL) in young children. Muscle mass was measured by body composition analysis, and trace elements were determined by using inductively coupled plasma mass spectrometry (ICP-MS). Logistic regression, restricted cubic spline (RCS) and weighted quantile sum regression (WQS) were used to assess the individual and joint associations between trace element levels and MDL. We enrolled 2851 children: 1595 boys (55.9%) and mean age 7.1 years (range 6.8-7.3). The proportion of insufficient muscle mass in the whole body, limbs, upper and lower limbs was 1.9%, 6.5%, 44.9% and 4.6%, respectively. The odds of insufficient MDL decreased with the fourth versus first quartile of zinc (OR = 0.67, 95% CI: 0.51-0.89), manganese (OR = 0.80, 95% CI: 0.65-1.00), and cobalt (OR = 0.89, 95% CI: 0.81-0.99) and was increased with the fourth quartile of nickel (OR = 2.23, 95% CI: 1.72-2.89) and selenium (OR = 1.51, 95% CI: 1.14-1.98). The RCS yielded similar results, except for the discrepancy in high cobalt levels. The odds of insufficient MDL decreased with the combination of nine trace elements (OR = 0.84, 95% CI: 0.73-0.97), primarily zinc (weight = 0.297), manganese (weight = 0.198) and cobalt (weight = 0.173). Insufficient MDL in young children was mainly in upper limbs. Low levels of zinc, manganese, and cobalt, individually or combined, were significantly associated with risk of insufficient MDL. Further foods rich in zinc, manganese, and cobalt should be suggested to supplement in diet, and increase exercise of upper limbs to improve insufficient MDL in the young children should be needed.

The effect of resistance training on patients with secondary sarcopenia: a systematic review and meta-analysis

To analyse the effectiveness of resistance training on secondary sarcopenia, we conducted a meta-analysis to elucidate the effects of resistance training (RT) on muscle strength (handgrip strength [HGS]), muscle mass (Skeletal muscle mass index [SMI]), and physical function (Gait speed [GS]) in patients with secondary sarcopenia. All studies published between 2015 and January 2024 on the effects of resistance training on patients with secondary sarcopenia were retrieved from 6 electronic databases: PubMed, Web of Science Core Collection, Embase, the Cochrane Library, the China National Knowledge Infrastructure (CNKI) Core journals and the Wanfang Database. Two researchers independently extracted and evaluated studies that met the inclusion and exclusion criteria. Finally, 12 randomized controlled trials were included. Pooled analyses of baseline data and results were performed using Review Manager 5.3 with standardized mean variance (SMD) and random effects model. The study included 12 randomized controlled trials involving 639 patients (mean age 57.28 ± 2.66 to 79.6 ± 5.4 years). There are five types of complications among the patients: obesity, type 2 diabetes, Alzheimer's disease, hemodiaysis, and pancreatic cancer. Compared with the control group, RT effectively improved HGS [SMD = 2.47, 95% CI (1.50, 3.43), p < 0.01, I2 = 94%]; SMI [SMD = 0.94, 95% CI (0.52, 1.36), p < 0.01, I2 = 56%]; and GS [SMD = 2.18, 95% CI (-0.01, 4.37), p ≥ 0.05, I2 = 97%]. Further subgroup analysis of the results showed that the intervention effect on grip strength was greater for non-elastic band resistance [SMD = 2.40, 95% CI (1.05, 3.75), p < 0.01, I2 = 94%] than for elastic band resistance (EBRT) [SMD = 1.22, 95% CI (-0.14, 2.58), p < 0.01, I2 = 95%]. The intervention effect of RT on grip strength is more significant in patients with T2D [SMD = 0.59, 95%CI (0.26-0.93, p < 0.01, I2 = 27%] and obesity [SMD = 0.74, 95%CI (0.32-1.15, p < 0.01, I2 = 0%]. For patients with secondary sarcopenia, Resistance training (RT) can effectively enhance muscle strength and muscle mass; however, it does not significantly improve physical function. Different RT intervention methods have different effects on patients, such as elastic band training and non-elastic band training (bounce ball RT; equipment RT, etc.). Different types of complications may influence the effectiveness of RT intervention.

CT parameters of psoas muscle predicts 28-day mortality in older patients with sepsis: a retrospective study

ODJECTIVES

To investigate the predictive value of computed tomography (CT)-based transverse diameter (TD) and longitudinal diameter (LD) of the psoas muscle at the level of third lumbar vertebra for 28-day mortality in older patients with sepsis.

METHODS

This retrospective single-center cohort study included 115 septic patients aged over 65 years old who were admitted to ICU in Beijing-Chaoyang Hospital between July 2017 and July 2022. The TD and LD of psoas muscle were obtained by measurement on abdominal CT images. Logistic regression analysis was conducted to identify the prognostic factors for 28-day mortality in older patients with sepsis, and their predictive performances were evaluated using the receiver operating characteristic (ROC) curve.

RESULTS

Multivariable logistic analysis indicated that TD (OR: 0.405, 95% CI: 0.190-0.864) was a protective factor for 28-day mortality in older patients with sepsis, whereas LD was not. The areas under the curve (AUCs) of TD, APACHE II, and SOFA were 0.666 (95% CI: 0.565-0.767), 0.660 (95% CI: 0.561-0.760), and 0.679 (95% CI: 0.581-0.777), respectively. Furthermore, the AUCs for the combination of TD with APACHE II or SOFA were 0.766 (95% CI: 0.679-0.853, P < 0.001) and 0.765 (95% CI: 0.679-0.852, P < 0.001).

CONCLUSIONS

TD of psoas muscle was a predictor for 28-day mortality in older patients with sepsis. The combination of TD with APACHE II or SOFA scores enhances the early identification of patients at high risk for poor prognosis.

CLINICAL TRIAL NUMBER

not applicable.

Dietary recommendations of the Moroccan Society of Rheumatology (SMR) for patients with ostéosarcopenia

OBJECTIVE

The objective of this study was to develop the first Moroccan recommendations concerning nutrition in patients with osteosarcopenia.

MATERIAL AND METHODS

A steering committee consisting of rheumatologists and nutritionists drafted the initial version of the recommendations in light of the literature review and the recommendations of international societies. The draft was reviewed by a reading committee of 13 experts to approve the final version.

RESULTS

Four overarching principles and ten recommendations were established. The overarching principles emphasize that nutritional advice is not a substitute for the pharmacological treatment of osteosarcopenia. Instead, it should be based on scientific evidence and take into account the specific characteristics of Moroccan society. The recommendations emphasize the significance of adequate calcium and vitamin D intake while evaluating the benefit-risk ratio in instances where calcium supplementation is indicated. A balanced intake of trace elements, vitamins, proteins, and dairy products should be maintained. The Mediterranean diet is recommended, while vegetarian diets and restrictive diets in individuals who are not overweight are not advised. It is recommended that individuals who fast during Ramadan consume a varied and balanced diet. It is recommended that the consumption of soft drinks and alcohol be limited. The consumption of phytoestrogens from food in moderation is considered beneficial as part of a balanced diet. Nevertheless, the use of supplements is not advised.

CONCLUSION

The purpose of this work is to provide Moroccan rheumatologists with a practical tool to improve the nutritional aspect in patients with osteosarcopenia.

Association between possible sarcopenia, all-cause mortality, and adverse health outcomes in community-dwelling older adults in China

The relationship between possible sarcopenia and mortality remains ambiguous within Asian populations. To clarify this, we investigated the association in older adults residing in Chinese communities. Utilizing data from the China Health and Retirement Longitudinal Study, this population-based cohort study included individuals aged ≥ 60 years, followed from 2011 to 2012 through 2020. Possible sarcopenia was defined in accordance with the Asian Working Group on Sarcopenia 2019 criteria, and Cox proportional hazards regression was used to analyze its impact on mortality, while exploratory analyses were conducted to investigate the associations of possible sarcopenia with chronic diseases, functional independence, and hospitalization frequency. The study encompassed 5,160 participants (median age: 66 years), nearly half of whom (48.8%) were identified with possible sarcopenia. Over a 9-year follow-up period, there were 1216 recorded deaths. Analysis indicated that individuals with possible sarcopenia faced a significantly elevated mortality risk compared to their counterparts (HR: 1.79, 95% CI: 1.58-2.03; P < 0.001). Further, subgroup analyses confirmed a strong association between possible sarcopenia and all-cause mortality across various subgroups, including those related to sex, obesity status, and living environment. Additionally, exploratory analyses revealed that possible sarcopenia was significantly associated with an increased likelihood of heart disease (OR = 1.18, 95% CI: 1.03-1.34, P = 0.014) and stroke (OR = 1.41, 95% CI: 1.19-1.68, P < 0.001), as well as reduced functional independence (β = -0.17, 95% CI: -0.24--0.10, P < 0.001). Possible sarcopenia was also associated with a higher frequency of hospitalizations at baseline (Exp(β) = 1.50, 95% CI: 1.25-1.81, P < 0.001), although this association was no longer significant during the follow-up period. In conclusion, in Chinese community-dwelling older adults, possible sarcopenia was associated with an increased risk of all-cause mortality, several chronic diseases, and functional dependence. Thus, alleviating or preventing possible sarcopenia may improve health outcomes and extend the lifespan of these individuals.

Comparison of the utility of SARC-F, SARC-CalF, and calf circumference as screening tools for sarcopenia in patients with osteoporosis

AIM

Patients with osteoporosis who also have sarcopenia are at a high risk for falls and fractures. Early detection of sarcopenia is crucial for these patients. This study aimed to compare the effectiveness of SARC-F, SARC-CalF, and calf circumference (CC) as screening tools for sarcopenia in patients with osteoporosis.

METHODS

This cross-sectional study was retrospectively conducted on patients who attended the outpatient clinic for Osteoporosis and Sarcopenia at Kyoto Medical Center. Sarcopenia was determined based on low skeletal muscle mass and weak handgrip strength. Sensitivity and specificity analyses were conducted on SARC-F, SARC-CalF, and CC. The diagnostic utility of these three tools was compared using the receiver-operating characteristic (ROC) curves and the area under the ROC curves (AUC).

RESULTS

A total of 225 patients (men/women: 33/192) with a median age of 69.0 years (interquartile range: 61.0‒75.0) were enrolled. The prevalence of sarcopenia was found to be 11.6%. CC had the highest sensitivity (80.8%), while SARC-F had the highest specificity (93.0%) for detecting sarcopenia. ROC analysis revealed that all three tools had significant potential for sarcopenia diagnosis, with SARC-CalF having the highest AUC compared to SARC-F and CC (0.753 vs. 0.619 and 0.700). A multivariate logistic regression, incorporating other confounders as explanatory variables, revealed that SARC-CalF was independently related to sarcopenia (odds ratio: 14.80, 95% confidence interval: 3.83-57.30, p < 0.001).

CONCLUSION

In patients with osteoporosis, SARC-CalF is more effective in the early detection of sarcopenia than SARC-F and CC.

Nutraceuticals in osteoporosis prevention

Nutraceuticals are gaining popularity as they can contribute to bone health by delaying the onset or slowing down the progression of pathological bone loss. Osteoporosis's bone loss is a concern for older adults and a crucial aspect of aging. Maintaining healthy bones is the key to living a full and active life. Our review explores the current knowledge on the role of nutraceuticals in preventing osteoporosis by focusing on three main aspects. First, we provide an overview of osteoporosis. Second, we discuss the latest findings on natural nutraceuticals and their efficacy in reducing bone loss, emphasizing clinical trials. Third, we conduct a structured analysis to evaluate nutraceuticals' pros and cons and identify translational gaps. In conclusion, we must address several challenges to consolidate our knowledge, better support clinicians in their prescriptions, and provide people with more reliable nutritional recommendations to help them lead healthier lives.

Sarcopenic obesity and osteoporosis: Research progress and hot spots

Sarcopenic obesity (SO) and osteoporosis (OP) are associated with aging and obesity. The pathogenesis of SO is complex, including glucolipid and skeletal muscle metabolic disorders caused by inflammation, insulin resistance, and other factors. Growing evidence links muscle damage to bone loss. Muscle-lipid metabolism disorders of SO disrupt the balance between bone formation and bone resorption, increasing the risk of OP. Conversely, bones also play a role in fat and muscle metabolism. In the context of aging and obesity, the comprehensive review focuses on the effects of mechanical stimulation, mesenchymal stem cells (MSCs), chronic inflammation, myokines, and adipokines on musculoskeletal, at the same time, the impact of osteokines on muscle-lipid metabolism were also analyzed. So far, exercise combined with diet therapy is the most effective strategy for increasing musculoskeletal mass. A holistic treatment of musculoskeletal diseases is still in the preliminary exploration stage. Therefore, this article aims to improve the understanding of musculoskeletal -fat interactions in SO and OP, explores targets that can provide holistic treatment for SO combined with OP, and discusses current limitations and challenges. We hope to provide relevant ideas for developing specific therapies and improving disease prognosis in the future.

Gui Qi Zhuang Jin Decoction ameliorates mitochondrial dysfunction in sarcopenia mice via AMPK/PGC-1α/Nrf2 axis revealed by a metabolomics approach

OBJECTIVE

Sarcopenia, as a condition of muscle mass loss and functional decline typically diagnosed in elderly individuals, severely affects human physical activity, metabolic homeostasis, and quality of life. Gui Qi Zhuang Jin Decoction (GQZJD), an approved hospital-based prescription with years of clinical application, has been demonstrated to have a notable therapeutic effect on sarcopenia. However, its potential mechanism of action in the treatment of sarcopenia remains uncertain.

METHODS

Ultra-performance liquid chromatography paired with Q Exactive™ HF-X mass spectrometry (UPLC-QE-MS) was used to identify the ingredients of GQZJD. Subsequently, GQZJD observed the basic growth and muscles of the sarcopenia mouse, while the behavioral indicators were also tested. Muscle histopathology and serum oxidative stress biochemicals were also detected, and mitochondrial function and energy metabolism-related indicators in the gastrocnemius muscle were examined. Then, a metabolomics strategy was applied to predict possible pathways involving mitochondria by which GQZJD could improve sarcopenia. Finally, quantitative real-time polymerase chain reaction and western blot analyses were carried out to validate the effects of GQZJD on sarcopenia-induced mitochondrial dysfunction, together with uncovering the associated mechanisms.

RESULTS

Twenty-seven ingredients absorbed into the blood (IAIBs) of GQZJD were identified using UPLC-QE-MS, which were regarded as the main active ingredients behind its sarcopenia treatment effects. GQZJD administration increased the body weight, gastrocnemius muscle mass, and autonomic activity, mitigated muscle tissue morphology and pathology; and alleviated the oxidative stress levels in sarcopenia mice. Treatment with GQZJD also decreased the mitochondrial reactive oxygen species level and serum lipid peroxide Malonaldehyde concentration. and increased the mitochondrial membrane potential, adenosine triphosphate level, 8‑hydroxy-2-deoxyguanosine content, mitochondrial DNA copy number, and the mitochondrial fission factor dynamin-related protein 1. Non-targeted metabolomics suggested that the sarcopenia therapeutic effect of GQZJD on sarcopenia may occur through the glycerophospholipid metabolism, choline metabolism in cancer, phenylalanine metabolism and tyrosine metabolism pathways, implying an association with AMP-activated protein kinase (AMPK) and related signals. Further, the molecular docking results hinted that AMPK performed well in terms of binding energy with the 27 IAIBs of GQZJD (average binding energy, -7.5 kcal/mol). Finally, we determined that GQZJD significantly activated the key targets of the AMPK/peroxisome proliferator-activated receptor γ coactivator-1α (PGC-1α)/nuclear factor erythroid 2-related factor 2 (Nrf2) axis..

CONCLUSIONS

Our results demonstrated that GQZJD ameliorated d-galactose-induced sarcopenia by promoting the animal behaviours, facilitating mitochondrial function and restoring mitochondrial energy metabolism. with its effects mediated by the AMPK/PGC-1α/Nrf2 axis. Over all, GQZJD represents a promising therapeutic candidate that ameliorated sarcopenia in aging mice.

Exploring the impact of protein intake on the association between oxidative balance score and lean mass in adults aged 20-59: NHANES 2011-2018

BACKGROUND

Previous studies have established a correlation between the pathogenesis of oxidative stress and sarcopenia. The Oxidative Balance Score (OBS) is an integrated measure that reflects the overall balance of antioxidants and pro-oxidants in dietary components and lifestyle. However, there are limited reports on the association between OBS and lean mass and the impact of protein intake on the association between OBS and lean mass.

METHODS

Using data from the National Health and Nutrition Examination Survey from 2011 to 2018, multivariate linear and logistic regression analyses were conducted to explore the associations between OBS and outcomes. The findings were then illustrated through fitted smoothing curves and threshold effect analyses.

RESULTS

This study included 2,441 participants, demonstrating that higher OBS is significantly associated with an increased ratio of appendicular lean mass to body mass index. Key inflection points at OBS 31 mark pronounced changes in these associations, with age and protein intake notably affecting the association. The effect of OBS on lean mass varies among populations with high and low protein intake.

CONCLUSIONS

Our findings suggest that OBS is significantly and positively associated with lean mass. A high protein intake of more than 84.5 g/day may enhance the role of OBS in influencing muscle health to improve muscle outcomes.

Strontium zinc silicate simultaneously alleviates osteoporosis and sarcopenia in tail-suspended rats via Piezo1-mediated Ca2+ signaling

Background

Long-term physical inactivity probably leads to a co-existence of osteoporosis and sarcopenia which result in a high risk of falls, fractures, disability and even mortality. However, universally applicable and feasible approaches are lacking in the concurrent treatment of osteoporosis and sarcopenia. In this study, we evaluated the effect of strontium zinc silicate bioceramic (SZS) extract on osteoporosis and sarcopenia and explored its underlying mechanisms.

Methods

Hindlimb osteoporosis and sarcopenia were established in a tail-suspended rat model. The bones were conducted μCT scanning, histological examination, and gene expression analysis, and the muscles were conducted histological examination and gene expression analysis. In vitro, the effect of SZS extract on osteoblasts was determined by alizarin red S staining, immunofluorescence and qPCR. Similarly, the effect of SZS extract on myoblasts was determined by immunofluorescence and qPCR.. At last, the role of Piezo1 and the change of intracellular calcium ion (Ca2+) were explored through blockading the Piezo1 by GsMTx4 in MC3T3-E1 and C2C12 cells, respectively.

Results

We found that SZS extract could concurrently and efficiently prevent bone structure deterioration, muscle atrophy and fibrosis in hind limbs of the tail-suspended rats. The in vivo study also showed that SZS extract could upregulate the mRNA expression of Piezo1, thereby maintaining the homeostasis of bones and muscles. In vitro study demonstrated that SZS extract could promote the proliferation and differentiation of MC3T3-E1 and C2C12 cells by increasing the intracellular Ca2+ in a Piezo1-dependent manner.

Conclusion

This study demonstrated that SZS extract could increase Piezo1-mediated intracellular Ca2+, and facilitate osteogenic differentiation of osteoblast and myogenic differentiation of myoblasts, contributing to alleviation of osteoporosis and sarcopenia in a tail-suspended rat model.

The translational potential of this article

The current study might provide a universally applicable and efficient strategy to treat musculoskeletal disorders based on bioactive ceramics. The verification of the role of Piezo1-modulated intracellular Ca2+ during osteogenesis and myogenesis provided a possible therapeutic target against mechanical related diseases.

Associations of sleep behaviors and genetic risk with risk of incident osteoporosis: A prospective cohort study of 293,164 participants

BACKGROUND

Unhealthy sleep behaviors are associated with higher risks of osteoporosis (OP), while prospective evidence is limited. This study aimed to prospectively investigate this association, quantify the attributable burden of OP incidence reduction due to unhealthy sleep behaviors, and explore potential modifications by genetic risk factors.

METHODS

This longitudinal cohort study was conducted utilizing data from the UK Biobank, comprising 293,164 participants initially free of OP and with requisite sleep behaviors data at baseline. We followed the participants after recruitment until November 30, 2022, to ascertain incident OP. We assessed the associations of five sleep behaviors including sleep duration, chronotype, insomnia, daytime napping, and morning wake-up difficulties, as well as sleep behavior patterns identified based on the above sleep behaviors, with the risk of OP, using Cox models adjusted for multiple confounders. The analyses were then performed separately among individuals with different OP susceptibility, indexed by standard polygenetic risk scores(PRS) for OP. Our secondary outcome was OP with pathologic fracture. Subgroup and sensitivity analyses were performed. Additionally, attributable risk percent in the exposed population (AR%) and population attributable fraction (PAF) of sleep behaviors were calculated.

RESULTS

Over a median follow-up of 13.7 years, 8253 new-onset OP cases were documented. Unhealthy sleep behaviors, such as long or short sleep duration, insomnia, daytime napping, morning wake-up difficulties, and unhealthy sleep patterns, were associated with elevated risks of OP (HRs ranging from 1.14 to 1.46, all P-value <0.001) compared to healthy sleep behaviors. Similar associations were observed for OP with pathologic fractures. Insomnia exhibited the largest AR% of 39.98 % (95%CI: 36.46, 43.31) and PAF of 33.25 % (95%CI: 30.00, 36.34) among healthy sleep patterns and components. A statistically significant multiplicative interaction was noted between sleep behaviors and OP PRS on OP risk (all P-interaction <0.001).

CONCLUSIONS

Four unhealthy sleep behaviors and sleep behavior patterns were associated to increased OP risk, with insomnia contributing the most to OP incidence, while genetic risk for OP modified this association. These findings underscore the crucial role of adhering to healthy sleep behaviors for effective OP prevention.

Research trends and hotspots on osteoporosis: a decade-long bibliometric and visualization analysis from 2014 to 2023

Background

Osteoporosis is characterized by diminished bone density and quality, compromised bone microstructure, and increased bone fragility, culminating in a heightened risk of fracture. Relatively few attempts have been made to survey the breadth of osteoporosis research using bibliometric approaches. This study aims to delineate the current landscape of osteoporosis research, offering clarity and visualization, while also identifying potential future directions for investigation.

Methods

We retrieved and filtered articles and reviews pertaining to osteoporosis from the Web of Science Core Collection database, specifically the Science Citation Index Expanded (SCI-E) edition, spanning the years 2014 to 2023. Informatics tools such as CiteSpace and VOSviewer were employed to dissect the intellectual framework, discern trends, and pinpoint focal points of interest within osteoporosis research.

Results

Our dataset comprised 33,928 osteoporosis-related publications, with a notable surge in annual publication numbers throughout the last decade. China and the United States lead in terms of research output. The University of California System contributed substantially to this body of work, with Amgen demonstrating the highest degree of centrality within the network. Cooper Cyrus emerged as a pivotal figure in the field. An analysis of highly-cited studies, co-citation networks, and keyword co-occurrence revealed that recent years have predominantly concentrated on elucidating mechanisms underlying osteoporosis, as well as its diagnosis, prevention, and treatment strategies. Burst detection analyses of citations and keywords highlighted osteoblasts, sarcopenia, gut microbiota, and denosumab as contemporary hotspots within osteoporosis research.

Conclusion

This bibliometric analysis has provided a visual representation of the fundamental knowledge structure, prevailing trends, and key focal areas within osteoporosis research. The identification of osteoblasts, sarcopenia, gut microbiota, and denosumab as current hotspots may guide future research endeavors. Continued efforts directed at understanding the mechanisms, fracture outcomes, diagnostics, and therapeutics related to osteoporosis are anticipated to deepen our comprehension of this complex disease.

The association between non‑high‑density lipoprotein cholesterol to high‑density lipoprotein cholesterol ratio (NHHR) and low muscle mass in adults aged 20-59: a population-based study in the United States

BACKGROUND

The ratio between non-high-density lipoprotein cholesterol and high-density lipoprotein cholesterol (NHHR) is a reliable marker for assessing the risk linked to lipid metabolism disorders. Sarcopenia, characterized by age-related loss of muscle mass and strength/function, includes the assessment of muscle mass, muscle strength, and muscle-specific strength. However, research into NHHR's relationship with low muscle mass risk remains unexplored.

METHODS

Our study utilized a cross-sectional approach, examining data derived from the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2018. Through multivariable linear and logistic regression, we investigated the relationships of the NHHR with muscle mass and low muscle mass. We visualized the results using smoothing curves and assessed threshold effects. We also performed various subgroup and sensitivity analyses.

RESULTS

This research encompassed 9,012 participants and demonstrated significant nonlinear associations between NHHR and ALMBMI or low muscle mass risk in a generalized additive model (GAM), pinpointing critical NHHR values (3.328 and 3.367) where changes in NHHR significantly impacted ALMBMI and low muscle mass risk.

CONCLUSIONS

The NHHR demonstrates a significant association with an increased risk of low muscle mass among middle-aged Americans. This ratio has potential as a predictive marker for low muscle mass. Further exploration of NHHR is expected to aid in advancing preventive and therapeutic measures for this condition.

The prevalence of sarcopenia and risk factors in the older adult in China: a systematic review and meta-analysis

Background

Understanding the epidemiological information of a certain disease is the first step in related prevention and control work. This article aims to understand the prevalence and associated risk factors of sarcopenia among the older adult (≥60 years old) in China and to provide an evidence-based basis for early identification, management, and prevention of sarcopenia patients.

Methods

We searched seven databases: CNKI, Wanfang, VIP, PubMed, Web of Science, Embase, and Cochrane Library databases from the establishment of the database until January 31, 2024. The Quality evaluation criteria of cross-sectional studies recommended by the Agency for Healthcare Research and Quality (AHRQ) were used for literature quality evaluation. Stata 18.0 software was used for statistical analysis.

Results

We finally included 45 studies, involving a total of 37,571 cases. After statistical analysis, we found that the prevalence of sarcopenia among the older adult in China was 20.7% [95% CI (18.3, 23.0%)]. The results of subgroup analysis suggest that: ① According to gender, the prevalence rate of sarcopenia in women (21.6%) is higher than that in men (19.2%); ② According to age, the prevalence rate of older adult people aged ≥80 (45.4%) was the highest, followed by 70-79 (27.2%) and 60-69 (15.7%). ③ According to region, the prevalence rate of the older adult in the south (21.7%) is higher than that in the north (19.0%); ④ According to the time of publication, the prevalence of sarcopenia among the older adult in China has increased (from 19.2% in 2014-2018 to 21.4% in 2019-2024); ⑤ According to the diagnostic criteria, the detection rate of AWGS (2019) is higher than that of AWGS (2014) (24.5% vs. 19.3%). Finally, aging, low BMI, low leg circumference, smoking, depression, osteoporosis, malnutrition and malnutrition risk are all risk factors for sarcopenia among the older adult in China.

Conclusion

The prevalence of sarcopenia in the older adult in China was higher (20.7%), which should be paid attention to by relevant health authorities. In addition, aging, low BMI, low calf circumference, smoking, depression, osteoporosis, malnutrition and malnutrition risk are risk factors for the development of sarcopenia in the older adult in China. For these high-risk populations, early identification, prevention, and intervention can be carried out to delay the occurrence and progression of sarcopenia.

Meat consumption and the risk of hip fracture in women and men: two prospective Swedish cohort studies

PURPOSE

To study the association between meat intake (predominantly red and processed meats) and the risk of hip fracture, as well as the association between meat intake and biomarkers of inflammation, oxidative stress, bone turnover, body composition, and bone mineral density (BMD).

METHODS

Data from the Swedish Mammography Cohort and the Cohort of Swedish men (n = 83,603, 54% men) with repeated investigations and their respective clinical sub-cohorts was utilised. Incident hip fractures were ascertained through individual linkage to registers. Associations were investigated using multivariable Cox and linear regression analyses.

RESULTS

During up to 23 years of follow-up (mean 18.2 years) and 1,538,627 person-years at risk, 7345 participants (2840 men) experienced a hip fracture. Each daily serving of meat intake conferred a hazard ratio (HR) of 1.03 (95% confidence interval [CI] 1.00; 1.06) for hip fracture. In quintile 5, compared to quintile 2, the HR was 1.11 (95% CI 1.01; 1.21) among all participants. In the sub-cohorts, meat intake was directly associated with circulating levels of interleukin-6, C-reactive protein, leptin, ferritin, parathyroid hormone, and calcium.

CONCLUSION

A modest linear association was found between a higher meat intake and the risk of hip fractures. Our results from the sub-cohorts further suggest that possible mechanisms linking meat intake and hip fracture risk may be related to the regulation of bone turnover, subclinical inflammation, and oxidative stress. Although estimates are modest, limiting red and processed meat intake in a healthy diet is advisable to prevent hip fractures.

Association of combined healthy lifestyle factors with incident osteoporosis in patients with and without type 2 diabetes

PURPOSE

The association between type 2 diabetes mellitus (T2DM), lifestyle factors, and the risk of osteoporosis (OP) is well-established. However, the impact of a healthy lifestyle on diabetes-related osteoporosis needs further investigation. Our objective was to explore if a combination of healthy lifestyle factors could mitigate the risk of OP in individuals with type 2 diabetes.

METHODS

This longitudinal analysis included 237,725 middle-aged and older participants. An overall lifestyle score, ranging from 0 to 7, was calculated by assigning a point for each of the seven healthy lifestyle factors, including no current smoking, non-excessive alcohol consumption, regular physical activity, healthy diet, adequate sleep duration, less sedentary behavior, and adequate sunshine exposure.

RESULTS

During a median follow-up 12.21 years, 5760 OP cases were documented. Participants with T2DM showed a higher risk of OP than those without diabetes. Compared with participants without diabetes who had a lifestyle score of 6-7, the hazard ratios (HRs) for OP were 1.58 (95% CI 1.23-2.03), 1.62 (95% CI 1.16-2.25), and 2.58 (95% CI 1.64-4.05) for participants with T2DM who had a lifestyle score of 4, 3, and 0-2, respectively. There was a graded association between higher lifestyle scores and lower risks of incident OP among participants without diabetes as well as among those with T2DM. We estimated that the population attributable fraction for not adhering to 6-7 lifestyle behaviors was 15.7%.

CONCLUSIONS

Participants with T2DM who adhered to a variety of healthy lifestyle factors demonstrated a substantially reduced risk of developing OP.

Osteoporosis management-current and future perspectives - A systemic review

Introduction

Osteoporosis is a geriatric metabolic ailment distinguished by low bone mineral density (BMD) and strength with enhanced micro-architectural retrogression of the extracellular matrix, further increasing bone fragility risk. Osteoporotic fractures and associated complications become common in women and men after 55 and 65 years, respectively. The loss in BMD markedly enhances the risk of fracture, non-skeletal injury, and subsequent pain, adversely affecting the quality of life.

Methods

Data summarised in this review were sourced and summarised, including contributions from 2008 to 2023, online from scientific search engines, based on scientific inclusion and exclusion criteria.

Results

Biochemical serum markers such as BALP, collagen, osteocalcin, and cathepsin-K levels can reveal the osteoporotic status. DEXA scan techniques evaluate the whole body's BMD and bone mineral content (BMC), crucial in osteoporosis management. Anabolic and anti-osteoporotic agents are commonly used to enhance bone formation, minimize bone resorption, and regulate remodelling. The challenges and side effects of drug therapy can be overcome by combining the various drug moieties.

Conclusion

The current review discusses the management protocol for osteoporosis, ranging from lifestyle modification, including physical exercise, pharmaceutical approaches, drug delivery applications, and advanced therapeutic possibilities of AI and machine learning techniques to reduce osteoporosis complications and fracture risk.

Association between Gastric Cancer and Osteoporosis: A Longitudinal Follow-Up Study Using a National Health Sample Cohort

Gastric cancer (GC) survivors may be more likely to develop osteoporosis. However, few studies on the relationship between GC and osteoporosis have been conducted on large patient populations. We aimed to determine the incidence of osteoporosis and identify related factors by comparing patients with GC and matched controls using the Korean National Health Insurance Service-National Sample Cohort (KNHIS-NSC). This study included 9078 patients with GC and 36,312 controls (1:4 propensity score-matched for sex, age, residence, and income). The hazard ratio (HR) for osteoporosis was significantly greater for GC patients than for controls according to Charlson Comorbidity Index (CCI) score-adjusted models (adjusted HR = 1.13). Kaplan-Meier analysis revealed that the cumulative incidence of osteoporosis during the follow-up period commencing from the index date was significantly greater in GC patients than in the controls (p = 0.0087). A positive correlation of osteoporosis with GC was detected for those aged < 65 years, males, and those with CCI scores = 0. In conclusion, the study findings suggest that men with GC aged < 65 years may be at an increased risk for osteoporosis. Research into additional risk factors and the optimal timing of interventions are needed to prevent fractures and minimize bone loss in GC survivors.

Inflammatory bowel disease and risk of autoimmune hepatitis: A univariable and multivariable Mendelian randomization study

OBJECTIVE

This study aimed to use Mendelian randomization (MR) to investigate the potential causal association between inflammatory bowel disease (IBD) and autoimmune hepatitis (AIH).

METHODS

Two-sample MR was performed to estimate the causal effect of IBD on AIH. The primary analysis employed the inverse variance weighted (IVW) method in univariable MR analysis, supplemented by additional methods including MR-Egger, weighted median, simple mode, and weighted mode. The p values were adjusted by FDR p-value adjustment. In the replication analysis, the primary IVW analysis was repeated and then pooled by meta-analysis. Sensitivity analyses were performed using Cochran's Q test, MR-Egger intercept test, MR-PRESSO, leave-one-out, and funnel plot analysis to evaluate the robustness of the MR findings. Additionally, multivariable MR (MVMR) was employed to estimate the direct causal effect of IBD on the risk of AIH.

RESULTS

In univariable MR analysis, a significant positive causal association was observed between IBD (both Crohn's disease (CD) or ulcerative colitis (UC)) and the risk of AIH (for CD and AIH, the IVW odds ratio (OR) = 1.10, 95% confidence interval (CI) = 1.00-1.16, P = 0.045, FDR P = 0.045; for UC and AIH, the IVW OR = 1.07, 95% CI = 1.00-1.13, P = 0.038, FDR P = 0.076). Furthermore, no significant positive correlation between IBD and the risk of AIH (OR = 1.13, 95% CI = 0.94-1.35, P = 0.194). Sensitivity analysis revealed no pleiotropic bias. MVMR analysis further confirmed the direct causal effect of CD or UC on the risk of AIH after adjusting for the common risk factors (cigarettes per day and osteoporosis). In the replication analysis, the positive causal association between UC and the risk of AIH remain significant (the IVW odds ratio (OR) = 1.32, 95% CI = 1.18-1.48, P = 2.90E-06). While no significant positive association was observed between CD or IBD and the risk of AIH in the replication analysis, a suggestive positive association between the identified risk factors (UC, CD, and IBD) and the risk of AIH was detected in the meta-analysis (OR = 1.09, 95% CI = 1.05-1.13, P<0.0001).

CONCLUSION

This MR study revealed a positive impact of the identified risk factors (CD, UC and IBD) on the risk of AIH within the European population.

Associations between special diet and incidence risk of osteoporosis: a Mendelian randomization study

Introduction

Osteoporosis is a prevalent challenge in clinical orthopedics, affecting a significant percentage of individuals aged 50 and above. The goal of this study was to comprehensively understand the relationships between a specialized dietary regimen and the risk of developing osteoporosis.

Methods

This study employed extensive genome-wide association study (GWAS) summary statistics derived from the UK Biobank. It encompassed 8 kinds of special diets and 7 datasets pertaining to osteoporosis and associated symptoms. The principal analytical approach employed was the inverse-variance weighted method. Additionally, sensitivity analysis was employed to elucidate the diverse multiplicity patterns observed in the final model.

Results

Our results showed that there is significant evidence that a gluten-free diet is associated with osteoporosis [odds ratio (OR): 1.080, 95% confidence interval (CI): 1.048-1.112, p = 4.23E-07)]. Furthermore, there exists a suggestive link between the three distinct dietary approaches and osteoporosis [(OR: 0.949, 95%CI: 0.929-0.970, p = 3.00E-06) for comprehensive consumption; (OR: 1.053, 95%CI: 1.018-1.089, p = 2.23E-03) for abstaining from wheat consumption; (OR: 1.036, 95%CI: 1.005-1.068, p = 1.97E-02) for abstaining from sugar consumption]. No additional correlation between the special dietary regimens and osteoporosis has been observed.

Conclusion

Our research has uncovered a notable correlation between a gluten-free diet and the occurrence of osteoporosis. Furthermore, it exerts a promoting influence on the onset of osteoporosis, which stands in direct contradiction to the therapeutic principles for Celiac Disease's complications. As such, a novel association among these three elements is postulated.

Association between the systemic immune-inflammation index and sarcopenia: a systematic review and meta-analysis

BACKGROUND

Sarcopenia is associated with increased morbidity and mortality. The systemic immune-inflammation index (SII) has been correlated to a variety of disorders. The present study conducted a systematic review and meta-analysis to investigate the relationship between SII and sarcopenia.

METHODS

A literature search was performed in Web of Science, PubMed, Embase, Cochrane Library, CINAHL, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, Wanfang Database, and VIP Chinese Science and Technology Database, from inception to March 2024. Then, the literature quality was assessed. After the heterogeneity test, a random effects or fixed effects model was applied to establish the forest plot, and investigate the relationship between SII and sarcopenia. Then, the sensitivity analysis and publication bias were examined.

RESULTS

Nine articles, which included 18,634 adults, were analyzed. Sarcopenic adults had higher SII levels, when compared to non-sarcopenic adults (standardized mean difference [SMD] = 0.66, 95% confidence interval [CI] = 0.22 - 0.19, p = 0.003). The high SII level was associated to the increased risk of sarcopenia (odds ratio = 1.52, 95% CI = 1.09-2.13, p = 0.01). In addition, the subgroup analysis revealed that the SII levels were higher in the sarcopenic group, when compared to the non-sarcopenic group, in elderly adults, as well as in adults with or without gastrointestinal disorders. The analysis was robust with a low risk of publication bias.

CONCLUSIONS

SII is closely associated to sarcopenia. Sarcopenic adults had elevated SII levels. The high SII level increased the risk of sarcopenia. Large scale multi-center prospective studies are required to validate these study findings.

Predictive value of anthropometric measurements in survival and free walking ability of geriatric hip fractures after surgery

BACKGROUND

We aimed to explore the predictive value of anthropometric measurements in survival and free walking ability of geriatric hip fractures after surgery.

METHODS

Eight common anthropometric measurements, including arm circumference (AC), waist circumference (WC), thigh circumference (TC), calf circumference (CC), biceps skinfold (BS), triceps skinfold (TS), suprailiac skinfold (SIS), and subscapular skinfold (SSS), were included to identify their predictive value in survival and free walking ability of geriatric hip fractures. The results of anthropometric measurements were compared between patients with different outcomes. Cox and logistics models were established to further identify the predictive value of anthropometric measurements.

RESULTS

Comparison among groups indicated that individuals with different outcomes may have significantly different anthropometric measurements. In the Cox analyses based on all individuals, all models proved that the patients with higher AC, as well as CC and BS, may have a lower risk of 1-year mortality. Similarly, in the logistics analysis, AC, CC, and BS were proven to have strong predictive ability for 6-month and 1-year mortality in females and overall individuals. However, the predictive value of the eight common anthropometric measurements in free walking ability is not significant.

CONCLUSION

AC, CC, and BS may have strong predictive ability for 6-month and 1-year mortality in all individuals and females.

Non-Pharmacological Strategies for Managing Sarcopenia in Chronic Diseases

This article focuses on a range of non-pharmacological strategies for managing sarcopenia in chronic diseases, including exercise, dietary supplements, traditional Chinese exercise, intestinal microecology, and rehabilitation therapies for individuals with limited limb movement. By analyzing multiple studies, the article aims to summarize the available evidence to manage sarcopenia in individuals with chronic diseases. The results strongly emphasize the role of resistance training in addressing chronic diseases and secondary sarcopenia. Maintaining the appropriate frequency and intensity of resistance training can help prevent muscle atrophy and effectively reduce inflammation. Although aerobic exercise has limited ability to improve skeletal muscle mass, it does have some positive effects on physical function. Building upon this, the article explores the potential benefits of combined training approaches, highlighting their helpfulness for overall quality of life. Additionally, the article also highlights the importance of dietary supplements in combating muscle atrophy in chronic diseases. It focuses on the importance of protein intake, supplements rich in essential amino acids and omega-3, as well as sufficient vitamin D to prevent muscle atrophy. Combining exercise with dietary supplements appears to be an effective strategy for preventing sarcopenia, although the optimal dosage and type of supplement remain unclear. Furthermore, the article explores the potential benefits of intestinal microecology in sarcopenia. Probiotics, prebiotics, and bacterial products are suggested as new treatment options for sarcopenia. Additionally, emerging therapies such as whole body vibration training, blood flow restriction, and electrical stimulation show promise in treating sarcopenia with limited limb movement. Overall, this article provides valuable insights into non-pharmacological strategies for managing sarcopenia in individuals with chronic diseases. It emphasizes the importance of a holistic and integrated approach that incorporates exercise, nutrition, and multidisciplinary interventions, which have the potential to promote health in the elderly population. Future research should prioritize high-quality randomized controlled trials and utilize wearable devices, smartphone applications, and other advanced surveillance methods to investigate the most effective intervention strategies for sarcopenia associated with different chronic diseases.

Combined Nutrition with Exercise: Fueling the Fight Against Sarcopenia Through a Bibliometric Analysis and Review

Objective

This bibliometric analysis and review aimed to examine the current research status and trends in the combination of nutrition and exercise training for sarcopenia. Additionally, it sought to provide researchers with future research directions in this field.

Methods

Relevant publications were obtained from the Web of Science Core Collection (WoSCC) database, covering the period from January 1995 to October 2023. The collected publications were analyzed using CiteSpace, VOSviewer, Bibliometrix, and Review Manager.

Results

Out of the 2528 retrieved publications, the United States emerged as the leading contributor in terms of publication volume. The University of Texas System was identified as the most productive institution. Luc J C van Loon emerged as the most published author in this field. Analysis of keywords revealed recent hot topics and emerging areas of interest, such as "gut microbiota" and "mechanisms". Upon further evaluation, resistance training (RT) and protein supplementation were identified as the most commonly employed and effective methods.

Conclusion

RT and protein supplementation are widely recognized as effective strategies. Future research should focus on investigating the molecular aspects of sarcopenia. Moreover, the potential therapeutic role of gut microbiota in sarcopenia requires further comprehensive investigation in human subjects to establish its correlation.

Dexamethasone-induced muscle atrophy and bone loss in six genetically diverse collaborative cross founder strains demonstrates phenotypic variability by Rg3 treatment

Background

Osteosarcopenia is a common condition characterized by the loss of both bone and muscle mass, which can lead to an increased risk of fractures and disability in older adults. The study aimed to elucidate the response of various mouse strains to treatment with Rg3, one of the leading ginsenosides, on musculoskeletal traits and immune function, and their correlation.

Methods

Six Collaborative Cross (CC) founder strains induced muscle atrophy and bone loss with dexamethasone (15 mg/kg) treatment for 1 month, and half of the mice for each strain were orally administered Rg3 (20 mg/kg). Different responses were observed depending on genetic background and Rg3 treatment.

Results

Rg3 significantly increased grip strength, running performance, and expression of muscle and bone health-related genes in a two-way analysis of variance considering the genetic backgrounds and Rg3 treatment. Significant improvements in grip strength, running performance, bone area, and muscle mass, and the increased gene expression were observed in specific strains of PWK/PhJ. For traits related to muscle, bone, and immune functions, significant correlations between traits were confirmed following Rg3 administration compared with control mice. The phenotyping analysis was compiled into a public web resource called Rg3-OsteoSarco.

Conclusion

This highlights the complex interplay between genetic determinants, pathogenesis of muscle atrophy and bone loss, and phytochemical bioactivity and the need to move away from single inbred mouse models to improve their translatability to genetically diverse humans. Rg3-OsteoSarco highlights the use of CC founder strains as a valuable tool in the field of personalized nutrition.

Application of machine learning algorithms to identify people with low bone density

Background

Osteoporosis is becoming more common worldwide, imposing a substantial burden on individuals and society. The onset of osteoporosis is subtle, early detection is challenging, and population-wide screening is infeasible. Thus, there is a need to develop a method to identify those at high risk for osteoporosis.

Objective

This study aimed to develop a machine learning algorithm to effectively identify people with low bone density, using readily available demographic and blood biochemical data.

Methods

Using NHANES 2017-2020 data, participants over 50 years old with complete femoral neck BMD data were selected. This cohort was randomly divided into training (70%) and test (30%) sets. Lasso regression selected variables for inclusion in six machine learning models built on the training data: logistic regression (LR), support vector machine (SVM), gradient boosting machine (GBM), naive Bayes (NB), artificial neural network (ANN) and random forest (RF). NHANES data from the 2013-2014 cycle was used as an external validation set input into the models to verify their generalizability. Model discrimination was assessed via AUC, accuracy, sensitivity, specificity, precision and F1 score. Calibration curves evaluated goodness-of-fit. Decision curves determined clinical utility. The SHAP framework analyzed variable importance.

Results

A total of 3,545 participants were included in the internal validation set of this study, of whom 1870 had normal bone density and 1,675 had low bone density Lasso regression selected 19 variables. In the test set, AUC was 0.785 (LR), 0.780 (SVM), 0.775 (GBM), 0.729 (NB), 0.771 (ANN), and 0.768 (RF). The LR model has the best discrimination and a better calibration curve fit, the best clinical net benefit for the decision curve, and it also reflects good predictive power in the external validation dataset The top variables in the LR model were: age, BMI, gender, creatine phosphokinase, total cholesterol and alkaline phosphatase.

Conclusion

The machine learning model demonstrated effective classification of low BMD using blood biomarkers. This could aid clinical decision making for osteoporosis prevention and management.