Prevalence of sarcopenia was higher in women than in men: a cross-sectional study from a rural area in eastern China

ALBI-sarcopenia score as a predictor of treatment outcomes in hepatocellular carcinoma

The recently developed ALBI-Sarcopenia score has demonstrated effectiveness in predicting mortality in hepatocellular carcinoma (HCC), emerging as a crucial factor in guiding treatment decisions. To assess the utility of the ALBI-Sarcopenia score in predicting the success of HCC treatment. A prospective study involving 262 liver cirrhosis with HCC patients were assigned to various treatment strategies according to Barcelona clinics of liver disease (BCLC) classification. Patients were followed up for 12 months reporting laboratory data, sarcopenia, ALBI-Sarcopenia score, and outcomes. Sarcopenia was prevalent in 43.1% (48.35% males and 31.25% females, P = 0.042). Most patients were HCV-positive (88.9%) and classified as CTP A (55.7%) or BCLC B (54.2%). Over the study period, TACE was the most administered treatment (41.2% at baseline), followed by a progressive shift toward best supportive care as disease severity increased. Complete response rates declined from 31.7% at 1 month to 21.4% at 12 months, while progressive disease rates increased from 21.8 to 37.8% over the same period. At 12 months, the ALBI-Sarcopenia score demonstrated the highest predictive accuracy for treatment response (AUC:0.69, p = 0.001), outperforming both the ALBI (AUC: 0.631, p = 0.001) and MELD (AUC:0.623, p = 0.003) scores. Logistic regression identified ALBI-Sarcopenia as a significant independent predictor of response at 1 month (OR:1.25, 95% CI:0.881-1.971, p = 0.002) and 12 months (OR:2.189, 95% CI:0.992-4.937, p = 0.001). The ALBI-Sarcopenia score is a robust predictor of treatment outcomes in HCC, offering superior prognostic accuracy compared to traditional scoring systems, and enhancing patient stratification for optimized treatment planning.

Impact of Sarcopenia and Functional Relationships Between Balance and Gait After Total Hip Arthroplasty

Background/Objectives: Total hip arthroplasty (THA) is an effective surgical intervention for restoring hip function and alleviating pain caused by osteoarthritis, femoral head avascular necrosis, or fractures. Despite its benefits, postoperative recovery is influenced by various factors, among which sarcopenia plays a critical role. This study aimed to analyze the characteristics of sarcopenia in THA patients admitted to a convalescent rehabilitation hospital and examine its relationship with functional variables such as balance and gait independence. Methods: This cross-sectional study included 84 THA patients, categorized into sarcopenia and non-sarcopenia groups using the Asian Working Group for Sarcopenia 2019 criteria. Data were collected on demographic characteristics (e.g., age, gender, height, weight, range of motion (ROM), manual muscle test (MMT)) and functional variables, including balance (Berg Balance Scale, BBS) and gait independence (Functional Ambulation Category, FAC). Results: The prevalence of sarcopenia among THA patients was 44.05%. Significant differences were observed between the sarcopenia and non-sarcopenia groups in sex, age, height, weight, ROM, MMT, BBS, and FAC (p < 0.05). Logistic regression analysis showed that advanced age increased the likelihood of sarcopenia (OR: 1.072, p < 0.05), whereas higher body weight reduced it (OR: 0.784, p < 0.05). However, sarcopenia was not significantly associated with balance (BBS: p = 0.710) or gait independence (FAC: p = 0.990). Instead, a significant positive correlation was found between FAC and BBS (OR: 0.413, p < 0.001), as well as BBS and FAC (OR: 0.467, p < 0.001), indicating that better balance was associated with greater gait independence and vice versa. Additionally, patients who underwent THA due to fractures had a lower FAC compared to those with osteoarthritis (OR: -0.276, p = 0.018). Conclusions: Sarcopenia is prevalent among THA patients, and functional variables such as balance and gait independence are closely associated. Additionally, age and body weight were identified as key factors related to sarcopenia. These findings emphasize the importance of early detection and management of sarcopenia in rehabilitation hospital settings and highlight the significance of functional variables in recovery.

A review of sarcopenia pathogenesis and therapeutic approaches: resistance exercise, nutrition, and monoterpenes

PURPOSE

Sarcopenia, characterized by the age-related loss of muscle mass and function, is a multifactorial condition influenced by oxidative stress, hormonal changes, and chronic inflammation. This study investigated the effects of resistance exercise and nutritional interventions, including antioxidants, such as monoterpenes, on sarcopenia prevention and treatment.

METHODS

To identify relevant studies, a comprehensive literature search was conducted using electronic databases including PubMed and Google Scholar. Keywords such as "sarcopenia," "resistance exercise," "antioxidants," "nutrition," "muscle regeneration," and related terms were utilized to gather evidence on the prevention and management of sarcopenia.

RESULTS

This review focuses on the etiological factors of sarcopenia, particularly the decline in muscle function and acceleration of muscle protein degradation. This highlights the critical importance of the combined effects of exercise and nutrition in overcoming these challenges, with special emphasis on the potential of antioxidant intake as a promising solution for managing this condition.

CONCLUSION

An integrated approach combining periodic resistance exercise with antioxidant-rich nutritional strategies is essential for the management of sarcopenia. By promoting muscle development and inhibiting protein breakdown, this dual strategy provides an effective framework for preventing and treating sarcopenia, and improving quality of life of the aging population. Further studies are warranted to explore the clinical potential of monoterpenes in the treatment of sarcopenia.

Roles of hypoxia-inducible factor-prolyl hydroxylases in aging and disease

The prolyl hydroxylase domain-containing (PHD or EGL9-homologs) enzyme family is mainly known for its role in the cellular response to hypoxia. HIF-PH inhibitors can stabilize hypoxia-inducible factors (HIFs), activating transcriptional programs that promote processes such as angiogenesis and erythropoiesis to adapt to changes in oxygen levels. HIF-PH inhibitors have been clinically approved for treating several types of anaemia. While most discussions of the HIF-PH signalling axis focus on hypoxia, there is a growing recognition of its importance under normoxic conditions. Recent advances in PHD biology have highlighted the potential of targeting this pathway therapeutically for a range of aging-related diseases. In this article, we review these recent discoveries, situate them within the broader context of aging and disease, and explore current therapeutic strategies that target PHD enzymes for these indications.

Urban-rural differences in the prevalence and associated factors of sarcopenia: A systematic review and meta-analysis

BACKGROUND

Loss of muscle mass, muscle strength, and/or physical performance due to aging is known as sarcopenia. Regardless of how serious this illness is, no single diagnostic criteria have been established. Much research conducted recently has demonstrated differences between built environment characteristics (i.e., urban and rural) and the occurrence of sarcopenia; however, variations in sarcopenia prevalence in urban-rural areas around the world have been reported by fewer studies. This work sought to determine how sarcopenia prevalence varied between urban and rural areas and to explore the associated influencing factors.

METHODS

Using the pertinent MESH phrases and free words, PubMed, Web of Science, Embase, and China national knowledge infrastructure databases were scanned for core sarcopenia literature up to February 26, 2023. Observational studies involving urban-rural patients with sarcopenia published in Chinese and English, and assessing muscle mass via computed tomography, bioelectrical impedance, or dual-energy X-ray absorption techniques were considered as inclusion criteria. The meta-analysis involved analysis of the urban-rural prevalence in subgroups by diagnostic criteria, tools for assessing muscle mass and study type, as well as the factors related to urban-rural differences in the occurrence of sarcopenia. STATA version 11.0 was used to perform the statistical analysis.

RESULTS

Sixty-six articles involving 433,091 participants were included for analysis: of which 27 were analyzed for both prevalence and related factors whereas 39 were for only prevalence. The meta-analysis revealed the prevalence of sarcopenia to be 0.18 (95 % CI 0.14-0.22), with significant heterogeneity (P < 0.001; I2 = 99.9 %). Moreover, the prevalence of sarcopenia in urban group [0.16 (I2 = 99.9 %, 95 % CI 0.1-0.22)] was lower than in rural group [0.2 (I2 = 99.6 %, 95 % CI 0.16-0.25)] and urban-rural group [0.21 (I2 = 97.5 %, 95 % CI 0.16-0.25)]. Besides, the factors significantly associated with sarcopenia in urban-rural areas were age, gender, BMI, malnutrition, physical activity, and polypharmacy. There was significant heterogeneity between these factors and the association of sarcopenia.

CONCLUSIONS

Sarcopenia is associated with aspects of the built environment, and studies have revealed that sarcopenia is more common in rural than in urban populations with influencing factors including age, gender, BMI, poor nutrition, insufficient physical activity, and polypharmacy. The lack of uniform diagnostic criteria makes a robust and comprehensive assessment difficult. Therefore, the formation of certain universal and standardized diagnostic criteria will help future research on sarcopenia.

Sex-Specific Sarcopenia Prevalence and Risk Factors in the Korean Population: A Cross-Sectional Epidemiological Study

Background and Objective: This study aimed to identify the incidence of sarcopenia and disease risk factors in Korean adults and to provide data for sarcopenia prevention. Materials and Methods: Based on the Korea National Health and Nutrition Survey, 2008-2011, we selected 14,185 adults over the age of 20 who participated in sarcopenia diagnostic tests and health surveys. We analyzed sarcopenia risk factors using complex sample multi-logistic regression analysis. Results: The prevalence of sarcopenia in Korea was 31.3%, with 20.2% in men and 40.4% in women. In men, there was a higher risk of sarcopenia in those of older age, without a spouse, with a low body mass index (BMI), who never engage in resistance exercise, or who do mid-level intensity resistance exercises. In women, sarcopenia risk was higher in those in their 20s compared to those in their 60s, and risk factors included a low BMI, high-density lipoprotein cholesterol and waist circumference measurements, alcohol consumption, aerobic exercise, and resistance exercise. Conclusions: Interventions and lifestyle improvements will help prevent the onset of sarcopenia in elderly men and young women with risk factors such as a low BMI.

Different Diagnostic Criteria for Determining the Prevalence of Sarcopenia in Older Adults: A Systematic Review

Background: Sarcopenia is defined as a loss of muscle mass, strength, and physical function associated with aging. It is due to a combination of genetic, environmental, and physiological factors. It is also associated with an increased risk of health problems. Since there are many different researchers in the field, with their own algorithms and cut-off points, there is no single criterion for diagnosis. This review aims to compare the prevalence of sarcopenia according to these different diagnostic criteria in older adult populations by age group and sex. Methods: Different databases were searched: Web of Science, Pubmed, Dialnet, Scopus, and Cochrane. The keywords used were "sarcopenia", "diagnosis", "prevalence", "assessment", "aged", "aging" and "older". Studies conducted in a population aged ≥65 assessing the prevalence of sarcopenia were selected. Results: Nineteen articles met the inclusion criteria, with a total of 33,515 subjects, 38.08% female and 61.42% male, at a mean age of 74.52. The diagnostic algorithms used were 52.63% AWGS2, 21.05% EWGSOP2, 10.53% AWGS1 and EWGS1, and 5.26% FNIH. Prevalence ranged from 1.7% to 37.47%, but was higher in males and increased with age. Conclusions: The prevalence of sarcopenia varies depending on the diagnostic algorithm used, but it increases with age and is higher in men. The EWGSOP2 and AWGS2 are the most used diagnostic criteria and measure the same variables but have different cut-off points. Of these two diagnostic algorithms, the one with the highest prevalence of sarcopenia and severe sarcopenia is the AWGS2. These differences may be due to the use of different tools and cut-off points. Therefore, a universal diagnostic criterion should be developed to allow early diagnosis of sarcopenia.

Prevalence of sarcopenia and depressive symptoms among older adults: a scoping review

Sarcopenia causes a loss of skeletal muscle mass and decreases muscle strength and function. Depressive symptoms are a common cause of distress among geriatrics, significantly affecting the quality of life of older adults. Recently, studies have shown that a correlation exists between sarcopenia and depression. To determine the prevalence of sarcopenia and depressive symptoms and identify the factors associated with sarcopenia, we systematically searched the SCOPUS, Science Direct, and PubMed databases for papers on sarcopenia and depressive symptoms published from 2012 to 2022. We reviewed the literature on sarcopenia, depressive symptom prevalence, the prevalence of subjects with both sarcopenia and depressive symptoms, and the factors associated with sarcopenia. Only cross-sectional studies were included. Nineteen articles met the inclusion criteria for review, with overall sarcopenia prevalence ranging from 3.9% to 41.7%. The prevalence of depressive symptoms was reported in seven studies, ranging from 8.09% to 40%. The most commonly used tools to diagnose sarcopenia and depressive symptoms were the European Working Group on Sarcopenia in Older People consensus and the Geriatric Depression Scale, respectively. Being aged, malnourished, obese, having comorbidities (hypertension and diabetes), having impaired cognitive function, and having polypharmacy were found to be the factors associated with sarcopenia. Sarcopenia and depressive symptoms have been found to cause adverse health outcomes among older people. Appropriate nutritional assessments and interventions should be taken to manage these two geriatric conditions. Further studies should be planned, considering multidomain intervention strategies to improve sarcopenia and older people's mental health.

Association Between Advanced Glycation End Products and Sarcopenia: The Mediating Role of Osteoporosis

CONTEXT

Advanced glycation end products (AGEs) are a group of molecules formed through nonenzymatic reactions. These compounds are associated with several age-related diseases, including sarcopenia and osteoporosis.

OBJECTIVE

This work aimed to investigate the relationships between AGEs, osteoporosis, and sarcopenia in community-dwelling older adults.

METHODS

This cross-sectional study included 1991 older adults aged 72.37 ± 5.90 years from China. AGE levels were measured by the AGE Reader device. Bone mineral density was assessed using dual-energy X-ray absorptiometry, and osteoporosis was diagnosed based on a T score of less than -2.5. Sarcopenia was defined as loss of muscle mass plus loss of muscle strength and/or reduced physical performance. Presarcopenia was defined as low muscle mass with normal muscle strength and normal physical performance.

RESULTS

The prevalence of sarcopenia was 18.5%, and that of osteoporosis was 40.5%. Compared to the lowest AGE quartile, the highest AGE quartile showed a significant association with sarcopenia (odds ratio [OR] 2.42; 95% CI, 1.60-3.66) (P for trend <.001), but not with presarcopenia. Per-SD increase in AGE was associated with higher odds of sarcopenia (OR 1.44; 95% CI, 1.26-1.66). Additionally, in the mediation analysis, when AGEs were treated as a continuous variable (the mediation effect is denoted by Za*Zb = 18.81; 95% CI, 8.07-32.32]-the 95% CI does not contain zero, representing a significant mediating effect) or a categorical variable (the mediating effect is expressed as Zmediation = 3.01 > 1.96, which represents a significant mediating effect), osteoporosis played a partial mediating role in the association between AGEs and sarcopenia.

CONCLUSION

Elevated AGEs are associated with sarcopenia but not with presarcopenia. This association was partially mediated by osteoporosis.

Prevalence of osteoporosis, sarcopenia, and high falls risk in healthy community-dwelling Thai older adults: a nationwide cross-sectional study

Thailand has transitioned from an aging society to an aged society, which implies that the prevalence of age-related disorders will increase; however, epidemiological data specific to the prevalence of age-related degenerative musculoskeletal disorders among Thai older adults remain limited. Accordingly, the aim of this study was to investigate the prevalence of age-related musculoskeletal diseases, including osteoporosis, sarcopenia, and high falls risk among healthy community-dwelling Thai older adults. This cross-sectional nationwide study enrolled Thai adults aged ≥60 yr from 2 randomly selected provinces from each of the 6 regions of Thailand via stratified multistage sampling during March 2021 to August 2022. All enrolled participants were evaluated for BMD, skeletal muscle mass, grip strength, and gait speed. Osteoporosis was diagnosed according to the World Health Organization definition, and sarcopenia was diagnosed according to the Asian Working Group for Sarcopenia (AWGS) 2019 criteria. Falls risk was determined using the self-rated Fall Risk Questionnaire. A total of 2991 eligible participants were recruited. The mean age of participants was 69.2 ± 6.5 yr (range: 60-107), and 63.1% were female. The prevalence of osteoporosis, sarcopenia, and high falls risk was 29.7%, 18.1%, and 38.5%, respectively. Approximately one-fifth of subjects (19.1%) had at least 2 of 3 risk factors (ie, osteoporosis, sarcopenia, and high falls risk) for sustaining a fragility fracture, and 3.4% had all 3 risk factors. In conclusion, the results of this study revealed a high and increasing prevalence of osteoporosis, sarcopenia, and high falls risk in healthy community-dwelling Thai older adults. Since these conditions are all major risk factors for fragility fracture, modification of Thailand's national health care policy is urgently needed to address the increasing prevalence of these conditions among healthy community-dwelling older adults living in Thailand.

Sarcopenic Obesity as a Risk Factor for Cardiovascular Disease: An Underrecognized Clinical Entity

Sarcopenic obesity (SO) is a chronic condition and an emerging health challenge, in view of the growing elderly population and the obesity epidemic. Due to a lack of awareness among treating doctors and the non-specific nauture of the associated symptoms, SO remains grossly underdiagnosed. There is no consensus yet on a standard definition or diagnostic criteria for SO, which limits the estimation of the global prevalence of this condition. It has been linked to numerous metabolic derangements, cardiovascular disease (CVD) and mortality. The treatment of SO is multimodal and requires expertise across multiple specialties. While dietary modifications and exercise regimens have shown a potential therapeutic benefit, there is currently no proven pharmacological management for SO. However, numerous drugs and the role of bariatric surgery are still under trial, and have great scope for further research. This article covers the available literature regarding the definition, diagnostic criteria, and prevalence of SO, with available evidence linking it to CVD, metabolic disease and mortality, and an overview of current directives on management.

Prevalence of sarcopenia in older women and level of agreement between the diagnostic instruments proposed by the European Working Group on Sarcopenia in Older People 2 (EWGSOP2)

BACKGROUND

The European Working Group on Sarcopenia in Older People 2 (EWGSOP2) proposed the use of different diagnostic tools to assess sarcopenia. This study aimed to determine prevalence rates of sarcopenia according to the diagnostic instruments proposed by EWGSOP2 and to assess their level of agreement in older Brazilian women.

METHODS

A cross-sectional study with 161 community-dwelling older Brazilian women. Probable sarcopenia was assessed through Handgrip Strength (HGS) and the 5-times sit-to-stand test (5XSST). In addition to reduced strength, Appendicular Skeletal Muscle Mass (ASM) (obtained by Dual-energy X-ray absorptiometry) and ASM/height² were considered for diagnosis confirmation. Sarcopenia severity was determined by reduced muscle strength and mass and poor functional performance assessed by Gait Speed (GS), Short Physical Performance Battery (SPPB), and Timed Up and Go test (TUG). McNemar's test and Cochran's Q-test were used to compare sarcopenia prevalence. Cohen's Kappa and Fleiss's Kappa tests were used to assess the level of agreement.

RESULTS

The prevalence of probable sarcopenia was significantly different (p < 0.05) when using HGS (12.8%) and 5XSST (40.6%). Regarding confirmed sarcopenia, the prevalence was lower when using ASM/height² than with ASM. Regarding severity, the use of SPPB resulted in a higher prevalence in relation to GS and TUG.

CONCLUSION

There were differences in the prevalence rates of sarcopenia and low agreement between the diagnostic instruments proposed by the EWGSOP2. The findings suggest that these issues must be considered in the discussion on the concept and assessment of sarcopenia, which could ultimately help to better identify patients with this disease in different populations.

Prevalence of sarcopenia and its association with clinical outcomes in heart failure: An updated meta-analysis and systematic review

BACKGROUND

Sarcopenia is thought to be strongly associated with heart failure, but meta-analyses with sufficient samples are still lacking to accurately address its clinical situation.

HYPOTHESIS

Sarcopenia has a high prevalence in patients with heart failure and is closely related to adverse clinical outcomes.

METHODS

Relevant databases were systematically searched in October 2021 and updated in July 2022. The data with high heterogeneity were combined with random effects model.

RESULTS

Twenty-one studies with 68,556 HF patients were included. The combined prevalence of sarcopenia in HF patients was 31%. Subgroup analysis found that the prevalence of sarcopenia in HF patients was 35% in Asia, 31% in Europe, 25% in the Americas, 31% in people aged ≥65 years, 25% in people with age <65 years, 28% in HF with reduced ejection fraction (HFrEF) patients and 18% in HF with preserved ejection fraction (HFpEF) patients. In addition, our analysis shows that sarcopenia in patients with HF is associated with an increased risk of poor prognosis, with a combined hazard ratio [HR] of 1.64 (95% confidence interval [CI] = 1.20-5.25), sarcopenia was also associated with poor outcomes in HFrEF patients with pooled HR of 2.77 (95% CI = 1.29-5.95). However, it was not associated with poor outcomes in HFpEF patients with pooled HR of 1.61 (95% CI = 0.82-3.16).

CONCLUSIONS

The prevalence of sarcopenia is high in HF patients, and patients with HF, particularly those with reduced ejection fraction, are at high risk of adverse outcomes from sarcopenia. Therefore, early identification and intervention for sarcopenia were beneficial for improving the prognosis of HF patients.