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Zhao W, Zhao B, Meng X, Li B, Wang Y, Yu F, Fu C, Yu X, Li X, Dai C, Wang J, Gao H, Cheng M. The regulation of MFG-E8 on the mitophagy in diabetic sarcopenia via the HSPA1L-Parkin pathway and the effect of D-pinitol. J Cachexia Sarcopenia Muscle 2024; 15:934-948. [PMID: 38553831 PMCID: PMC11154748 DOI: 10.1002/jcsm.13459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 02/26/2024] [Accepted: 03/05/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND Diabetic sarcopenia is a disease-related skeletal muscle disorder that causes progressive symptoms. The complete understanding of its pathogenesis is yet to be unravelled, which makes it difficult to develop effective therapeutic strategies. This study investigates how MFG-E8 affects mitophagy and the protective role of D-pinitol (DP) in diabetic sarcopenia. METHODS In vivo, streptozotocin-induced diabetic SAM-R1 (STZ-R1) and SAM-P8 (STZ-P8) mice (16-week-old) were used, and STZ-P8 mice were administrated of DP (150 mg/kg per day) for 6 weeks. Gastrocnemius muscles were harvested for histological analysis including transmission electron microscopy. Proteins were evaluated via immunohistochemistry (IHC), immunofluorescence (IF), and western blotting (WB) assay. In vitro, advanced glycation end products (AGEs) induced diabetic and D-galactose (DG) induced senescent C2C12 models were established and received DP, MFG-E8 plasmid (Mover)/siRNA (MsiRNA), or 3-MA/Torin-1 intervention. Proteins were evaluated by IF and WB assay. Immunoprecipitation (IP) and co-immunoprecipitation (CO-IP) were used for hunting the interacted proteins of MFG-E8. RESULTS In vivo, sarcopenia, mitophagy deficiency, and up-regulated MFG-E8 were confirmed in the STZ-P8 group. DP exerted protective effects on sarcopenia and mitophagy (DP + STZ-P8 vs. STZ-P8; all P < 0.01), such as increased lean mass (8.47 ± 0.81 g vs. 7.08 ± 1.64 g), grip strength (208.62 ± 39.45 g vs. 160.87 ± 26.95 g), rotarod tests (109.7 ± 11.81 s vs. 59.3 ± 20.97 s), muscle cross-sectional area (CSA) (1912.17 ± 535.61 μm2 vs. 1557.19 ± 588.38 μm2), autophagosomes (0.07 ± 0.02 per μm2 vs. 0.02 ± 0.01 per μm2), and cytolysosome (0.07 ± 0.03 per μm2 vs. 0.03 ± 0.01 per μm2). DP down-regulated MFG-E8 in both serum (DP + STZ-P8: 253.19 ± 34.75 pg/mL vs. STZ-P8: 404.69 ± 78.97 pg/mL; P < 0.001) and gastrocnemius muscle (WB assay. DP + STZ-P8: 0.39 ± 0.04 vs. STZ-P8: 0.55 ± 0.08; P < 0.01). DP also up-regulated PINK1, Parkin and LC3B-II/I ratio, and down-regulated P62 in gastrocnemius muscles (all P < 0.01). In vitro, mitophagy deficiency and MFG-E8 up-regulation were confirmed in diabetic and senescent models (all P < 0.05). DP and MsiRNA down-regulated MFG-E8 and P62, and up-regulated PINK1, Parkin and LC3B-II/I ratio to promote mitophagy as Torin-1 does (all P < 0.05). HSPA1L was confirmed as an interacted protein of MFG-E8 in IP and CO-IP assay. Mover down-regulated the expression of Parkin via the HSPA1L-Parkin pathway, leading to mitophagy inhibition. MsiRNA up-regulated the expression of PINK1 via SGK1, FOXO1, and STAT3 phosphorylation pathways, leading to mitophagy stimulation. CONCLUSIONS MFG-E8 is a crucial target protein of DP and plays a distinct role in mitophagy regulation. DP down-regulates the expression of MFG-E8, reduces mitophagy deficiency, and alleviates the symptoms of diabetic sarcopenia, which could be considered a novel therapeutic strategy for diabetic sarcopenia.
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Affiliation(s)
- Wenqian Zhao
- Department of Geriatric Medicine, Qilu Hospital, Cheeloo College of MedicineShandong UniversityJinanChina
- Key Laboratory of Cardiovascular Proteomics of Shandong Province, Qilu Hospital, Cheeloo College of MedicineShandong UniversityJinanChina
- Jinan Clinical Research Center for Geriatric Medicine (202132001)JinanChina
| | - Bin Zhao
- Postdoctoral Research StationShandong University of Traditional Chinese MedicineJinanChina
| | - Xinyue Meng
- Department of Geriatric Medicine, Qilu Hospital, Cheeloo College of MedicineShandong UniversityJinanChina
- Key Laboratory of Cardiovascular Proteomics of Shandong Province, Qilu Hospital, Cheeloo College of MedicineShandong UniversityJinanChina
- Jinan Clinical Research Center for Geriatric Medicine (202132001)JinanChina
| | - Baoying Li
- Key Laboratory of Cardiovascular Proteomics of Shandong Province, Qilu Hospital, Cheeloo College of MedicineShandong UniversityJinanChina
- Health Management Center (East Area)Qilu Hospital of Shandong UniversityJinanChina
| | - Yajuan Wang
- Department of Geriatric Medicine, Qilu Hospital, Cheeloo College of MedicineShandong UniversityJinanChina
- Key Laboratory of Cardiovascular Proteomics of Shandong Province, Qilu Hospital, Cheeloo College of MedicineShandong UniversityJinanChina
- Jinan Clinical Research Center for Geriatric Medicine (202132001)JinanChina
| | - Fei Yu
- Department of Geriatric Medicine, Qilu Hospital, Cheeloo College of MedicineShandong UniversityJinanChina
- Key Laboratory of Cardiovascular Proteomics of Shandong Province, Qilu Hospital, Cheeloo College of MedicineShandong UniversityJinanChina
- Jinan Clinical Research Center for Geriatric Medicine (202132001)JinanChina
| | - Chunli Fu
- Department of Geriatric Medicine, Qilu Hospital, Cheeloo College of MedicineShandong UniversityJinanChina
- Key Laboratory of Cardiovascular Proteomics of Shandong Province, Qilu Hospital, Cheeloo College of MedicineShandong UniversityJinanChina
- Jinan Clinical Research Center for Geriatric Medicine (202132001)JinanChina
| | - Xin Yu
- Department of Geriatric Medicine, Qilu Hospital, Cheeloo College of MedicineShandong UniversityJinanChina
- Key Laboratory of Cardiovascular Proteomics of Shandong Province, Qilu Hospital, Cheeloo College of MedicineShandong UniversityJinanChina
- Jinan Clinical Research Center for Geriatric Medicine (202132001)JinanChina
| | - Xiaoli Li
- Department of PharmacyQilu Hospital of Shandong UniversityJinanChina
| | - Chaochao Dai
- Key Laboratory of Cardiovascular Proteomics of Shandong Province, Qilu Hospital, Cheeloo College of MedicineShandong UniversityJinanChina
| | - Jie Wang
- Key Laboratory of Cardiovascular Proteomics of Shandong Province, Qilu Hospital, Cheeloo College of MedicineShandong UniversityJinanChina
| | - Haiqing Gao
- Department of Geriatric Medicine, Qilu Hospital, Cheeloo College of MedicineShandong UniversityJinanChina
- Key Laboratory of Cardiovascular Proteomics of Shandong Province, Qilu Hospital, Cheeloo College of MedicineShandong UniversityJinanChina
- Jinan Clinical Research Center for Geriatric Medicine (202132001)JinanChina
| | - Mei Cheng
- Department of Geriatric Medicine, Qilu Hospital, Cheeloo College of MedicineShandong UniversityJinanChina
- Key Laboratory of Cardiovascular Proteomics of Shandong Province, Qilu Hospital, Cheeloo College of MedicineShandong UniversityJinanChina
- Jinan Clinical Research Center for Geriatric Medicine (202132001)JinanChina
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Du X, Yao Z, Wang D, Dong X, Bai J, Gu Y, Yu Y, Zhang W, Qi Q, Gu S. An insight into the causal relationship between sarcopenia-related traits and venous thromboembolism: A mendelian randomization study. PLoS One 2024; 19:e0303148. [PMID: 38753690 PMCID: PMC11098320 DOI: 10.1371/journal.pone.0303148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 04/20/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND As a geriatric syndrome, sarcopenia has a high prevalence in the old population and represents an impaired state of health with adverse health outcomes. A strong clinical interest in its relationship with venous thromboembolism (VTE), which is a complex trait disease with a heterogeneous annual incidence rate in different countries, has emerged. The relationship between sarcopenia and venous thromboembolism has been reported in observational studies but the causality from sarcopenia to VTE remained unclarified. We aimed to assess the causal effect of sarcopenia on the risk of VTE with the two-sample Mendelian randomization (MR) method. METHODS Two sets of single-nucleotide polymorphisms (SNPs), derived from two published genome-wide association study (GWAS) meta-analyses and genetically indexing muscle weakness and lean muscle mass separately, were pooled into inverse variance weighted (IVW), weighted median and MR-Egger analyses. RESULTS No evidence was found for the causal effect of genetically predicted muscle weakness (IVW: OR = 0.90, 95% CI = 0.76-1.06, p = 0.217), whole body lean mass (IVW: OR = 1.01, 95% CI = 0.87-1.17, p = 0.881) and appendicular lean mass (IVW: OR = 1.13, 95% CI = 0.82-1.57, p = 0.445) on the risk of VTE. However, both genetically predicted whole-body lean mass and appendicular lean mass can causally influence diabetes mellitus (IVW of whole-body lean mass: OR = 0.87, 95% CI = 0.78-0.96, p = 0.008; IVW of appendicular lean mass: OR = 0.71, 95% CI = 0.54-0.94, p = 0.014) and hypertension (IVW of whole-body lean mass: OR = 0.92, 95% CI = 0.87-0.98, p = 0.007; IVW of appendicular lean mass: OR = 0.84, 95% CI = 0.73-0.96, p = 0.013). CONCLUSIONS Genetically predicted sarcopenia does not causally influence VTE directly, but it might still have an indirect effect on VTE incidence via diabetes mellitus and hypertension.
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Affiliation(s)
- Xinchao Du
- Department of Cardiology, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, China
| | - Zhiwei Yao
- Department of Thyroid Surgery, The Affiliated Taian City Central Hospital of Qingdao University, Taian, Shandong, China
| | - Dongwei Wang
- Department of Cardiac Rehabilitation, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, China
| | - Xinwei Dong
- Department of Cardiology, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, China
| | - Juncai Bai
- Department of Cardiac Rehabilitation, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, China
| | - Yingchun Gu
- Department of Cardiac Rehabilitation, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, China
| | - Yaohua Yu
- Department of Respiratory Medicine and Pulmonary Rehabilitation, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, China
| | - Weifeng Zhang
- Department of Rheumatism and Immunology, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, China
| | - Qingxia Qi
- Department of Cardiology, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, China
| | - Shengyuan Gu
- Department of Cardiology, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, China
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Baharirad N, Pasdar Y, Nachvak M, Ghavamzadeh S, Soroush A, Saber A, Mostafai S, Naghipour A, Abdollahzad H. The relationship of dietary total antioxidant capacity with sarcopenia and cardiometabolic biomarkers in type 2 diabetes patients. Physiol Rep 2022; 10:e15190. [PMID: 35150209 PMCID: PMC8839419 DOI: 10.14814/phy2.15190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 01/10/2022] [Accepted: 01/10/2022] [Indexed: 11/24/2022] Open
Abstract
Background The aim of this study was to investigate the relationship of dietary total antioxidant capacity (DTAC) with sarcopenia and metabolic biomarkers in people with type 2 diabetes in the Kurdish race. Methods In this cross‐sectional study, data of 189 type 2 diabetic patients (35–65 years old) from RaNCD cohort study were evaluated. DTAC, fasting blood sugar, lipid profile, body composition, muscle strength, and sarcopenia were assessed. t and χ2 tests to compare the variables between sarcopenic and non‐sarcopenic patients and one‐way analysis of variance to compare the variables in DTAC tertiles were used. The relationship between DTAC and different variables was evaluated using multiple logistic regression model. Results The mean age and body mass index were 49.7 ± 8.7 years and 27.1 ± 3.9 kg/m2. Body mass index, waist circumference, and hip circumference were significantly different between diabetic patients with and without sarcopenia (p < 0.05). In crude (p = 0.010) and adjusted (p = 0.035) models, there was a significant relationship between DTAC and fasting blood sugar. Also, the relationship between DTAC with waist (p = 0.019) and hip (β = −4.25, p = 0.026) circumference was significant. Sarcopenia was significantly lower in the third tertile in comparison with the first tertile of DTAC (p = 0.016). Conclusion Diet with higher DTAC can be associated with lower fasting blood sugar, abdominal obesity and sarcopenia in type 2 diabetic patients. However, further studies are required to confirm these relationships.
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Affiliation(s)
- Nadya Baharirad
- Student Research Committee, School of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Yahya Pasdar
- Department of Nutritional Sciences, School of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mostafa Nachvak
- Department of Nutritional Sciences, School of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Saeid Ghavamzadeh
- Department of Nutrition, Medicine Faculty, Urmia University of Medical Sciences, Urmia, Iran
| | - Ali Soroush
- Cardiovascular Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Amir Saber
- Department of Nutritional Sciences, School of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shayan Mostafai
- Research Center for Environmental Determinants of Health (RCEDH), Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Armin Naghipour
- Clinical Research Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hadi Abdollahzad
- Department of Nutritional Sciences, School of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran.,Research Center for Environmental Determinants of Health (RCEDH), Kermanshah University of Medical Sciences, Kermanshah, Iran
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Bellary S, Kyrou I, Brown JE, Bailey CJ. Type 2 diabetes mellitus in older adults: clinical considerations and management. Nat Rev Endocrinol 2021; 17:534-548. [PMID: 34172940 DOI: 10.1038/s41574-021-00512-2] [Citation(s) in RCA: 158] [Impact Index Per Article: 52.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/13/2021] [Indexed: 02/06/2023]
Abstract
The past 50 years have seen a growing ageing population with an increasing prevalence of type 2 diabetes mellitus (T2DM); now, nearly half of all individuals with diabetes mellitus are older adults (aged ≥65 years). Older adults with T2DM present particularly difficult challenges. For example, the accentuated heterogeneity of these patients, the potential presence of multiple comorbidities, the increased susceptibility to hypoglycaemia, the increased dependence on care and the effect of frailty all add to the complexity of managing diabetes mellitus in this age group. In this Review, we offer an update on the key pathophysiological mechanisms associated with T2DM in older people. We then evaluate new evidence relating particularly to the effects of frailty and sarcopenia, the clinical difficulties of age-associated comorbidities, and the implications for existing guidelines and therapeutic options. Our conclusions will focus on the effect of T2DM on an ageing society.
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Affiliation(s)
- Srikanth Bellary
- School of Life and Health Sciences, Aston University, Birmingham, UK.
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
- Aston Research Centre for Healthy Ageing (ARCHA), Aston University, Birmingham, UK.
| | - Ioannis Kyrou
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
- Aston Medical Research Institute, Aston Medical School, Aston University, Birmingham, UK
- Warwick Medical School, University of Warwick, Coventry, UK
- Centre for Sport, Exercise and Life Sciences, Research Institute for Health & Wellbeing, Coventry University, Coventry, UK
| | - James E Brown
- School of Life and Health Sciences, Aston University, Birmingham, UK
- Aston Research Centre for Healthy Ageing (ARCHA), Aston University, Birmingham, UK
| | - Clifford J Bailey
- School of Life and Health Sciences, Aston University, Birmingham, UK
- Aston Research Centre for Healthy Ageing (ARCHA), Aston University, Birmingham, UK
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Nakashima A, Horita S, Matsunaga T, Inoue R, Zoshima T, Mizushima I, Hara S, Ito K, Fujii H, Nomura H, Kawano M. Factors contributing to discrepant estimated glomerular filtration values measured by creatinine and cystatin C in patients with rheumatoid arthritis. Sci Rep 2021; 11:9884. [PMID: 33972623 PMCID: PMC8110572 DOI: 10.1038/s41598-021-89303-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 04/19/2021] [Indexed: 11/23/2022] Open
Abstract
This study aimed to clarify the factors underlying the discrepancy that has been noted between estimated glomerular filtration ratio (eGFR) measured using serum creatinine (Cr) and eGFR using serum cystatin C (CysC) in patients with rheumatoid arthritis (RA) and to identify those patients whose renal function should be evaluated using CysC. We retrospectively evaluated clinical features, disease activity, Steinbrocker radiological staging, and co-morbidities (diabetes mellitus, hypertension, dyslipidemia) in 238 RA patients. eGFR using serum creatinine (eGFR-Cr) and eGFR using serum cystatin C (eGFR-CysC) were calculated using the new Japanese coefficient-modified Modification of Diet in Renal Disease study equation. To clarify the cause(s) of differences of 20% or more between the two eGFRs, we divided our RA patients into Group A (eGFR-Cr/eGFR-CysC ≥ 1.2) and Group B (eGFR-Cr/eGFR-CysC < 1.2), and searched for factors independently related to Group A. Forty-five patients (18.9%) were assigned to Group A, and 193 (81.1%) to Group B. BMI (Odds Ratio [OR] 0.820, 95% confidence interval [CI] 0.675–0.996), Hb (OR 0.633, 95% CI 0.433–0.926), CK (OR 0.773 per 10 units, 95% CI 0.644–0.933), NSAID use (OR 0.099, 95% CI 0.020–0.494), diabetes mellitus (OR 6.024, 95% CI 1.508–24.390) and stage 4 Steinbrocker radiological stage (OR 10.309, 95% CI 2.994–35.714) were identified as independent relevant factors for Group A by a multifactorial analysis. Renal function in RA patients with low BMI, diabetes, anemia and low CK may be overestimated using eGFR-Cr alone, and such patients need to be evaluated using eGFR-CysC.
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Affiliation(s)
- Akikatsu Nakashima
- Division of Nephrology and Rheumatology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
| | - Shigeto Horita
- Division of Nephrology and Rheumatology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
| | - Takahiro Matsunaga
- Division of Nephrology and Rheumatology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
| | - Ryo Inoue
- Division of Internal Medicine and Rheumatology, Ishikawa-Ken Saiseikai Kanazawa Hospital, Kanazawa, Japan
| | - Takeshi Zoshima
- Department of Rheumatology, Kanazawa University Hospital, 13-1, Takaramachi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Ichiro Mizushima
- Department of Rheumatology, Kanazawa University Hospital, 13-1, Takaramachi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Satoshi Hara
- Department of Rheumatology, Kanazawa University Hospital, 13-1, Takaramachi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Kiyoaki Ito
- Department of Rheumatology, Kanazawa University Hospital, 13-1, Takaramachi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Hiroshi Fujii
- Department of Rheumatology, Kanazawa University Hospital, 13-1, Takaramachi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Hideki Nomura
- Department of General Medicine, Kanazawa University Hospital, Kanazawa, Japan
| | - Mitsuhiro Kawano
- Department of Rheumatology, Kanazawa University Hospital, 13-1, Takaramachi, Kanazawa, Ishikawa, 920-8641, Japan.
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He Q, Wang X, Yang C, Zhuang X, Yue Y, Jing H, Hu J, Sun M, Guo L. Metabolic and Nutritional Characteristics in Middle-Aged and Elderly Sarcopenia Patients with Type 2 Diabetes. J Diabetes Res 2020; 2020:6973469. [PMID: 33204732 PMCID: PMC7661113 DOI: 10.1155/2020/6973469] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 08/13/2020] [Accepted: 10/24/2020] [Indexed: 11/18/2022] Open
Abstract
Sarcopenia is considered to be a new complication of type 2 diabetes (T2DM) leading to increased risk of adverse outcome. We performed a survey to evaluate glucose metabolism and nutritional status in sarcopenia patients with T2DM. Diabetic participants aged ≥50 years were grouped into a probable sarcopenia group with low muscle strength (n = 405) and a nonsarcopenia group with normal muscle strength (n = 720) according to the revised recommendations from EWGSOP2 (2018). Compared to the controls, the probable sarcopenia participants were older and had lower waist-to-hip ratio and BMI, longer diabetes duration, higher fasting plasma glucose level and glycosylated hemoglobin (HbA1c), decreased estimated glomerular filtration rate and lower bone mineral content, lower fatless upper arm circumference, lower appendicular skeletal muscle mass index (ASMI), and muscle quality in both genders. Multivariable logistic regression analysis showed increased age, male, low BMI, and increased HbA1c, combined with diabetic nephropathy and decreased serum albumin levels, were risk factors associated with low muscle strength in diabetes patients. In conclusion, diabetic patients with sarcopenia had worse glucose metabolism and nutritional status, decreased renal function and reduced muscle quality ,and muscle mass with a greater likelihood of osteoporosis, who need an overall health management to improve outcomes. This clinical trial registration is registered with the Chinese Clinical Trial Registry, ChiCTR-EOC-15006901.
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Affiliation(s)
- Qinghua He
- Department of Endocrinology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, 100730, China
| | - Xiuzhi Wang
- Department of Endocrinology, Pinggu Hospital, Beijing Traditional Chinese Medicine Hospital, Beijing 10120, China
| | - Caizhe Yang
- Department of Endocrinology, Air Force Medical Center, PLA, Beijing 100142, China
| | - Xiaoming Zhuang
- Department of Endocrinology, Fuxing Hospital Affiliated to Capital Medical University, Beijing 100038, China
| | - Yanfen Yue
- Department of Nutriology, Pinggu Hospital, Beijing Traditional Chinese Medicine Hospital, Beijing 10120, China
| | - Hongjiang Jing
- Department of Nutriology, Air Force Medical Center, PLA, Beijing 100142, China
| | - Jing Hu
- Department of Nutriology, Fuxing Hospital Affiliated to Capital Medical University, Beijing 100038, China
| | - Mingxiao Sun
- Department of Endocrinology, Beijing Eden Hospital, Beijing 100195, China
| | - Lixin Guo
- Department of Endocrinology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, 100730, China
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The relationships between sarcopenic skeletal muscle loss during ageing and macronutrient metabolism, obesity and onset of diabetes. Proc Nutr Soc 2019; 79:158-169. [PMID: 31685055 DOI: 10.1017/s0029665119001150] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Skeletal muscle is integral to the metabolism and utilisation of macronutrients; however, substantial muscle loss and morphological changes occur with ageing. These are associated with loss of muscle function and accelerate rapidly from the age of 60 years, leading to the conditions of sarcopenia and frailty. As the relationship between muscle ageing and macronutrient metabolism and utilisation has seen limited research to date, this review focuses on the interactions between skeletal muscle changes during ageing, metabolism and utilisation of fat, carbohydrates and overall energy expenditure.Skeletal muscle contributes less to resting energy expenditure during ageing, potentially contributing to onset of obesity from middle age. Age-related changes to skeletal muscle lead to glucose dysregulation, with consequent reduction in glycaemic control, increased insulin resistance and ultimately onset of type-2 diabetes. Recent studies indicate that high total fat and SFA intake are detrimental to skeletal muscle, while higher intakes of PUFA are protective. Age-associated changes in skeletal muscle may also reduce total fatty acid utilisation.In conclusion, further research is needed to understand the relationships between macronutrient metabolism and utilisation and age-related changes to skeletal muscle. No dietary recommendations exist specifically for skeletal muscle health during ageing, but we advise individuals to follow healthy eating guidelines, by consuming sufficient protein, fruit and vegetables, and limited SFA and to maintain physically active lifestyles. Clinicians responsible for managing type-2 diabetes need to be aware of growing evidence relating age-related skeletal muscle changes to diabetes onset and progression.
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Sugimoto K, Tabara Y, Ikegami H, Takata Y, Kamide K, Ikezoe T, Kiyoshige E, Makutani Y, Onuma H, Gondo Y, Ikebe K, Ichihashi N, Tsuboyama T, Matsuda F, Kohara K, Kabayama M, Fukuda M, Katsuya T, Osawa H, Hiromine Y, Rakugi H. Hyperglycemia in non-obese patients with type 2 diabetes is associated with low muscle mass: The Multicenter Study for Clarifying Evidence for Sarcopenia in Patients with Diabetes Mellitus. J Diabetes Investig 2019; 10:1471-1479. [PMID: 31074209 PMCID: PMC6825926 DOI: 10.1111/jdi.13070] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Revised: 03/25/2019] [Accepted: 04/29/2019] [Indexed: 12/14/2022] Open
Abstract
AIMS/INTRODUCTION Hyperglycemia is a risk factor for sarcopenia when comparing individuals with and without diabetes. However, no studies have investigated whether the findings could be extrapolated to patients with diabetes with relatively higher glycemic levels. Here, we aimed to clarify whether glycemic control was associated with sarcopenia in patients with type 2 diabetes. MATERIALS AND METHODS Study participants consisted of patients with type 2 diabetes (n = 746, the average age was 69.9 years) and an older general population (n = 2,067, the average age was 68.2 years). Sarcopenia was defined as weak grip strength or slow usual gait speed and low skeletal mass index. RESULTS Among patients with type 2 diabetes, 52 were diagnosed as having sarcopenia. The frequency of sarcopenia increased linearly with glycated hemoglobin (HbA1c) level, particularly in lean individuals (HbA1c <6.5%, 7.0%, ≥6.5% and <7.0%: 18.5%; HbA1c ≥7.0% and <8.0%: 20.3%; HbA1c ≥8.0%: 26.7%). The linear association was independent of major covariates, including anthropometric factors and duration of diabetes (HbA1c <6.5%: reference; ≥6.5% and <7.0%: odds ratio [OR] 4.38, P = 0.030; HbA1c ≥7.0% and <8.0%: 4.29, P = 0.024; HbA1c ≥8.0%: 7.82, P = 0.003). HbA1c level was specifically associated with low skeletal mass index (HbA1c ≥8.0%: OR 5.42, P < 0.001) rather than weak grip strength (OR 1.89, P = 0.058) or slow gait speed (OR 1.13, P = 0.672). No significant association was observed in the general population with a better glycemic profile. CONCLUSIONS Poor glycemic control in patients with diabetes was associated with low muscle mass.
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Affiliation(s)
- Ken Sugimoto
- Department of Geriatric and General MedicineOsaka University Graduate School of MedicineSuitaJapan
| | - Yasuharu Tabara
- Center for Genomic MedicineKyoto University Graduate School of MedicineKyotoJapan
| | - Hiroshi Ikegami
- Department of Endocrinology, Metabolism and DiabetesKindai UniversityOsaka‐sayamaJapan
| | - Yasunori Takata
- Department of Diabetes and Molecular GeneticsEhime University Graduate School of MedicineToonJapan
| | - Kei Kamide
- Department of Health Promotion SciencesDivision of Health SciencesOsaka University Graduate School of MedicineSuitaJapan
| | - Tome Ikezoe
- Department of Physical TherapyHuman Health SciencesKyoto University Graduate School of MedicineKyotoJapan
| | - Eri Kiyoshige
- Department of Health Promotion SciencesDivision of Health SciencesOsaka University Graduate School of MedicineSuitaJapan
| | - Yukako Makutani
- Department of Endocrinology, Metabolism and DiabetesKindai UniversityOsaka‐sayamaJapan
| | - Hiroshi Onuma
- Diabetes/Metabolic EndocrinologyYachiyo Medical CenterTokyo Women's Medical UniversityYachiyoJapan
| | - Yasuyuki Gondo
- Department of Clinical Thanatology and Geriatric Behavioral ScienceOsaka University Graduate School of Human SciencesJapan
| | - Kazunori Ikebe
- Department of Prosthodontics, Gerodontology and Oral RehabilitationOsaka University Graduate School of DentistrySuitaJapan
| | - Noriaki Ichihashi
- Department of Physical TherapyHuman Health SciencesKyoto University Graduate School of MedicineKyotoJapan
| | - Tadao Tsuboyama
- Department of Physical TherapyHuman Health SciencesKyoto University Graduate School of MedicineKyotoJapan
- School of Health SciencesBukkyo UniversityKyotoJapan
| | - Fumihiko Matsuda
- Center for Genomic MedicineKyoto University Graduate School of MedicineKyotoJapan
| | - Katsuhiko Kohara
- Department of Regional Resource ManagementFaculty of Collaborative Regional InnovationEhime UniversityMatsuyamaJapan
| | - Mai Kabayama
- Department of Health Promotion SciencesDivision of Health SciencesOsaka University Graduate School of MedicineSuitaJapan
| | | | - Tomohiro Katsuya
- Katsuya ClinicAmagasakiJapan
- Department of Clinical Gene TherapyOsaka University Graduate School of MedicineSuitaJapan
| | - Haruhiko Osawa
- Department of Diabetes and Molecular GeneticsEhime University Graduate School of MedicineToonJapan
| | - Yoshihisa Hiromine
- Department of Endocrinology, Metabolism and DiabetesKindai UniversityOsaka‐sayamaJapan
| | - Hiromi Rakugi
- Department of Geriatric and General MedicineOsaka University Graduate School of MedicineSuitaJapan
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