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Wang C, Wang J, Wan R, Kurihara H, Wang M. The causal association between circulating cytokines with the risk of frailty and sarcopenia under the perspective of geroscience. Front Endocrinol (Lausanne) 2024; 15:1293146. [PMID: 38505750 PMCID: PMC10948489 DOI: 10.3389/fendo.2024.1293146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 02/12/2024] [Indexed: 03/21/2024] Open
Abstract
Introduction Circulating cytokines were considered to play a critical role in the initiation and propagation of sarcopenia and frailty from observational studies. This study aimed to find the casual association between circulating cytokines and sarcopenia and frailty from a genetic perspective by two-sample Mendelian randomization (MR) analysis. Methods Data for 41 circulating cytokines were extracted from the genome-wide association study dataset of 8,293 European participants. Inverse-variance weighted (IVW) method, MR-Egger, and weighted median method were applied to assess the relationship of circulating cytokines with the risk of aging-related syndromes and frailty. Furthermore, MR-Egger regression was used to indicate the directional pleiotropy, and Cochran's Q test was used to verify the potential heterogeneity. The "leave-one-out" method was applied to visualize whether there was a causal relationship affected by only one anomalous single-nucleotide polymorphisms. Results Genetic predisposition to increasing levels of interleukin-10 (IL-10), IL-12, and vascular endothelial growth factor (VEGF) was associated with the higher risk of low hand grip strength according to the IVW method [R = 1.05, 95% CI = 1.01-1.10, P = 0.028, false discovery rate (FDR)-adjusted P = 1.000; OR = 1.03, 95% CI = 1.00-1.07, P = 0.042, FDR-adjusted P = 0.784; OR = 1.02, 95% CI = 1.00-1.05, P = 0.038, FDR-adjusted P = 0.567]. Furthermore, genetically determined higher macrophage colony-stimulating factors (M-CSFs) were associated with a lower presence of appendicular lean mass (OR = 1.01, 95% CI = 1.00-1.02, P = 0.003, FDR-adjusted P = 0.103). Monokine induced by interferon-γ (MIG) and tumor necrosis factor-beta (TNF-β) were associated with a higher risk of frailty (OR = 1.03, 95% CI = 1.01-1.05, P < 0.0001, FDR-adjusted P = 0.012; OR = 1.01, 95% CI = 1.00-1.03, P = 0.013, FDR-adjusted P = 0.259). In this study, we did not find heterogeneity and horizontal pleiotropy between the circulating cytokines and the risk of frailty and sarcopenia. Conclusion Genetic predisposition to assess IL-10, IL-12, and VEGF levels was associated with a higher risk of low hand grip strength and M-CSF with the presence of appendicular lean mass. The high levels of TNF-β and MIG were associated with a higher risk of frailty. More studies will be required to explore the molecular biological mechanisms underlying the action of inflammatory factors.
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Affiliation(s)
- Congzhi Wang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Jiazhi Wang
- Sports Institute, Chi Zhou College, Chizhou, Anhui, China
| | - Rui Wan
- Business School, Yunnan University of Finance and Economics, Kunming, Yunnan, China
| | - Hiroshi Kurihara
- Guangdong Engineering Research Center of Chinese Medicine and Disease Susceptibility/International Cooperative Laboratory of Traditional Chinese Medicine (TCM), Modernization, and Innovative Drug Development of Chinese Ministry of Education (MOE)/Guangdong Province Key Laboratory of Pharmacodynamic Constituents of Traditional Chinese Medicine (TCM) and New Drugs Research, Jinan University, Guangzhou, China
| | - Min Wang
- Department of Pharmacy, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, Hainan, China
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Zhang Y, Zheng Z, Gu M, Wu Y, Li C. Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome may present with extra-articular and cutaneous manifestations. Int J Rheum Dis 2024; 27:e15093. [PMID: 38443985 DOI: 10.1111/1756-185x.15093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 02/05/2024] [Accepted: 02/07/2024] [Indexed: 03/07/2024]
Affiliation(s)
- YuRu Zhang
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - ZiXiang Zheng
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - MengJiao Gu
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - YuanHao Wu
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Chen Li
- Fangshan Hospital, Beijing University of Chinese Medicine, Beijing, China
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Lee S, Lee M, Kim YE, Kim HK, Lee SJ, Kim J, Yang Y, Kim CH, Lee H, Joo DJ, Kim MS, Kang ES. Association of Muscle Mass Loss with Diabetes Development in Liver Transplantation Recipients. Diabetes Metab J 2024; 48:146-156. [PMID: 38173368 PMCID: PMC10850281 DOI: 10.4093/dmj.2022.0100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 02/27/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGRUOUND Post-transplant diabetes mellitus (PTDM) is one of the most significant complications after transplantation. Patients with end-stage liver diseases requiring transplantation are prone to sarcopenia, but the association between sarcopenia and PTDM remains to be elucidated. We aimed to investigate the effect of postoperative muscle mass loss on PTDM development. METHODS A total of 500 patients who underwent liver transplantation at a tertiary care hospital between 2005 and 2020 were included. Skeletal muscle area at the level of the L3-L5 vertebrae was measured using computed tomography scans performed before and 1 year after the transplantation. The associations between the change in the muscle area after the transplantation and the incidence of PTDM was investigated using a Cox proportional hazard model. RESULTS During the follow-up period (median, 4.9 years), PTDM occurred in 165 patients (33%). The muscle mass loss was greater in patients who developed PTDM than in those without PTDM. Muscle depletion significantly increased risk of developing PTDM after adjustment for other confounding factors (hazard ratio, 1.50; 95% confidence interval, 1.23 to 1.84; P=0.001). Of the 357 subjects who had muscle mass loss, 124 (34.7%) developed PTDM, whereas of the 143 patients in the muscle mass maintenance group, 41 (28.7%) developed PTDM. The cumulative incidence of PTDM was significantly higher in patients with muscle loss than in patients without muscle loss (P=0.034). CONCLUSION Muscle depletion after liver transplantation is associated with increased risk of PTDM development.
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Affiliation(s)
- Sejeong Lee
- Graduate School, Yonsei University College of Medicine, Seoul, Korea
- Division of Endocrinology and Metabolism, Department of Internal Medicine, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Korea
| | - Minyoung Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Young-Eun Kim
- Graduate School, Yonsei University College of Medicine, Seoul, Korea
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Hae Kyung Kim
- Graduate School, Yonsei University College of Medicine, Seoul, Korea
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Sook Jung Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jiwon Kim
- Graduate School, Yonsei University College of Medicine, Seoul, Korea
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Yurim Yang
- Department of Pharmacology, Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, Korea
| | - Chul Hoon Kim
- Department of Pharmacology, Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, Korea
| | - Hyangkyu Lee
- Mo-Im Kim Nursing Research Institute, Biobehavioral Research Center, Yonsei University College of Nursing, Seoul, Korea
| | - Dong Jin Joo
- Division of Transplantation, Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Myoung Soo Kim
- Division of Transplantation, Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Eun Seok Kang
- Graduate School, Yonsei University College of Medicine, Seoul, Korea
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
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Tam K, Wong-Pack M, Liu T, Adachi J, Lau A, Ma J, Papaioannou A, Rodrigues IB. Risk Factors and Clinical Outcomes Associated With Sarcopenia in Rheumatoid Arthritis: A Systematic Review and Meta-analysis. J Clin Rheumatol 2024; 30:18-25. [PMID: 37092889 DOI: 10.1097/rhu.0000000000001980] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Abstract
ABSTRACT Sarcopenia is underrecognized in patients with rheumatoid arthritis (RA). Risk factors of sarcopenia and its impact on outcomes in RA patients are relatively unknown. We conducted a systematic review to identify factors and outcomes associated with sarcopenia in RA. We conducted this review according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 guidelines. We searched PubMed, Embase, CINAHL, and Web of Science databases by combining the following search concepts: (1) RA and (2) sarcopenia. Articles were included if they included RA patients, assessed for sarcopenia using a consensus working group definition, and assessed for clinical outcomes. Meta-analysis was performed using studies that shared the same sarcopenia definition and consistency in reporting patient or disease variables. Our search identified 3602 articles. After removal of duplicates, title and abstract screen, and full-text review, 16 articles were included for final analysis. All studies had observational study designs. The pooled prevalence of sarcopenia ranged from 24% to 30%, depending on the criteria for sarcopenia used. Factors associated with sarcopenia included higher 28-joint Disease Activity Scale scores (+0.39; 95% confidence interval, +0.02 to +0.77) and baseline methotrexate use (odds ratio, 0.70; 95% confidence interval, 0.51-0.97). Baseline glucocorticoid use had a positive correlation with sarcopenia in multiple studies. Several studies found lower bone mineral density and higher incidence of falls and fractures in patients with sarcopenia. Sarcopenia is prevalent in RA, and it may be associated with higher RA disease activity, lower bone mineral density, and increased falls and fractures. Therefore, early screening of sarcopenia in RA patients is important to incorporate into clinical rheumatology practice.
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Affiliation(s)
- Keith Tam
- From the Department of Rheumatology, McMaster University, Hamilton
| | | | | | | | | | - Jinhui Ma
- GERAS Centre for Aging Research, Hamilton Health Sciences
| | | | - Isabel B Rodrigues
- Division of Geriatric Medicine, Department of Medicine, McMaster University, Hamilton, Ontario, Canada
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Oliveira VHF, Webel AR, Borsari AL, Cárdenas JDG, Deminice R. Health and sociodemographic factors associated with low muscle strength, muscle mass, and physical performance among people living with HIV. AIDS Care 2023; 35:1863-1873. [PMID: 36404290 DOI: 10.1080/09540121.2022.2147482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 11/09/2022] [Indexed: 11/22/2022]
Abstract
ABSTRACTThis study examined the factors associated with low muscle strength, muscle mass, and physical performance in 331 people living with HIV. Participants completed handgrip as a strength measure, appendicular skeletal muscle mass using bioimpedance analysis, and chair rise was a physical performance measure. Multivariate logistic regression was used to analyze the association between low values on these measures with sociodemographic, HIV-related factors, and comorbidities. Higher body mass index (BMI) (OR = 0.91; CI = 0.86-0.97) and higher CD4/CD8 ratio (OR = 0.38; 95% CI = 0.18-0.82) were associated with decreased likelihood of low handgrip strength. Being non-employed (OR = 2.08; 95% CI = 1.07-4.06), having hypertension (OR = 2.27; 95% CI = 1.13-4.54) and rheumatism (OR = 5.46; 95% CI = 1.68-17.74) increased the chance of low handgrip strength. Higher BMI (OR = 0.43; 95% CI = 0.34-0.56), CD4/CD8 ratio (OR = 0.29; 95% CI = 0.09-0.93), and bioimpedance phase angle (OR = 0.22; 95% CI = 0.12-0.40) were associated with decreased likelihood of low muscle mass. Lastly, having less than eight years of education (OR = 1.87; 95% CI = 1.02-3.41) and being non-employed (OR = 8.18; 95% CI = 3.09-21.61) increased the chance of low chair stand performance. In addition, higher CD4 + lymphocytes count (OR = 0.99; 95% CI = 0.99-0.99) was associated with a decreased likelihood of low chair stand performance. In conclusion, specific and non-specific HIV-related factors are associated with low handgrip strength, low muscle mass, and/or low chair stand performance.
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Affiliation(s)
- Vitor H F Oliveira
- Department of Child, Family, and Population Health Nursing, School of Nursing, University of Washington, Seattle, WA, USA
| | - Allison R Webel
- Department of Child, Family, and Population Health Nursing, School of Nursing, University of Washington, Seattle, WA, USA
| | - Ana Lucia Borsari
- Department of Physical Education, Londrina State University, Londrina, Brazil
| | | | - Rafael Deminice
- Department of Physical Education, Londrina State University, Londrina, Brazil
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Bilski J, Schramm-Luc A, Szczepanik M, Mazur-Biały AI, Bonior J, Luc K, Zawojska K, Szklarczyk J. Adipokines in Rheumatoid Arthritis: Emerging Biomarkers and Therapeutic Targets. Biomedicines 2023; 11:2998. [PMID: 38001998 PMCID: PMC10669400 DOI: 10.3390/biomedicines11112998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 11/05/2023] [Accepted: 11/06/2023] [Indexed: 11/26/2023] Open
Abstract
Rheumatoid arthritis (RA) is a chronic inflammatory disease manifested by joint involvement, extra-articular manifestations, and general symptoms. Adipose tissue, previously perceived as an inert energy storage organ, has been recognised as a significant contributor to RA pathophysiology. Adipokines modulate immune responses, inflammation, and metabolic pathways in RA. Although most adipokines have a pro-inflammatory and aggravating effect on RA, some could counteract this pathological process. The coexistence of RA and sarcopenic obesity (SO) has gained attention due to its impact on disease severity and outcomes. Sarcopenic obesity further contributes to the inflammatory milieu and metabolic disturbances. Recent research has highlighted the intricate crosstalk between adipose tissue and skeletal muscle, suggesting potential interactions between these tissues in RA. This review summarizes the roles of adipokines in RA, particularly in inflammation, immune modulation, and joint destruction. In addition, it explores the emerging role of adipomyokines, specifically irisin and myostatin, in the pathogenesis of RA and their potential as therapeutic targets. We discuss the therapeutic implications of targeting adipokines and adipomyokines in RA management and highlight the challenges and future directions for research in this field.
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Affiliation(s)
- Jan Bilski
- Department of Biomechanics and Kinesiology, Chair of Biomedical Sciences, Institute of Physiotherapy, Faculty of Health Sciences, Jagiellonian University Medical College, 31-008 Krakow, Poland; (A.I.M.-B.); (K.Z.)
| | - Agata Schramm-Luc
- Department of Internal and Agricultural Medicine, Faculty of Medicine, Jagiellonian University Medical College, 31-121 Krakow, Poland; (A.S.-L.); (K.L.)
| | - Marian Szczepanik
- Chair of Biomedical Sciences, Institute of Physiotherapy, Faculty of Health Sciences, Jagiellonian University Medical College, 31-034 Krakow, Poland;
| | - Agnieszka Irena Mazur-Biały
- Department of Biomechanics and Kinesiology, Chair of Biomedical Sciences, Institute of Physiotherapy, Faculty of Health Sciences, Jagiellonian University Medical College, 31-008 Krakow, Poland; (A.I.M.-B.); (K.Z.)
| | - Joanna Bonior
- Department of Medical Physiology, Chair of Biomedical Sciences, Institute of Physiotherapy, Faculty of Health Sciences, Jagiellonian University Medical College, 31-126 Krakow, Poland; (J.B.); (J.S.)
| | - Kevin Luc
- Department of Internal and Agricultural Medicine, Faculty of Medicine, Jagiellonian University Medical College, 31-121 Krakow, Poland; (A.S.-L.); (K.L.)
| | - Klaudia Zawojska
- Department of Biomechanics and Kinesiology, Chair of Biomedical Sciences, Institute of Physiotherapy, Faculty of Health Sciences, Jagiellonian University Medical College, 31-008 Krakow, Poland; (A.I.M.-B.); (K.Z.)
| | - Joanna Szklarczyk
- Department of Medical Physiology, Chair of Biomedical Sciences, Institute of Physiotherapy, Faculty of Health Sciences, Jagiellonian University Medical College, 31-126 Krakow, Poland; (J.B.); (J.S.)
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Carvalho BMD, Silva RSC, Lima VVMD, Almondes KGDS, Rodrigues FNS, D'Almeida JAC, Melo MLPD. Excess weight increases the risk of sarcopenia in patients with multiple sclerosis. Mult Scler Relat Disord 2023; 79:105049. [PMID: 37864991 DOI: 10.1016/j.msard.2023.105049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 09/25/2023] [Accepted: 10/01/2023] [Indexed: 10/23/2023]
Abstract
BACKGROUND Multiple sclerosis (MS) is an autoimmune neurodegenerative disease. Nutritional status influences the course of the disease, however, its relationship with sarcopenia needs further investigation. The aim of the study was to identify patients with sarcopenia and assess its association with nutritional status and the clinical course of the disease. METHODS The study assessed 110 patients submitted to evaluation of sociodemographic characteristics, level of physical activity, nutritional status, and presence of sarcopenia. The clinical course of the disease, age at onset, disease duration, disease-modifying therapy, and expanded scale of disability status (EDSS) were investigated. RESULTS Mean age was 37.17 (SD = 10.60) years, disease duration was 6.29 years (SD = 4.65), with a predominance of female gender (80.90 %), relapsing-remitting clinical form (RRMS) (89.10 %) and mild level of disability (EDSS median = 1.92). The group had excess weight (53.6 %) according to body mass index (BMI) and abdominal fat accumulation measured by waist circumference (WC) (53.6 %). High percentage of fat mass ( % FM) was observed in 54.5 % and 38.2 % of the patients according to bioimpedance (BIA) and ultrasound (US), respectively. It was observed that 15.5 % were at risk for sarcopenia, which was associated with excess weight, and high % FM (p<0.05). CONCLUSION These findings highlight the importance of including nutritional status indicators, and sarcopenia assessment in the care of patients with MS.
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Affiliation(s)
- Beatriz Melo de Carvalho
- Postgraduate Programme in Nutrition and Health, State University of Ceará (UECE), Fortaleza, Brazil
| | | | | | | | | | - José Artur Costa D'Almeida
- Interdisciplinary Multiple Sclerosis Centre, Department of Neurology, Fortaleza General Hospital (HGF), Fortaleza, Brazil
| | - Maria Luísa Pereira de Melo
- Postgraduate Programme in Nutrition and Health, State University of Ceará (UECE), Fortaleza, Brazil; Interdisciplinary Multiple Sclerosis Centre, Department of Neurology, Fortaleza General Hospital (HGF), Fortaleza, Brazil.
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Li HH, Livneh H, Huang HL, Wang YH, Lu MC, Chen WJ, Tsai TY. Integrating Chinese Herbal Medicine into Conventional Care Was Related to Lower Risk of Sarcopenia Among Rheumatid Arthritis Patients: A Retrospective, Population-Based Study. J Multidiscip Healthc 2023; 16:3117-3127. [PMID: 37901596 PMCID: PMC10612505 DOI: 10.2147/jmdh.s428948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 09/28/2023] [Indexed: 10/31/2023] Open
Abstract
Objective Sarcopenia is a frequently observed comorbidity of rheumatoid arthritis (RA) due to the chronic activation of the innate immune system. Accumulating evidence has indicated that Chinese herbal medicine (CHM) safely suppresses proinflammatory pathways and controls inflammation-associated disease, but its effect in reducing the risk of developing sarcopenia among RA subjects has not been established. We conducted a population-level cohort study to compare the sarcopenia risk in patients with RA who use or do not use CHM. Methods Using claims from a nationwide insurance database, we recruited patients with newly diagnosed RA and without sarcopenia between 2002 and 2010. Propensity score matching was applied to randomly select sets of CHM users and non-CHM users to compare the sarcopenia risk until the end of 2013. The risk of new-onset sarcopenia was assessed using the Cox proportional hazards model. Results As compared to non-CHM users, those receiving CHM treatment had a lower incidence of sarcopenia (7.69 vs 9.83 per 1000 person-years). CHM was correlated with a decreased chance of sarcopenia after controlling for potential covariates. Notably, use of CHM for more than two years may diminish the risk of getting sarcopenia by about 47% when taken as prescribed. Prescriptions of several herbal formulae may benefit the reduction of sarcopenia risk, such as Yan-Hu-Suo, Bei-Mu, Da-Huang, Huang Qin, Ping-Wei-San (PWS), Shu-Jing-Huo-Xue-Tang (SJHXT) and Chuan-Xiong-Cha-Tiao-San (CXCTS). Conclusion This study produced new evidence as it is the first to show that the longer duration of CHM use was correlated to reduced risk of sarcopenia in a dose-dependent manner, implying that CHM treatment could be embraced as a routine care strategy for preventing sarcopenia.
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Affiliation(s)
- Hsin-Hua Li
- Department of Chinese Medicine, Dalin Tzu Chi Hospital, The Buddhist Tzu Chi Medical Foundation, Chiayi, 62247, Taiwan
| | - Hanoch Livneh
- Rehabilitation Counseling Program, Portland State University, Portland, OR, 97207-0751, USA
| | - Hua-Lung Huang
- Department of Rehabilitation, Dalin Tzu Chi Hospital, The Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan
| | - Yu-Han Wang
- Center of Sports Medicine, Dalin Tzu Chi Hospital, The Buddhist Tzu Chi Medical Foundation, Chiayi, 62247, Taiwan
| | - Ming-Chi Lu
- Division of Allergy, Immunology and Rheumatology, Dalin Tzu Chi Hospital, The Buddhist Tzu Chi Medical Foundation, Chiayi, 62247, Taiwan
- School of Medicine, Tzu Chi University, Hualien, 97004, Taiwan
| | - Wei-Jen Chen
- Department of Chinese Medicine, Dalin Tzu Chi Hospital, The Buddhist Tzu Chi Medical Foundation, Chiayi, 62247, Taiwan
- Center of Sports Medicine, Dalin Tzu Chi Hospital, The Buddhist Tzu Chi Medical Foundation, Chiayi, 62247, Taiwan
- School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien, 97004, Taiwan
- Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan, 33301, Taiwan
| | - Tzung-Yi Tsai
- Department of Medical Research, Dalin Tzu Chi Hospital, The Buddhist Tzu Chi Medical Foundation, Chiayi, 62247, Taiwan
- Department of Nursing, Tzu Chi University of Science and Technology, Hualien, 97004, Taiwan
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, 70428, Taiwan
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Ding H, Lin X, Huang S, Liao J, Li Z, Chen L, Zhu L, Xie Y, Nie Q, Chen X. Suitable ultrasound screening method for older adults with disability to identify low muscle mass. Front Med (Lausanne) 2023; 10:1270176. [PMID: 37869165 PMCID: PMC10585103 DOI: 10.3389/fmed.2023.1270176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 09/19/2023] [Indexed: 10/24/2023] Open
Abstract
Objective This study aimed to investigate the accuracy and consistency of different ultrasound protocols for the measurement of gastrocnemius muscle (GM) thickness and to identify a suitable ultrasound scheme that can be used to detect the low muscle mass in older with disability. Materials and methods In this cross-sectional study, each participant underwent three different ultrasound protocols for the measurement of the GM thickness, and each measurement was repeated three times. The three measurement schemes were as follows: method A, lying on the examination bed in a prone position with legs stretched and relaxed and feet hanging outside the examination bed; method B, lateral right side lying position with legs separated (left leg flexed and right leg in a relaxed state); and method C, right side lying position with legs together and lower limb muscles in a relaxed state. The low muscle mass was determined by averaging two or three measurements of the GM thickness determined using different sonographic protocols. Results The study included 489 participants. The difference in the prevalence of low muscle mass identified between two and three replicates of the same measurement protocol ranged from 0 to 1.3%. Considering the three repeated measurements of the method A as the reference, the area under the curve (AUC) in different measurement schemes were 0.977-1 and 0.973-1 in males and females, respectively. Furthermore, male and female Kappa values from low to high were 0.773, 0.801, 0.829, 0.839, and 0.967 and 0.786, 0.794, 0.804, 0.819, and 0.984, respectively. Conclusion Different ultrasound measurement protocols showed high accuracy and consistency in identifying low muscle mass. Repeating the measurements two or three times was found to be feasible.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Xiaoyan Chen
- Zigong Psychiatric Research Center, Zigong Affiliated Hospital of Southwest Medical University, Zigong, Sichuan Province, China
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Tarantino G, Sinatti G, Citro V, Santini SJ, Balsano C. Sarcopenia, a condition shared by various diseases: can we alleviate or delay the progression? Intern Emerg Med 2023; 18:1887-1895. [PMID: 37490203 PMCID: PMC10543607 DOI: 10.1007/s11739-023-03339-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 06/01/2023] [Indexed: 07/26/2023]
Abstract
Sarcopenia is a severe condition common to various chronic diseases and it is reckoned as a major health problem. It encompasses many different molecular mechanisms that have been for a while discovered but not definitely clarified. Although sarcopenia is a disability status that leads to serious health consequences, the scarcity of suitable animal models has curtailed research addressing this disorder. Another limitation in the field of clinical investigation of sarcopenic patients is the lack of a generally accepted definition coupled with the difficulty of adopting common diagnostic criteria. In fact, both do not permit to clarify the exact prevalence rate and consequently limit physicians to establish any kind of therapeutical approach or, when possible, to adopt preventive measures. Unfortunately, there is no standardized cure, apart from doing more physical activity and embracing a balanced diet, but newly discovered substances start being considered. In this review, authors try to give an overview addressing principal pathways of sarcopenia and offer critical features of various possible interventions.
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Affiliation(s)
- Giovanni Tarantino
- Department of Clinical Medicine and Surgery, Federico II University Medical School of Naples, Naples, Italy
| | - Gaia Sinatti
- Department of Life, Health and Environmental Sciences‑MESVA, School of Emergency‑Urgency Medicine, University of L'Aquila, 67100, L'Aquila, Italy
| | - Vincenzo Citro
- Department of General Medicine, "Umberto I" Hospital, Nocera Inferiore, SA, Italy
| | - Silvano Jr Santini
- Department of Life, Health and Environmental Sciences‑MESVA, School of Emergency‑Urgency Medicine, University of L'Aquila, 67100, L'Aquila, Italy
- Francesco Balsano Foundation, Via Giovanni Battista Martini 6, 00198, Rome, Italy
| | - Clara Balsano
- Department of Life, Health and Environmental Sciences‑MESVA, School of Emergency‑Urgency Medicine, University of L'Aquila, 67100, L'Aquila, Italy.
- Francesco Balsano Foundation, Via Giovanni Battista Martini 6, 00198, Rome, Italy.
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11
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Hanaoka H, Kikuchi J, Hiramoto K, Akiyama M, Saito S, Kondo Y, Kaneko Y. Sarcopenia in patients with rheumatic musculoskeletal diseases. Int J Rheum Dis 2023; 26:2007-2013. [PMID: 37540070 DOI: 10.1111/1756-185x.14856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 07/20/2023] [Accepted: 07/24/2023] [Indexed: 08/05/2023]
Abstract
AIM To investigate the impact of high-dose glucocorticoid therapy on sarcopenia in hospitalized patients with rheumatic musculoskeletal diseases (RMDs). METHODS We included patients with RMDs who were hospitalized between 2020 and 2022 for remission induction treatment and collected information on skeletal mass index (SMI) before high-dose glucocorticoid therapy and 1 month later. We divided the patients into 2 groups according to the progression of sarcopenia, defined as a >10% decrease in SMI, and compared their clinical characteristics. RESULTS Forty-nine patients were included in this analysis. The mean age was 53.3 years, 73.5% were female, and the mean SMI was 5.3 kg/m2 . Before treatment, 83.7% had already met the definition of sarcopenia, and 57.1% experienced further sarcopenia progression after 1 month of high-dose glucocorticoid treatment. Patients with sarcopenia progression were predominantly male (P = 0.025), had a higher body weight (P = 0.048), and showed a higher SMI than those without sarcopenia at baseline (P = 0.008). Multivariable analysis revealed that body weight increase from 0 to week 1 of high-dose glucocorticoid treatment was associated with sarcopenia progression (odds ratio: 0.22, 95% CI: 0.04-0.61, P = 0.007) with a cut-off of -1.8 kg. During a mean observation period of 30.2 days, the incidence of infection was significantly higher in patients with progressive sarcopenia (P = 0.042). CONCLUSIONS One-month hospitalization with high-dose glucocorticoid therapy is associated with sarcopenia progression in patients with RMDs. An early decrease in body weight can be used to predict muscle volume loss.
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Affiliation(s)
- Hironari Hanaoka
- Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Jun Kikuchi
- Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Kazuoto Hiramoto
- Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Mitsuhiro Akiyama
- Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Shutaro Saito
- Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Yasushi Kondo
- Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Yuko Kaneko
- Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
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Nagayoshi K, Mizuuchi Y, Zhang J, Hisano K, Tamura K, Sada M, Nakata K, Ohuchida K, Nakamura M. Strong impact of sarcopenic state defined by skeletal muscle mass index on postoperative complication of Crohn's disease patients. Surg Open Sci 2023; 15:54-59. [PMID: 37609367 PMCID: PMC10440350 DOI: 10.1016/j.sopen.2023.07.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 07/27/2023] [Accepted: 07/29/2023] [Indexed: 08/24/2023] Open
Abstract
Background Malnutrition impacts the clinical course of Crohn's disease; however, there is little evidence of its influence on perioperative adverse events. We assessed whether nutritional indicators are associated with postoperative complications in surgical treatment of Crohn's disease. Methods 137 patients with Crohn's disease who underwent surgical treatment between January 2011 and December 2020 were included. Skeletal muscle index was calculated by a single CT slice. We analyzed the risk factors for adverse events. Results 37 % of patients had postoperative complications. Adverse events occurred more frequently in patients with high serum C-reactive protein, low serum albumin, prognostic nutritional index <38.3, skeletal muscle index <38.9 cm2/m2, abdominoperineal resection, long surgical duration, and mass hemorrhage. Among patients with skeletal muscle index <38.9 cm2/m2, patients who experienced adverse events had higher visceral fat index compared with those who did not (0.85 vs. 0.45, P = 0.04). Multivariate analysis revealed that skeletal muscle index <38.9 cm2/m2 and low serum albumin were the independent risk factors for postoperative complications (Odds ratio, 2.85; 95 % confidence interval, 1.13-7.16; P = 0.03, 2.62; 1.09-6.26; P = 0.03, respectively). Separated by sex, low serum albumin (<3.5 and <2.8 g/dL, male and female, respectively) and skeletal muscle index (<38.9 and <36.6 cm2/m2, male and female, respectively) were statistically related to postoperative complications. Conclusions Skeletal muscle index is the most useful nutritional predictor of postoperative complications in Crohn's disease patients among other nutritional indices. We believe that these patients are at high risk of postoperative complications and need appropriate nutritional support in the perioperative period.
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Affiliation(s)
- Kinuko Nagayoshi
- Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yusuke Mizuuchi
- Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Jinghui Zhang
- Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kyoko Hisano
- Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Koji Tamura
- Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masafumi Sada
- Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kohei Nakata
- Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kenoki Ohuchida
- Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masafumi Nakamura
- Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Buehring B, Mueller C, Parvaee R, Andreica I, Kiefer D, Kiltz U, Tsiami S, Pourhassan M, Westhoff T, Wirth R, Baraliakos X, Babel N, Braun J. [Frequency and severity of sarcopenia in patients with inflammatory and noninflammatory musculoskeletal diseases : Results of a monocentric study in a tertiary care center]. Z Rheumatol 2023; 82:563-572. [PMID: 36877305 DOI: 10.1007/s00393-023-01332-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2023] [Indexed: 03/07/2023]
Abstract
INTRODUCTION Sarcopenia (SP) is defined as the pathological loss of muscle mass and function. This is a clinically relevant problem, especially in geriatric patients, because SP is associated with falls, frailty, loss of function, and increased mortality. People with inflammatory and degenerative rheumatic musculoskeletal disorders (RMD) are also at risk for developing SP; however, there is little research on the prevalence of this health disorder in this patient group using currently available SP criteria. OBJECTIVE To investigate the prevalence and severity of SP in patients with RMD. METHODS A total of 141 consecutive patients over 65 years of age with rheumatoid arthritis (RA), spondylarthritis (SpA), vasculitis, and noninflammatory musculoskeletal diseases were recruited in a cross-sectional study at a tertiary care center. The European Working Group on Sarcopenia in Older People (EWGSOP 1 and 2) definitions of presarcopenia, SP, and severe SP were used to determine the prevalence. Lean mass as a parameter of muscle mass and bone density were measured by dual X‑ray absorptiometry (DXA). Handgrip strength and the short physical performance battery (SPPB) were performed in a standardized manner. Furthermore, the frequency of falls and the presence of frailty were determined. Student's T-test and the χ2-test were used for statistics. RESULTS Of the patients included 73% were female, the mean age was 73 years and 80% had an inflammatory RMD. According to EWGSOP 2, 58.9% of participants probable had SP due to low muscle function. When muscle mass was added for confirmation, the prevalence of SP was 10.6%, 5.6% of whom had severe SP. The prevalence was numerically but not statistically different between inflammatory (11.5%) and noninflammatory RMD (7.1%). The prevalence of SP was highest in patients with RA (9.5%) and vasculitis (24%), and lowest in SpA (4%). Both osteoporosis (40% vs. 18.5%) and falls (15% vs. 8.6%) occurred more frequently in patients with SP than those without SP. DISCUSSION This study showed a relatively high prevalence of SP, especially in patients with RA and vasculitis. In patients at risk, measures to detect SP should routinely be performed in a standardized manner in the clinical practice. The high frequency of muscle function deficits in this study population supports the importance of measuring muscle mass in addition to bone density with DXA to confirm SP.
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Affiliation(s)
- B Buehring
- Rheumazentrum Ruhrgebiet, Ruhr-Universität Bochum, Herne, Deutschland.
- Klinik für Rheumatologie, Immunologie und Osteologie, Bergisches Rheuma - Zentrum, Klinisches Osteologisches Schwerpunktzentrum DVO, Europäisches Expertenzentrum Systemische Sklerose, Krankenhaus St. Josef, Akademisches Lehrkrankenhaus der Heinrich-Heine-Universität Düsseldorf, Bergstr. 6-12, 42105, Wuppertal, Deutschland.
| | - C Mueller
- Rheumazentrum Ruhrgebiet, Ruhr-Universität Bochum, Herne, Deutschland
| | - R Parvaee
- Rheumazentrum Ruhrgebiet, Ruhr-Universität Bochum, Herne, Deutschland
| | - I Andreica
- Rheumazentrum Ruhrgebiet, Ruhr-Universität Bochum, Herne, Deutschland
| | - D Kiefer
- Rheumazentrum Ruhrgebiet, Ruhr-Universität Bochum, Herne, Deutschland
| | - U Kiltz
- Rheumazentrum Ruhrgebiet, Ruhr-Universität Bochum, Herne, Deutschland
| | - S Tsiami
- Rheumazentrum Ruhrgebiet, Ruhr-Universität Bochum, Herne, Deutschland
| | - M Pourhassan
- Marienhospital Herne, Ruhr-Universität Bochum, Herne, Deutschland
| | - T Westhoff
- Marienhospital Herne, Ruhr-Universität Bochum, Herne, Deutschland
| | - R Wirth
- Marienhospital Herne, Ruhr-Universität Bochum, Herne, Deutschland
| | - X Baraliakos
- Rheumazentrum Ruhrgebiet, Ruhr-Universität Bochum, Herne, Deutschland
| | - N Babel
- Marienhospital Herne, Ruhr-Universität Bochum, Herne, Deutschland
| | - J Braun
- Rheumazentrum Ruhrgebiet, Ruhr-Universität Bochum, Herne, Deutschland
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Zhang D, Wang M, Chen X, Cui W, Chen X. Sarcopenia in patients with SAPHO syndrome: A case-control study based on computed tomography. Int J Rheum Dis 2023; 26:1844-1848. [PMID: 37088837 DOI: 10.1111/1756-185x.14701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 03/15/2023] [Accepted: 04/08/2023] [Indexed: 04/25/2023]
Affiliation(s)
- Dingzhe Zhang
- Department of Radiology, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Miaomiao Wang
- Department of Radiology, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
- Department of Radiology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Xin Chen
- Department of Radiology, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wenjing Cui
- Department of Radiology, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Xiao Chen
- Department of Radiology, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
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15
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Ahn SS, Park YB, Lee SW. Association between computed tomography-assessed sarcopenia and mortality in patients with anti-neutrophil cytoplasmic antibody-associated vasculitis. Int J Rheum Dis 2023; 26:1704-1713. [PMID: 37350277 DOI: 10.1111/1756-185x.14795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 05/31/2023] [Accepted: 06/12/2023] [Indexed: 06/24/2023]
Abstract
AIM Sarcopenia is frequently observed in patients with autoimmune rheumatic diseases; however, its relationship with patient outcomes has not been well understood. This study evaluated the influence of sarcopenia, especially muscle quality, on outcomes of antineutrophil cytoplasmic antibody-associated vasculitis (AAV). METHODS Records of patients with AAV at the Severance Hospital with computed tomography (CT) images taken at initial disease diagnosis were retrospectively reviewed. For measures of sarcopenia, normal attenuation muscle area (NAMA), low attenuation muscle area (LAMA), intramuscular adipose tissue (IMAT), and total abdominal muscle area (TAMA) in the axial muscles of the middle third lumbar vertebra level were calculated. Correlations between NAMA, LAMA, IMAT, and baseline patient characteristics, as well as the association between the NAMA/TAMA ratio and clinical outcomes were assessed. RESULTS A total of 136 patients with CT images at AAV diagnosis were identified. Correlation analyses revealed that age, female sex, total cholesterol, and alanine aminotransferase were significantly associated with NAMA. LAMA was associated with age, body mass index (BMI), five-factor score (FFS), and C-reactive protein, and a relationship between IMAT and age and BMI was observed. During the follow up of 31.2 months, 23 (16.9%) patients died, and Cox-proportional hazard analysis demonstrated that a NAMA/TAMA ≤0.46 (odds ratio [OR] 10.247, p < .001), female sex (OR 0.206, p = .006), dyslipidemia (OR 3.143, p = .027), creatinine (OR 1.342, p = .012), and FFS (OR 1.775, p = .046), were independently associated with patient mortality. CONCLUSION A higher rate of mortality was observed in patients with AAV with NAMA/TAMA ≤0.46, indicating that careful monitoring is required in these patients.
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Affiliation(s)
- Sung Soo Ahn
- Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea
| | - Yong-Beom Park
- Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, Korea
| | - Sang-Won Lee
- Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, Korea
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Hu N, Liu J, Cui W, Wang J, Wang Z, Chen X. Extracutaneous/osteoarticular manifestations in patients with SAPHO syndrome. Int J Rheum Dis 2023; 26:1649-1652. [PMID: 37664960 DOI: 10.1111/1756-185x.14779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 05/24/2023] [Accepted: 05/28/2023] [Indexed: 09/05/2023]
Affiliation(s)
- Nandong Hu
- Department of Radiology, The Affiliated Hospital of Nanjing, University of Chinese Medicine, Nanjing, China
| | - Jingjing Liu
- Department of Radiology, The Affiliated Hospital of Nanjing, University of Chinese Medicine, Nanjing, China
- The First Clinical Institute, Nanjing University of Chinese Medicine, Nanjing, China
| | - Wenjing Cui
- Department of Radiology, The Affiliated Hospital of Nanjing, University of Chinese Medicine, Nanjing, China
| | - Jianhua Wang
- Department of Radiology, The Affiliated Hospital of Nanjing, University of Chinese Medicine, Nanjing, China
| | - Zhongqiu Wang
- Department of Radiology, The Affiliated Hospital of Nanjing, University of Chinese Medicine, Nanjing, China
| | - Xiao Chen
- Department of Radiology, The Affiliated Hospital of Nanjing, University of Chinese Medicine, Nanjing, China
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Su Q, Jin C, Yang Y, Wang J, Wang J, Zeng H, Chen Y, Zhou J, Wang Y. Association Between Autoimmune Diseases and Sarcopenia: A Two-Sample Mendelian Randomization Study. Clin Epidemiol 2023; 15:901-910. [PMID: 37650009 PMCID: PMC10464831 DOI: 10.2147/clep.s416778] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 07/27/2023] [Indexed: 09/01/2023] Open
Abstract
Purpose Observational studies have reported that autoimmune diseases are closely related to sarcopenia, but the causalities of autoimmune diseases with sarcopenia have not been established. We conducted this Mendelian randomization (MR) study to reveal the causal associations of overall autoimmune disease and five common autoimmune diseases with sarcopenia-related traits. Methods The publicly available summary-level data of autoimmune diseases and three sarcopenia-related traits were used for analysis. The causal effects of autoimmune diseases on sarcopenia-related traits were first identified in discovery samples using the inverse-variance-weighted method as the primary method, and the robustness of results was examined by additional sensitivity analyses. Replication MR analyses were then conducted using replication samples of five autoimmune diseases. Finally, the possibility of reverse causation was assessed by reverse MR analyses. Results In both the discovery and replication samples, we identified potential causal effects of rheumatoid arthritis (RA) on appendicular lean mass (ALM) and low grip strength (OR = 0.979, 95% CI: 0.964-0.995 for ALM; OR = 1.042, 95% CI: 1.013-1.072 for low grip strength), but not on walking pace. We also found that inflammatory bowel disease (IBD) and type 1 diabetes (T1D) were only causally negatively associated with ALM in the discovery stage (OR = 0.986, 95% CI: 0.974-0.999 for IBD; OR = 0.987, 95% CI: 0.975-0.999 for T1D), whereas systemic lupus erythematosus, multiple sclerosis, and overall autoimmune disease were not associated with any of the three sarcopenia-related traits. Additionally, reverse MR analysis only found an association between walking pace and overall autoimmune disease, but this association did not remain in the weighted-median method. Conclusion This study demonstrates that RA is causally associated with low grip strength and reduced ALM, and that IBD and T1D may be causally negatively related to ALM.
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Affiliation(s)
- Qing Su
- Department of Epidemiology and Biostatistics, School of Public Health and Management, Wenzhou Medical University, Wenzhou, People’s Republic of China
| | - Chen Jin
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, People’s Republic of China
| | - Yi Yang
- Department of Epidemiology and Biostatistics, School of Public Health and Management, Wenzhou Medical University, Wenzhou, People’s Republic of China
| | - Jingxian Wang
- Department of Epidemiology and Biostatistics, School of Public Health and Management, Wenzhou Medical University, Wenzhou, People’s Republic of China
| | - Juejin Wang
- Department of Epidemiology and Biostatistics, School of Public Health and Management, Wenzhou Medical University, Wenzhou, People’s Republic of China
| | - Hao Zeng
- Department of Epidemiology and Biostatistics, School of Public Health and Management, Wenzhou Medical University, Wenzhou, People’s Republic of China
| | - Yaqing Chen
- Department of Epidemiology and Biostatistics, School of Public Health and Management, Wenzhou Medical University, Wenzhou, People’s Republic of China
| | - Junxi Zhou
- Department of Epidemiology and Biostatistics, School of Public Health and Management, Wenzhou Medical University, Wenzhou, People’s Republic of China
| | - Yi Wang
- Department of Epidemiology and Biostatistics, School of Public Health and Management, Wenzhou Medical University, Wenzhou, People’s Republic of China
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Chen WJ, Livneh H, Li HH, Wang YH, Lu MC, Tsai TY, Chien KY. Use of Chinese Herbal Medicine Was Related to Lower Risk of Osteoporotic Fracture in Sarcopenia Patients: Evidence from Population-Based Health Claims. Int J Gen Med 2023; 16:3345-3354. [PMID: 37576913 PMCID: PMC10417589 DOI: 10.2147/ijgm.s416705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 06/14/2023] [Indexed: 08/15/2023] Open
Abstract
Introduction With population aging, sarcopenia and its accompanying risk of osteoporotic fracture has drawn increased attention. Nowadays, while Chinese herbal medicine (CHM) is often used as complementary therapy for many medical conditions, its effect against likelihood of osteoporotic fracture among sarcopenia subjects was not fully elucidated yet. We therefore conducted a population-level study to compare osteoporotic fracture risk for sarcopenia persons with or without CHM use. Methods Using the patient record from a nationwide insurance database, we recruited persons with newly diagnosed sarcopenia and simultaneously free of osteoporotic fracture between 2000 and 2010. Propensity score matching was then applied to randomly select sets of CHM users and non-CHM users. All of them were tracked until end of 2013 to measure the incidence and adjusted hazard ratios (HRs) for new new-onset fracture in multivariable Cox proportional hazards model. Results Compared to non-CHM users, the CHM users indeed had a lower incidence of osteoporotic fracture (121.22 vs 156.61 per 1000 person-years). Use of CHM correlated significantly with a lower fracture likelihood after adjusting for potential covariates, and those receiving CHM treatment for more than two years experienced a remarkably lower risk by 73%. Uses of several herbal formulae were correlated to reduced risk of osteoporotic fracture, such as Caulis Spatholobi, Xuduan, Duzhong, Danshen, Shu-Jing-Huo-Xue-Tang, Du-Huo-Ji-Sheng-Tang, Shao-Yao-Gan-Cao-Tang, and Shen-Tong-Zhu-Yu -Tang. Conclusion Our study depicted that cumulative CHM exposure was inversely associated with osteoporotic fracture risk in a duration-dependent manner, implying that CHM treatment may be embraced as routine care in preventing incident osteoporotic fracture.
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Affiliation(s)
- Wei-Jen Chen
- Department of Chinese Medicine, Dalin Tzu chi Hospital, The Buddhist Tzu chi Medical Foundation, Chiayi, 62247, Taiwan
- Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan, 33301, Taiwan
- School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien, 97004, Taiwan
- Center of Sports Medicine, Dalin Tzu chi Hospital, The Buddhist Tzu chi Medical Foundation, Chiayi, 62247, Taiwan
| | - Hanoch Livneh
- Rehabilitation Counseling Program, Portland State University, Portland, OR, 97207-0751, USA
| | - Hsin-Hua Li
- Department of Chinese Medicine, Dalin Tzu chi Hospital, The Buddhist Tzu chi Medical Foundation, Chiayi, 62247, Taiwan
| | - Yu-Han Wang
- Center of Sports Medicine, Dalin Tzu chi Hospital, The Buddhist Tzu chi Medical Foundation, Chiayi, 62247, Taiwan
| | - Ming-Chi Lu
- Division of Allergy, Immunology and Rheumatology, Dalin Tzu chi Hospital, The Buddhist Tzu chi Medical Foundation, Chiayi, 62247, Taiwan
- School of Medicine, Tzu Chi University, Hualien, 97004, Taiwan
| | - Tzung-Yi Tsai
- Department of Medical Research, Dalin Tzu chi Hospital, The Buddhist Tzu chi Medical Foundation, Chiayi, 62247, Taiwan
- Department of Nursing, Tzu Chi University of Science and Technology, Hualien, 97004, Taiwan
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, 70428, Taiwan
| | - Kuei-Yu Chien
- Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan, 33301, Taiwan
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Zhang G, Wang X, Tong M, Chen J, Ji Q. U-Shaped Association of Standardized Serum 25-Hydroxyvitamin D with Risk of Low Muscle Mass: A Population-Based Cross-Sectional Study. J Multidiscip Healthc 2023; 16:2167-2177. [PMID: 37547808 PMCID: PMC10402717 DOI: 10.2147/jmdh.s420963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 07/18/2023] [Indexed: 08/08/2023] Open
Abstract
Background In the United States (U.S.) general population, the association between standardized serum 25-hydroxyvitamin D (25(OH)D) concentration and risk of low muscle mass (LMM) remains unclear. Our research aimed to determine whether or not there was a relationship between serum 25(OH)D concentration and risk of LMM. Methods We analyzed the cross-sectional data of the US population that participated in the National Health and Nutrition Examination Survey between 2011 and 2014. The relationship between serum 25(OH)D concentration and LMM risk was evaluated using restricted cubic spline (RCS) with multivariate logistic regression model and subgroup analysis. Results In all, we included 10,256 people in our analysis. The RCS plot demonstrated a U-shaped relationship between serum 25(OH)D concentration and risk of LMM (P for nonlinearity <0.05). At a Vitamin D concentration of 38.5 nmol/L, LMM risk was at its lowest. Based on analyses stratified by age, sex, hypertension, and diabetes mellitus (DM), serum 25(OH)D concentration and risk of LMM were U-curve correlated for those age 40 or older, male, with hypertension, or without DM. However, LMM risk was positively related to serum 25(OH)D concentration in those younger than age 40 or in women. Conclusion There is a U-shaped relationship between serum 25(OH)D concentration and the risk of LMM in the general U.S. population. Careful monitoring and appropriate Vitamin D supplementation might lessen the risk of LMM.
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Affiliation(s)
- Gang Zhang
- Department of Rehabilitation, The First Affiliated Hospital of Anhui Medical University, Anhui Public Health Clinical Center, Hefei, Anhui, 230000, People’s Republic of China
| | - Xiaotong Wang
- Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, 221000, People’s Republic of China
| | - Mingyue Tong
- Department of Rehabilitation, The First Affiliated Hospital of Anhui Medical University, Anhui Public Health Clinical Center, Hefei, Anhui, 230000, People’s Republic of China
| | - Jian Chen
- Department of Rehabilitation, The First Affiliated Hospital of Anhui Medical University, Anhui Public Health Clinical Center, Hefei, Anhui, 230000, People’s Republic of China
| | - Qian Ji
- Department of Emergency, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, 210003, People’s Republic of China
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Peng Y, Wu X, Ma X, Xu D, Wang Y, Xia D. Comparison Between the Clinical Effect of Percutaneous Kyphoplasty for Osteoporosis Vertebral Compression Fracture Patient with or Without Sarcopenia: A Retrospective Cohort Study. Int J Gen Med 2023; 16:3095-3103. [PMID: 37496597 PMCID: PMC10368018 DOI: 10.2147/ijgm.s423016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 07/13/2023] [Indexed: 07/28/2023] Open
Abstract
Background Sarcopenia and osteoporosis vertebral compression fractures (OVCF) are common diseases that increase with age. This study aimed to investigate the effects of sarcopenia on OVCF patients after percutaneous kyphoplasty (PKP). Methods Data of 101 patients who were treated with single-level PKP between January 2021 and March 2022 at Ningbo No.6 Hospital were enrolled. Forty-five OVCF patients with sarcopenia who met our inclusion criteria were included in the Sarcopenia-PKP group (SPKP group), and 56 patients in the Normal-PKP group (NPKP group). All clinical and radiological data were collected from medical records. Baseline characteristics, operation-related parameters (operation time, time to ambulation, hospital stay, surgery segment), clinical outcomes (visual analog score [VAS], Oswestry Disability Index [ODI], Japanese Orthopaedic Association Scores [JOA] of lumber), radiological outcomes (vertebral anterior height rate and local kyphosis angle), Macnab score, and complications were evaluated and compared. Results There were no significant differences in age, sex, surgical segment preoperative VAS score, ODI, or JOA between the two groups (P > 0.05). The SPKP group had a significantly lower body mass index (BMI), bone mineral density (BMD), and smooth muscle index (SMI) than the NPKP group (P < 0.05). Significantly longer hospital stays and time to ambulation in SPKP group than NPKP group (3.7±0.8 vs 3.4±0.5 and 2.0±0.8 vs 1.6±0.5, P < 0.05). In SPKP group, significantly better clinical outcomes at 6- and 12-months follow-up were observed in NPKP group than SPKP group (P < 0.05), and NPKP group showed significantly better in vertebral anterior height rates than SPKP group after 6-month follow-up (P < 0.05). Moreover, there were significantly more cases of complications in the SPKP group (P < 0.05). Conclusion Sarcopenia could reduce the clinical effect of percutaneous kyphoplasty, and furthermore. Related studies are needed to verify the effect of sarcopenia on OVCF patients.
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Affiliation(s)
- Yujie Peng
- Orthopeadic Department, The First Affiliated Hospital of Ningbo University, Ningbo, People’s Republic of China
| | - Xiaochuan Wu
- Orthopeadic Department, The First Affiliated Hospital of Ningbo University, Ningbo, People’s Republic of China
| | - Xinyu Ma
- Emergency Department, The Affiliated Lihuili Hospital of Ningbo University, Ningbo, People’s Republic of China
| | - Dingli Xu
- Clinical Department, Health Science Center, Ningbo University Zhejiang, Ningbo, People’s Republic of China
| | - Yang Wang
- Orthopeadic Department, Ningbo No.6 Hospital, Ningbo, Zhejiang, People’s Republic of China
| | - Dongdong Xia
- Orthopeadic Department, The First Affiliated Hospital of Ningbo University, Ningbo, People’s Republic of China
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Ren L, Wang Y, Ju F, Sun M, Gang X, Wang G. Causality between sarcopenia and diabetic nephropathy: a bidirectional Mendelian randomization study. Front Endocrinol (Lausanne) 2023; 14:1188972. [PMID: 37284212 PMCID: PMC10239922 DOI: 10.3389/fendo.2023.1188972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 05/09/2023] [Indexed: 06/08/2023] Open
Abstract
Background and purpose Observational studies have shown that sarcopenia and diabetic nephropathy (DN), are closely related; however, the causal relationship is unclear. This study aims to address this issue using a bidirectional Mendelian randomization (MR) study. Methodology We data from genome-wide association studies including appendicular lean mass (n = 244,730), grip strength (right: n = 461,089, left: n = 461026), walking speed (n = 459,915), and DN (3283 cases and 181,704 controls) to conduct a bidirectional MR study. First, we conducted a Forward MR analysis to evaluate the causality of sarcopenia on the risk of DN from the genetic perspective with appendicular lean mass, grip strength, and walking speed as exposure and DN as the outcome. Then, DN as the exposure, we performed a Reverse MR analysis to determine whether DN impacted the appendicular lean mass, grip strength, and walking speed of the appendices. Finally, a series of sensitivity studies, such as heterogeneity tests, pleiotropy evaluations, and Leave-one-out analyses, were conducted to assess the MR analysis's accuracy further. Results According to a forward MR analysis, a genetically predicted decrease in appendicular lean mass is associated with an increased risk of developing DN risk (inverse variance weighting[IVW]: odd ratio [OR] = 0.863, 95% confidence interval [CI] 0.767-0.971; P = 0.014). According to reverse MR results, grip strength decreased as DN progressed (IVW: right β = 0.003, 95% CI: - 0.021 to - 0.009, P = 5.116e-06; left β = 0.003, 95% CI: - 0.024 to - 0.012, P = 7.035e-09). However, the results of the other MR analyses were not statistically different. Conclusion Notably, our findings suggest that the causal relationship between sarcopenia and DN cannot be generalized. According to analysis of the individual characteristic factors of sarcopenia, reducing in appendicular lean mass increases the risk of developing DN and DN is linked to reduced grip strength. But overall, there is no causal relationship between sarcopenia and DN, because the diagnosis of sarcopenia cannot be determined by one of these factors alone.
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Affiliation(s)
- Linan Ren
- Department of Endocrinology and Metabolism, First Hospital of Jilin University, Changchun, Jilin, China
| | - Yao Wang
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, Jilin, China
| | - Feng Ju
- Department of Orthopedics, Yuci District People’s Hospital, Yuci, Shanxi, China
| | - Meixin Sun
- Department of Endocrinology and Metabolism, First Hospital of Jilin University, Changchun, Jilin, China
| | - Xiaokun Gang
- Department of Endocrinology and Metabolism, First Hospital of Jilin University, Changchun, Jilin, China
| | - Guixia Wang
- Department of Endocrinology and Metabolism, First Hospital of Jilin University, Changchun, Jilin, China
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Zhong Q, Zheng K, Li W, An K, Liu Y, Xiao X, Hai S, Dong B, Li S, An Z, Dai L. Post-translational regulation of muscle growth, muscle aging and sarcopenia. J Cachexia Sarcopenia Muscle 2023. [PMID: 37127279 DOI: 10.1002/jcsm.13241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 03/07/2023] [Accepted: 04/02/2023] [Indexed: 05/03/2023] Open
Abstract
Skeletal muscle makes up 30-40% of the total body mass. It is of great significance in maintaining digestion, inhaling and exhaling, sustaining body posture, exercising, protecting joints and many other aspects. Moreover, muscle is also an important metabolic organ that helps to maintain the balance of sugar and fat. Defective skeletal muscle function not only limits the daily activities of the elderly but also increases the risk of disability, hospitalization and death, placing a huge burden on society and the healthcare system. Sarcopenia is a progressive decline in muscle mass, muscle strength and muscle function with age caused by environmental and genetic factors, such as the abnormal regulation of protein post-translational modifications (PTMs). To date, many studies have shown that numerous PTMs, such as phosphorylation, acetylation, ubiquitination, SUMOylation, glycosylation, glycation, methylation, S-nitrosylation, carbonylation and S-glutathionylation, are involved in the regulation of muscle health and diseases. This article systematically summarizes the post-translational regulation of muscle growth and muscle atrophy and helps to understand the pathophysiology of muscle aging and develop effective strategies for diagnosing, preventing and treating sarcopenia.
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Affiliation(s)
- Qian Zhong
- Department of Endocrinology and Metabolism, General Practice Ward/International Medical Center Ward, General Practice Medical Center and National Clinical Research Center for Geriatrics, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Kun Zheng
- Department of Endocrinology and Metabolism, General Practice Ward/International Medical Center Ward, General Practice Medical Center and National Clinical Research Center for Geriatrics, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Wanmeng Li
- Department of Endocrinology and Metabolism, General Practice Ward/International Medical Center Ward, General Practice Medical Center and National Clinical Research Center for Geriatrics, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Kang An
- Department of Endocrinology and Metabolism, General Practice Ward/International Medical Center Ward, General Practice Medical Center and National Clinical Research Center for Geriatrics, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Yu Liu
- Department of Endocrinology and Metabolism, General Practice Ward/International Medical Center Ward, General Practice Medical Center and National Clinical Research Center for Geriatrics, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Xina Xiao
- Department of Endocrinology and Metabolism, General Practice Ward/International Medical Center Ward, General Practice Medical Center and National Clinical Research Center for Geriatrics, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Shan Hai
- Department of Endocrinology and Metabolism, General Practice Ward/International Medical Center Ward, General Practice Medical Center and National Clinical Research Center for Geriatrics, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Biao Dong
- Department of Endocrinology and Metabolism, General Practice Ward/International Medical Center Ward, General Practice Medical Center and National Clinical Research Center for Geriatrics, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Shuangqing Li
- Department of Endocrinology and Metabolism, General Practice Ward/International Medical Center Ward, General Practice Medical Center and National Clinical Research Center for Geriatrics, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Zhenmei An
- Department of Endocrinology and Metabolism, General Practice Ward/International Medical Center Ward, General Practice Medical Center and National Clinical Research Center for Geriatrics, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Lunzhi Dai
- Department of Endocrinology and Metabolism, General Practice Ward/International Medical Center Ward, General Practice Medical Center and National Clinical Research Center for Geriatrics, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
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Ben Tekaya A, Mehmli T, Ben Sassi M, Teyeb Z, Bouden S, Rouached L, Mahmoud I, Dziri C, Abdelmoula L. Effects of biologic and target synthetic disease-modifying anti-rheumatic drugs on sarcopenia in spondyloarthritis and rheumatoid arthritis: a systematic review and meta-analysis. Clin Rheumatol 2023; 42:979-97. [PMID: 36462127 DOI: 10.1007/s10067-022-06454-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 11/10/2022] [Accepted: 11/11/2022] [Indexed: 12/04/2022]
Abstract
Sarcopenia is a syndrome defined by generalized and progressive loss of skeletal muscle mass, strength, and function. Besides affecting elderly population, it is actually common among inflammatory rheumatic diseases (IRD) patients. We performed a systematic literature review with a meta-analysis to investigate the influence of biologic and target synthetic disease-modifying anti-rheumatic drugs (bDMARDs/tsDMARDs) on sarcopenia in IRD. A systematic search has been performed on Pubmed, Scopus, and Web of science. Studies characteristics were collected. Assessment tools were body composition (total lean mass (TLM) and percentage, appendicular skeletal mass (ASM), fat-free mass and index (FFM and FFMI), skeletal mass index (SMI) and segmental lean mass (SLM)), and muscle strength and physical performance tests. Treatment effect defined the difference in change from baseline to the end of follow-up treatment was divided by the pooled SD of the difference. Twenty-two studies on 778 patients receiving bDMARDs/tsDMARDs and 157 controls were reviewed. They investigated rheumatoid arthritis (RA) (N = 14), spondyloarthritis (SpA) (N = 6), psoriatic arthritis (N = 1), and both RA and SpA (N = 1). tsDMARDs were used in one study with no effect on sarcopenia. Ten studies demonstrated that bDMARDs increased significantly muscle measures in 347 patients (44.6%) with a significant increase in TLM (6/15 studies; 57.4%), FFMI (4/6 studies; 59.9%), ASM (2/5 studies; 17.6%), SMI (2/5 studies; 18.1%), and SLM (2/2 studies; 3.6%). bDMARDs showed also a positive effect on handgrip strength in 1/3 of studies (45.2%) and on physical performance in 1/2 of studies (61%). In 1/5 of comparative studies, IRD patients on bDMARDs showed significantly higher increase of TLM in comparison to controls naïve bDMARDs. Regarding diagnosis, positive effect of bDMARDs was seen in 67.4% in SpA versus 49.3% in RA, with a significant increase of TLM, ASM and FFMI in 59.4%, 100%, and 65.2% in SpA versus 54.9%, 24.1%, and 54.8% in RA, respectively. Meta-analysis assessed the effect of bDMARD on TLM in 10 studies. There was no statistically significant difference [SMD - 0.10 (95% Confidence Interval - 0.26 - 0.06; tau2 = 0). Heterogeneity across studies was null, and the 95% confidence interval (index of precision) was equal to the 95% predictive interval. The first systematic literature review showed that bDMARDs have a significant improve effect in nearly half of RA and SpA patients on muscle mass and muscle strength, assessed separately. However, the meta-analysis concluded that bDMARDs have no significant effect on TLM.
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da Rocha DS, Tessari JA, Mainardi NB, Hax V, Gasparin AA, de Oliveira CAV, Garcia TS, Xavier RM, Chakr RMDS. Assessment of muscle mass using chest computed tomography-based quantitative and qualitative measurements in patients with systemic sclerosis: A retrospective study with cross-sectional and longitudinal analyses. Semin Arthritis Rheum 2023; 59:152168. [PMID: 36736023 DOI: 10.1016/j.semarthrit.2023.152168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 01/03/2023] [Accepted: 01/16/2023] [Indexed: 01/20/2023]
Abstract
BACKGROUND/ PURPOSE Sarcopenia has been increasingly studied in systemic sclerosis (SSc), which is one of the most lethal autoimmune diseases, mainly due to lung involvement. Our objective was to study the associations of myopenia and/or myosteatosis with clinical features of SSc and subsequent adverse outcomes. METHODS This is a retrospective study with cross-sectional and longitudinal analyses, in which patients with SSc were consecutively included in the outpatient clinic of a tertiary university hospital between 2012 and 2021. Clinical and laboratory parameters of patients with SSc were collected from their medical records. Skeletal muscle mass was assessed on chest computed tomography (CT) at the level of the first lumbar vertebra (L1) by skeletal muscle area (SMA), skeletal muscle index ([SMI] SMA/height2), and skeletal muscle radiation attenuation (SMRA). Cut-off values for myopenia in women and men were SMA <70.1 cm² and <110.4 cm², and SMI <25.9 cm²/m² and <34.6 cm²/m², respectively; values for myosteatosis in women and men were SMRA <29.8 HU and <36.3 HU, respectively. In a subgroup of 31 patients followed-up between 2017 and 2019, the diagnostic properties of SMA, SMI, and SMRA by CT were compared with the appendicular skeletal muscle mass index (ASMI) by dual-energy X-ray absorptiometry (DXA). Low muscle quantity was defined according to the European Working Group on Sarcopenia in Older People 2: ASMI <5.5 kg/m2 in women and <7.0 kg/m2 in men. Afterwards, a better tomographic index was used for correlating with clinical and laboratory parameters. RESULTS Myopenia and/or myosteatosis were present in 75.7 % of patients with SSc. The prevalence rates according to each index were SMA 25.2%, SMI 12.1%, and SMRA 69.2%. In 73% of the patients with overweight/obesity (body mass index [BMI] ≥25 kg/m²), only SMRA was reduced. Considering ASMI as the gold standard, the sensitivity, specificity, positive and negative predictive values for SMA were 60%, 96.2%, 75% and 92.6%, respectively; for SMI, they were 40%, 96.2%, 66.7%, and 89.3%, respectively; for SMRA, these values were 60%, 34.6%, 15%, and 81.8%. Pearson's correlation coefficients were 0.73, 0.74, and 0.10 for SMA, SMI, and SMRA, respectively, and ASMI significantly agreed with SMA (kappa 0.611, p < 0.001) and SMI (kappa 0.431, p = 0.012). After adjustments in a multivariate model, BMI (p < 0.001) and female sex (p < 0.001) remained significantly associated with myopenia by SMA; BMI (p =0.010) remained significantly associated with low muscle mass by ASMI. CONCLUSION The SMA index at L1 level on chest CT was demonstrated to be an accurate measure that is useful for detecting myopenia in patients with SSc. BMI and male sex predicted low SMA and BMI was associated with low ASMI on DXA. STATEMENT OF CLINICAL SIGNIFICANCE In recent years, great advances have been made in sarcopenia-related research, resulting in broader knowledge on its definition, causes, diagnosis, and treatment options. Regarding the techniques used for assessing muscle composition, computed tomography (CT) was demonstrated by many studies to be an efficient and easy-to-use method that can be employed by professionals of different specialties, including rheumatologists. This study was able to demonstrate that although the L3 image was not present on CT, the analysis of SMA at the L1 level on chest CT proved to be an accurate and useful measure to detect myopenia in patients with SSc. This study identified some associated factors of myopenia and/or myosteatosis according to each method employed for assessing muscle composition. Reduced BMI and male sex were associated factors of myopenia when using SMA, and reduced BMI was associated with myopenia when employing ASMI by DXA. Finally, we highlight the need not to generalize the term "sarcopenia" in clinical studies assessing imaging parameters of body composition. The use of the terms myopenia and/or myosteatosis would be more adequate, because CT allows the assessment of muscle composition and not strength or physical performance.
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Affiliation(s)
- Daniela Silva da Rocha
- Rheumatology Service, Hospital de Clínicas de Porto Alegre (HCPA), Rua Ramiro Barcelos, 2350, Porto Alegre, RS 90035-903, Brazil; School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), R. Ramiro Barcelos, 2400, Porto Alegre, RS 90035-003, Brazil.
| | - Julia Andressa Tessari
- School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), R. Ramiro Barcelos, 2400, Porto Alegre, RS 90035-003, Brazil
| | - Natalia Bocaccio Mainardi
- School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), R. Ramiro Barcelos, 2400, Porto Alegre, RS 90035-003, Brazil
| | - Vanessa Hax
- Rheumatology Service, Hospital de Clínicas de Porto Alegre (HCPA), Rua Ramiro Barcelos, 2350, Porto Alegre, RS 90035-903, Brazil; School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), R. Ramiro Barcelos, 2400, Porto Alegre, RS 90035-003, Brazil
| | - Andrese Aline Gasparin
- Rheumatology Service, Hospital de Clínicas de Porto Alegre (HCPA), Rua Ramiro Barcelos, 2350, Porto Alegre, RS 90035-903, Brazil; School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), R. Ramiro Barcelos, 2400, Porto Alegre, RS 90035-003, Brazil
| | | | - Tiago Severo Garcia
- School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), R. Ramiro Barcelos, 2400, Porto Alegre, RS 90035-003, Brazil
| | - Ricardo Machado Xavier
- Rheumatology Service, Hospital de Clínicas de Porto Alegre (HCPA), Rua Ramiro Barcelos, 2350, Porto Alegre, RS 90035-903, Brazil; School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), R. Ramiro Barcelos, 2400, Porto Alegre, RS 90035-003, Brazil
| | - Rafael Mendonça da Silva Chakr
- Rheumatology Service, Hospital de Clínicas de Porto Alegre (HCPA), Rua Ramiro Barcelos, 2350, Porto Alegre, RS 90035-903, Brazil; School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), R. Ramiro Barcelos, 2400, Porto Alegre, RS 90035-003, Brazil
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Merle B, Cottard M, Sornay-Rendu E, Szulc P, Chapurlat R. Spondyloarthritis and Sarcopenia: Prevalence of Probable Sarcopenia and its Impact on Disease Burden: The Saspar Study. Calcif Tissue Int 2023; 112:647-655. [PMID: 36944706 DOI: 10.1007/s00223-023-01074-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 02/23/2023] [Indexed: 03/23/2023]
Abstract
To evaluate the prevalence of probable, confirmed, and severe sarcopenia in spondyloarthritis (SpA), according to the European Working Group on Sarcopenia in Older People 2019 (EWGSOP2) definition. A total of 103 patients (51% women) with SpA, mean age 47.1 ± 13.7 years, were included and compared to 103 age- and sex-matched controls. Grip strength was measured by dynamometry. Body composition was assessed by whole-body densitometry. In SpA patients gait speed was measured by the 4-m-distance walk test and quality of life was evaluated with a specific health-related questionnaire for sarcopenia (SaRQoL®). Twenty-two SpA patients (21%) versus 7 controls (7%) had a low grip strength, i.e., probable sarcopenia (p < 0.01), 15 SpA (15%) patients and 7 controls (7%) had low Skeletal Muscle mass Index (SMI) (ns), respectively, and 5 and 2% of SpA patients and controls had low grip strength and low SMI, i.e., confirmed sarcopenia (ns). All the sarcopenic SpA patients had a low gait speed, i.e., severe sarcopenia. Finally, probable sarcopenic SpA patients had significantly higher C-Reactive Protein (CRP, p < 0.001) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI score, p < 0.01), lower gait speed (p < 0.001), and SarQoL® score (p < 0.001) than SpA patients with normal grip strength. According to EWGSOP2 definition, the prevalence of probable sarcopenia was significantly higher in SpA patients compared to controls. Probable sarcopenia was associated with higher inflammation and disease activity, impaired muscle performance, and quality of life. These results suggest that muscle strength may be a salient hallmark in SpA.
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Affiliation(s)
- Blandine Merle
- INSERM UMR 1033-Université de Lyon, 5 Place d'Arsonval, 69437, Lyon, France.
| | - Marie Cottard
- Service de Rhumatologie, Hôpital Edouard Herriot, Hospices Civils de Lyon, 5 Place d'Arsonval, 69437, Lyon, France
| | | | - Pawel Szulc
- INSERM UMR 1033-Université de Lyon, 5 Place d'Arsonval, 69437, Lyon, France
| | - Roland Chapurlat
- INSERM UMR 1033-Université de Lyon, 5 Place d'Arsonval, 69437, Lyon, France
- Service de Rhumatologie, Hôpital Edouard Herriot, Hospices Civils de Lyon, 5 Place d'Arsonval, 69437, Lyon, France
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Kao CI, Liau BY, Lai KL, Kuo FC. Correlation Among Disease Activity, Musculoskeletal Function, and Quality of Life in Patients with Ankylosing Spondylitis with Mild to Moderate Radiographic Signs. J Med Biol Eng 2023. [DOI: 10.1007/s40846-023-00780-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2023]
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Sebastian S, Segal JP, Hedin C, Pellino G, Kotze PG, Adamina M, Campmans-Kuijpers M, Davies J, de Vries AC, Casbas AG, El-Hussuna A, Juillerat P, Meade S, Millán M, Spinelli A. ECCO Topical Review: Roadmap to Optimal Peri-Operative Care in IBD. J Crohns Colitis 2023; 17:153-169. [PMID: 36055337 DOI: 10.1093/ecco-jcc/jjac129] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIMS Despite the advances in medical therapies, a significant proportion of patients with inflammatory bowel diseases [IBD] require surgical intervention. This Topical Review aims to offer expert consensus practice recommendations for peri-operative care to optimize outcomes of IBD patients who undergo surgery. METHODS A multidisciplinary panel of IBD healthcare providers systematically reviewed aspects relevant to peri-operative care in IBD. Consensus statements were developed using Delphi methodology. RESULTS A total of 20 current practice positions were developed following systematic review of the current literature covering use of medication in the peri-operative period, nutritional assessment and intervention, physical and psychological rehabilitation and prehabilitation, and immediate postoperative care. CONCLUSION Peri-operative planning and optimization of the patient are imperative to ensure favourable outcomes and reduced morbidity. This Topical Review provides practice recommendations applicable in the peri-operative period in IBD patients undergoing surgery.
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Affiliation(s)
- Shaji Sebastian
- IBD Unit, Hull University Teaching Hospitals, Hull, UK
- Hull York Medical School, University of Hull, Hull, UK
| | - Jonathan P Segal
- Northern Hospital Epping, Melbourne, Australia
- University of Melbourne, Parkville, Melbourne, Australia
| | - Charlotte Hedin
- Department of Medicine, Karolinska Institutet, Solna, Stockholm, Sweden
- Gastroenterology Unit, Department of Gastroenterology, Dermatovenereology and Rheumatology, Karolinska University Hospital, Stockholm, Sweden
| | - Gianluca Pellino
- Department of Advanced Medical and Surgical Sciences, Universitá degli Studi della Campania 'Luigi Vanvitelli', Naples, Italy
| | - Paulo Gustavo Kotze
- Colorectal Surgery Unit, Pontificia Universidade Católica do Paraná [PUCPR], Curitiba, Brazil
| | - Michel Adamina
- Department of Surgery, Cantonal Hospital Winterthur, Winterthur, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Marjo Campmans-Kuijpers
- Department of Gastroenterology and Hepatology, University Medical Centre Groningen, Groningen, the Netherlands
| | - Justin Davies
- Cambridge Colorectal Unit, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Annemarie C de Vries
- Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Ana Gutiérrez Casbas
- Gastroenterology Department, Hospital General Universitario de Alicante, ISABIAL and CIBERehd, Alicante, Spain
| | - Alaa El-Hussuna
- OpenSourceResearch organisation (osrc.network), Aalborg, Denmark
| | - Pascal Juillerat
- Clinic for Visceral Surgery and Medicine, Inselspital, University Hospital of Bern, Bern, Switzerland
| | - Susanna Meade
- Department of Gastroenterology, Guy's and Saint Thomas' Hospitals NHS Trust, London, UK
| | - Monica Millán
- General Surgery, Colorectal Unit, Hospital Universitari i Politecnic La Fe, Valencia, Spain
| | - Antonino Spinelli
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- IRCCS Humanitas Research Hospital, Milan, Italy
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Grova M, Crispino F, Maida M, Vitello A, Renna S, Casà A, Tesè L, Macaluso FS, Orlando A. Sarcopenia is a negative predictive factor for endoscopic remission in patients with Crohn's disease treated with biologics. Dig Liver Dis 2023:S1590-8658(23)00482-6. [PMID: 36925319 DOI: 10.1016/j.dld.2023.02.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 02/20/2023] [Accepted: 02/22/2023] [Indexed: 03/18/2023]
Abstract
BACKGROUND Sarcopenia has been associated with poor prognosis in chronic diseases. AIMS To investigate the role of sarcopenia in predicting clinical and endoscopic outcomes in patients with Crohn's disease (CD). METHODS Consecutive CD patients who started biologics between 2014 and 2020 and underwent abdominal magnetic resonance or computed tomography within 6 months from the beginning of the biological therapy were enroled. Sarcopenia was defined as Psoas Muscle Index (PMI) lower than 5.4 cm²/m² (men) and 3.56 cm²/m² (women). Univariate and multivariate analyses were used to evaluate whether sarcopenia could predict steroid-free clinical remission (SFCR), endoscopic remission (ER), hospitalisation and surgery after 12 months of therapy. RESULTS 358 patients were included. Sarcopenia was found in 18.2% of patients, and it was associated with a lower rate of ER (14.8% vs 47.7%; p = 0.002) after 12 months of therapy, while it was not associated with SFCR (65.1% vs 70.1%; p = 0.435), hospitalisation (9.2% vs 7.8%; p = 0.801) and surgery (3.1% vs 6.1%; p = 0.549). Sarcopenia was identified as a predictor of lack of ER (odds ratio [OR]=5.2; p = 0.006), as well as smoking (OR=2.5; p = 0.028) and perianal disease (OR=2.6; p = 0.020). CONCLUSION Sarcopenia is a negative prognostic factor for ER in CD patients treated with biologics.
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Affiliation(s)
- Mauro Grova
- Inflammatory Bowel Disease Unit, Department of Medicine, A.O.O.R. "Villa Sofia-Cervello" Hospital, Palermo, Italy; Section of Gastroenterology and Hepatology, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy.
| | - Federica Crispino
- Inflammatory Bowel Disease Unit, Department of Medicine, A.O.O.R. "Villa Sofia-Cervello" Hospital, Palermo, Italy; Section of Gastroenterology and Hepatology, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
| | - Marcello Maida
- Section of Gastroenterology, "S. Elia-Raimondi" Hospital", Caltanissetta, Italy
| | - Alessandro Vitello
- Section of Gastroenterology, "S. Elia-Raimondi" Hospital", Caltanissetta, Italy
| | - Sara Renna
- Inflammatory Bowel Disease Unit, Department of Medicine, A.O.O.R. "Villa Sofia-Cervello" Hospital, Palermo, Italy
| | - Angelo Casà
- Inflammatory Bowel Disease Unit, Department of Medicine, A.O.O.R. "Villa Sofia-Cervello" Hospital, Palermo, Italy
| | - Lorenzo Tesè
- Radiology Unit, A.O.O.R. "Villa Sofia-Cervello Hospital", Palermo, Italy
| | - Fabio Salvatore Macaluso
- Inflammatory Bowel Disease Unit, Department of Medicine, A.O.O.R. "Villa Sofia-Cervello" Hospital, Palermo, Italy
| | - Ambrogio Orlando
- Inflammatory Bowel Disease Unit, Department of Medicine, A.O.O.R. "Villa Sofia-Cervello" Hospital, Palermo, Italy
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Moschou D, Krikelis M, Georgakopoulos C, Mole E, Chronopoulos E, Tournis S, Mavragani C, Makris K, Dontas I, Gazi S. Sarcopenia in Rheumatoid arthritis. A narrative review. J Frailty Sarcopenia Falls 2023; 8:44-52. [PMID: 36873824 PMCID: PMC9975974 DOI: 10.22540/jfsf-08-044] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2023] [Indexed: 03/06/2023] Open
Abstract
Sarcopenia was recently identified as an entity in the ICD-10 classification of October 2016. According to the recommendation of the European Working Group on Sarcopenia in Older People (EWGSOP2), sarcopenia is defined as low muscle strength and low muscle mass, while physical performance is used to categorize the severity of sarcopenia. In recent years, sarcopenia has become increasingly common in younger patients with autoimmune diseases such as Rheumatoid arthritis (RA). Due to the chronic inflammation caused by RA, patients have reduced physical activity, immobility, stiffness, and joint destruction and all of that lead to the loss of muscle mass, muscle strength, disability and significantly lowering the patients' quality of life. This article is a narrative review about sarcopenia in RA, with a special focus in its pathogenesis and management.
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Affiliation(s)
- Dimitra Moschou
- Rheumatology Department, KAT General Hospital, Attica, Greece
| | | | | | - Evangelia Mole
- Rheumatology Department, KAT General Hospital, Attica, Greece
| | - Efstathios Chronopoulos
- Laboratory for Research of the Musculoskeletal System "Theodoros Garofalidis", School of Medicine, National and Kapodistrian University of Athens, KAT General Hospital, Attica, Greece
| | - Symeon Tournis
- Laboratory for Research of the Musculoskeletal System "Theodoros Garofalidis", School of Medicine, National and Kapodistrian University of Athens, KAT General Hospital, Attica, Greece
| | - Clio Mavragani
- Department of Physiology, School of Medicine, National and Kapodistrian University of Athens, Attica, Greece
| | | | - Ismene Dontas
- Laboratory for Research of the Musculoskeletal System "Theodoros Garofalidis", School of Medicine, National and Kapodistrian University of Athens, KAT General Hospital, Attica, Greece
| | - Susana Gazi
- Rheumatology Department, KAT General Hospital, Attica, Greece
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Di Matteo A, Moscioni E, Lommano MG, Cipolletta E, Smerilli G, Farah S, Airoldi C, Aydin SZ, Becciolini A, Bonfiglioli K, Carotti M, Carrara G, Cazenave T, Corradini D, Cosatti MA, de Agustin JJ, Destro Castaniti GM, Di Carlo M, Di Donato E, Di Geso L, Elliott A, Fodor D, Francioso F, Gabba A, Hernández-Díaz C, Horvath R, Hurnakova J, Jesus D, Marin J, Martire MV, Mashadi Mirza R, Massarotti M, Musca AA, Nair J, Okano T, Papalopoulos I, Rosa J, Rosemffet M, Rovisco J, Rozza D, Salaffi F, Scioscia C, Scirè CA, Tamas MM, Tanimura S, Ventura-Rios L, Villota-Eraso C, Villota O, Voulgari PV, Vreju FA, Vukatana G, Hereter JZ, Zanetti A, Grassi W, Filippucci E. Reliability assessment of ultrasound muscle echogenicity in patients with rheumatic diseases: Results of a multicenter international web-based study. Front Med (Lausanne) 2023; 9:1090468. [PMID: 36733934 PMCID: PMC9886677 DOI: 10.3389/fmed.2022.1090468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 12/29/2022] [Indexed: 01/18/2023] Open
Abstract
Objectives To investigate the inter/intra-reliability of ultrasound (US) muscle echogenicity in patients with rheumatic diseases. Methods Forty-two rheumatologists and 2 radiologists from 13 countries were asked to assess US muscle echogenicity of quadriceps muscle in 80 static images and 20 clips from 64 patients with different rheumatic diseases and 8 healthy subjects. Two visual scales were evaluated, a visual semi-quantitative scale (0-3) and a continuous quantitative measurement ("VAS echogenicity," 0-100). The same assessment was repeated to calculate intra-observer reliability. US muscle echogenicity was also calculated by an independent research assistant using a software for the analysis of scientific images (ImageJ). Inter and intra reliabilities were assessed by means of prevalence-adjusted bias-adjusted Kappa (PABAK), intraclass correlation coefficient (ICC) and correlations through Kendall's Tau and Pearson's Rho coefficients. Results The semi-quantitative scale showed a moderate inter-reliability [PABAK = 0.58 (0.57-0.59)] and a substantial intra-reliability [PABAK = 0.71 (0.68-0.73)]. The lowest inter and intra-reliability results were obtained for the intermediate grades (i.e., grade 1 and 2) of the semi-quantitative scale. "VAS echogenicity" showed a high reliability both in the inter-observer [ICC = 0.80 (0.75-0.85)] and intra-observer [ICC = 0.88 (0.88-0.89)] evaluations. A substantial association was found between the participants assessment of the semi-quantitative scale and "VAS echogenicity" [ICC = 0.52 (0.50-0.54)]. The correlation between these two visual scales and ImageJ analysis was high (tau = 0.76 and rho = 0.89, respectively). Conclusion The results of this large, multicenter study highlighted the overall good inter and intra-reliability of the US assessment of muscle echogenicity in patients with different rheumatic diseases.
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Affiliation(s)
- Andrea Di Matteo
- Rheumatology Unit, Department of Clinical and Molecular Sciences, “Carlo Urbani” Hospital, Polytechnic University of Marche, Ancona, Italy,Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, United Kingdom,*Correspondence: Andrea Di Matteo,
| | - Erica Moscioni
- Rheumatology Unit, Department of Clinical and Molecular Sciences, “Carlo Urbani” Hospital, Polytechnic University of Marche, Ancona, Italy
| | - Maria Giovanna Lommano
- Rheumatology Unit, Department of Clinical and Molecular Sciences, “Carlo Urbani” Hospital, Polytechnic University of Marche, Ancona, Italy
| | - Edoardo Cipolletta
- Rheumatology Unit, Department of Clinical and Molecular Sciences, “Carlo Urbani” Hospital, Polytechnic University of Marche, Ancona, Italy
| | - Gianluca Smerilli
- Rheumatology Unit, Department of Clinical and Molecular Sciences, “Carlo Urbani” Hospital, Polytechnic University of Marche, Ancona, Italy
| | - Sonia Farah
- Rheumatology Unit, Department of Clinical and Molecular Sciences, “Carlo Urbani” Hospital, Polytechnic University of Marche, Ancona, Italy
| | - Carla Airoldi
- Hospital Provincial, Rheumatology, Rosario, Argentina
| | - Sibel Zehra Aydin
- Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada
| | - Andrea Becciolini
- Internal Medicine and Rheumatology Unit, Department of Medicine, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Karina Bonfiglioli
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Marina Carotti
- Department of Radiology, Ospedali Riuniti, Università Politecnica delle Marche, Ancona, Italy
| | - Greta Carrara
- Epidemiology Unit, Italian Society of Rheumatology, Milan, Italy
| | - Tomas Cazenave
- Rheumatology Unit, Instituto de Rehabilitación Psicofísica, Buenos Aires, Argentina
| | - Davide Corradini
- Rheumatology Unit, University Clinic AOU Cagliari, Monserrato, CA, Italy
| | - Micaela Ana Cosatti
- CEMIC, Centro de Educación Médica e Investigaciones Médicas “Norberto Quirno”, Buenos Aires, Argentina
| | - Juan Josè de Agustin
- Rheumatology Unit, Vall d’Hebron Hospital Universitari, Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Giulia Maria Destro Castaniti
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Rheumatology Section, University of Palermo, Palermo, Italy
| | - Marco Di Carlo
- Rheumatology Unit, Department of Clinical and Molecular Sciences, “Carlo Urbani” Hospital, Polytechnic University of Marche, Ancona, Italy
| | - Eleonora Di Donato
- Internal Medicine and Rheumatology Unit, Department of Medicine, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Luca Di Geso
- Department of Internal Medicine, Ospedale Madonna del Soccorso, San Benedetto del Tronto, Marche, Italy
| | - Ashley Elliott
- Centre for Experimental Medicine, Queen’s University Belfast, Belfast, United Kingdom
| | - Daniela Fodor
- 2nd Department of Internal Medicine, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Francesca Francioso
- Rheumatology Unit, Department of Clinical and Molecular Sciences, “Carlo Urbani” Hospital, Polytechnic University of Marche, Ancona, Italy
| | - Alessandra Gabba
- Local Health Unit (ASL), Samugheo, OR, Italy,Local Health Unit (ASL), Orosei, NU, Italy
| | - Cristina Hernández-Díaz
- División de Reumatología, Instituto Nacional de Rehabilitación “Luis Guillermo Ibarra Ibarra”, Mexico City, Mexico
| | - Rudolf Horvath
- Department of Paediatric and Adult Rheumatology, University Hospital Motol, Prague, Czechia
| | - Jana Hurnakova
- Department of Paediatric and Adult Rheumatology, University Hospital Motol, Prague, Czechia
| | - Diogo Jesus
- Department of Rheumatology, Centro Hospitalar de Leiria, Leiria, Portugal
| | - Josefina Marin
- Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | | | | | - Marco Massarotti
- Department of Rheumatology, University Hospitals Dorset NHS Foundation Trust, Christchurch Hospital, Christchurch, United Kingdom
| | | | - Jagdish Nair
- Department of Rheumatology, Liverpool University Hospitals Foundation Trust, Liverpool, United Kingdom
| | - Tadashi Okano
- Department of Orthopedic Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Ioannis Papalopoulos
- Department of Rheumatology, Clinical Immunology and Allergy, University Hospital of Heraklion, Heraklion, Greece
| | - Javier Rosa
- Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Marcos Rosemffet
- Rheumatology Unit, Instituto de Rehabilitación Psicofísica, Buenos Aires, Argentina
| | - João Rovisco
- Department of Rheumatology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Davide Rozza
- Epidemiology Unit, Italian Society of Rheumatology, Milan, Italy
| | - Fausto Salaffi
- Rheumatology Unit, Department of Clinical and Molecular Sciences, “Carlo Urbani” Hospital, Polytechnic University of Marche, Ancona, Italy
| | - Crescenzio Scioscia
- Rheumatology Unit, Department of Emergency and Organ Transplants (DETO), University of Bari, Bari, Italy
| | | | - Maria-Magdalena Tamas
- Department of Rheumatology, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Shun Tanimura
- Department of Rheumatology, Hokkaido Medical Center for Rheumatic Diseases, Sapporo, Japan
| | - Lucio Ventura-Rios
- División de Reumatología, Instituto Nacional de Rehabilitación “Luis Guillermo Ibarra Ibarra”, Mexico City, Mexico
| | - Catalina Villota-Eraso
- IPS Servicio Integral de Reumatología e Inmunología Doctor Orlando Villota, Pasto, Colombia
| | - Orlando Villota
- Division of Rheumatology, Fundación Hospital San Pedro, Pasto, Colombia
| | - Paraskevi V. Voulgari
- Department of Rheumatology, School of Health Science, Faculty of Medicine, University of Ioannina, Ioannina, Greece
| | - Florentin Ananu Vreju
- Department of Rheumatology, University of Medicine and Pharmacy of Craiova, Craiova, Romania
| | - Gentiana Vukatana
- Rheumatology Unit, IRCCS Policlinico S. Orsola-Malpighi, Bologna, Italy
| | | | - Anna Zanetti
- Epidemiology Unit, Italian Society of Rheumatology, Milan, Italy
| | - Walter Grassi
- Rheumatology Unit, Department of Clinical and Molecular Sciences, “Carlo Urbani” Hospital, Polytechnic University of Marche, Ancona, Italy
| | - Emilio Filippucci
- Rheumatology Unit, Department of Clinical and Molecular Sciences, “Carlo Urbani” Hospital, Polytechnic University of Marche, Ancona, Italy
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Vogele D, Otto S, Sollmann N, Haggenmüller B, Wolf D, Beer M, Schmidt SA. Sarcopenia - Definition, Radiological Diagnosis, Clinical Significance. ROFO-FORTSCHR RONTG 2023; 195:393-405. [PMID: 36630983 DOI: 10.1055/a-1990-0201] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Sarcopenia is an age-related syndrome characterized by a loss of muscle mass and strength. As a result, the independence of the elderly is reduced and the hospitalization rate and mortality increase. The onset of sarcopenia often begins in middle age due to an unbalanced diet or malnutrition in association with a lack of physical activity. This effect is intensified by concomitant diseases such as obesity or metabolic diseases including diabetes mellitus. METHOD With effective preventative diagnostic procedures and specific therapeutic treatment of sarcopenia, the negative effects on the individual can be reduced and the negative impact on health as well as socioeconomic effects can be prevented. Various diagnostic options are available for this purpose. In addition to basic clinical methods such as measuring muscle strength, sarcopenia can also be detected using imaging techniques like dual X-ray absorptiometry (DXA), computed tomography (CT), magnetic resonance imaging (MRI), and sonography. DXA, as a simple and cost-effective method, offers a low-dose option for assessing body composition. With cross-sectional imaging techniques such as CT and MRI, further diagnostic possibilities are available, including MR spectroscopy (MRS) for noninvasive molecular analysis of muscle tissue. CT can also be used in the context of examinations performed for other indications to acquire additional parameters of the skeletal muscles (opportunistic secondary use of CT data), such as abdominal muscle mass (total abdominal muscle area - TAMA) or the psoas as well as the pectoralis muscle index. The importance of sarcopenia is already well studied for patients with various tumor entities and also infections such as SARS-COV2. RESULTS AND CONCLUSION Sarcopenia will become increasingly important, not least due to demographic changes in the population. In this review, the possibilities for the diagnosis of sarcopenia, the clinical significance, and therapeutic options are described. In particular, CT examinations, which are repeatedly performed on tumor patients, can be used for diagnostics. This opportunistic use can be supported by the use of artificial intelligence. KEY POINTS · Sarcopenia is an age-related syndrome with loss of muscle mass and strength.. · Early detection and therapy can prevent negative effects of sarcopenia.. · In addition to DEXA, cross-sectional imaging techniques (CT, MRI) are available for diagnostic purposes.. · The use of artificial intelligence (AI) offers further possibilities in sarcopenia diagnostics.. CITATION FORMAT · Vogele D, Otto S, Sollmann N et al. Sarcopenia - Definition, Radiological Diagnosis, Clinical Significance. Fortschr Röntgenstr 2023; DOI: 10.1055/a-1990-0201.
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Affiliation(s)
- Daniel Vogele
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Germany
| | - Stephanie Otto
- Comprehensive Cancer Center (CCCU), University Hospital Ulm, Germany
| | - Nico Sollmann
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Germany
| | - Benedikt Haggenmüller
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Germany
| | - Daniel Wolf
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Germany
| | - Meinrad Beer
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Germany
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Koca TT. Bibliometric analysis of “sarcopenia” in Web of Science. Egypt Rheumatol Rehabil 2023; 50:26. [PMCID: PMC10228437 DOI: 10.1186/s43166-023-00194-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 05/22/2023] [Indexed: 08/29/2023] Open
Abstract
Background Sarcopenia is defined as age-related muscle wasting defined by the combination of appendicular muscle mass, muscle strength, and physical performance measures. Here, we made a bibliometric analysis of the publications published in the Web of Science (WoS) between 2018 and 2023 in terms of “sarcopenia.” In total, 12,461 articles were analyzed. The authors, publication year, title, publishing country/journal/institution, keywords, Web of Science categories, publishers, indexes, citation topics, and reports were reviewed for each article. All digital researches were done on January 03, 2023. Results Among 12,461 articles, according to documents types, 8855 were research articles, 1793 were reviews, 1028 were meeting abstracts, 3963 were early accesses, 364 were letters, and others (proceeding paper, correction, book chapter, etc.). A total of 7446 was open accesses. According to the number of papers and according to publication year, 3537 were in 2021 (highest), 3349 were in 2022, 3024 were in 2020, 2532 were in 2019, and 19 were in 2023. According to the top 5 Web of Science categories list, 2792 were in Geriatrics Gerontology, 1857 were in Nutrition Dietetics, 1575 were in Medicine General Internal, 983 were in Oncology, and 914 were in Endocrinology and Metabolism. Additionally, 243 papers were in Sport Sciences, 201 were in Rehabilitation, 196 were in Rheumatology, and 187 were in Clinical Neurology. Top citation topics were Nutrition and Dietetics (6225), Musculoskeletal Disorders (803), Bone Disease (251), Urology & Nephrology-General (236), and Hepatitis (163) (respectively). The number of citing articles, between 2019 and 2023 years, was 39,534 (with self-citations) and 39,088 (without self-citations); times cited was 94,584 (with self-citations) and 69,585 (without self-citations). Conclusion Our study highlights the characteristics of researches in sarcopenia and provides an objective insight into the importance of sarcopenia in elderly and patients with chronic rheumatic diseases.
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Affiliation(s)
- Tuba Tülay Koca
- Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Sütçü İmam University, Kahramanmaraş, Turkey
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Affiliation(s)
- Adam S Faye
- *Department of Medicine, New York University School of Medicine, New York, U.S
| | - John A Dodson
- *Department of Medicine, New York University School of Medicine, New York, U.S
| | - Aasma Shaukat
- *Department of Medicine, New York University School of Medicine, New York, U.S
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Wu S, Lin S, Zhang X, Alizada M, Wang L, Zheng Y, Ke Q, Xu J. Recent advances in cell-based and cell-free therapeutic approaches for sarcopenia. FASEB J 2022; 36:e22614. [PMID: 36250337 DOI: 10.1096/fj.202200675r] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 07/02/2022] [Accepted: 10/04/2022] [Indexed: 11/11/2022]
Abstract
Sarcopenia is a progressive loss of muscle mass and function that is connected with increased hospital expenditures, falls, fractures, and mortality. Although muscle loss has been related to aging, injury, hormonal imbalances, and diseases such as malignancies, chronic obstructive pulmonary disease, heart failure, and kidney failure, the underlying pathogenic mechanisms of sarcopenia are unclear. Exercise-based interventions and multimodal strategies are currently being considered as potential therapeutic approaches to prevent or treat these diseases. Although drug therapy research is ongoing, no drug has yet been proven to have a substantial safety and clinical value to be the first drug therapy to be licensed for sarcopenia. To better understand the molecular alterations underlying sarcopenia and effective treatments, we review leading research and available findings from the systemic change to the muscle-specific microenvironment. Furthermore, we explore possible mechanisms of sarcopenia and provide new knowledge for the development of novel cell-free and cell-based therapeutics. This review will assist researchers in developing better therapies to improve muscle health in the elderly.
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Affiliation(s)
- Shiqiang Wu
- Department of Orthopedic, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Shu Lin
- Centre of Neurological and Metabolic Research, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China.,Group of Neuroendocrinology, Garvan Institute of Medical Research, Sydney, New South Wales, Australia
| | - Xiaolu Zhang
- Department of Orthopedic, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Mujahid Alizada
- Department of Neurosurgery, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Liangmin Wang
- Department of Orthopedic, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Yiqiang Zheng
- Department of Orthopedic, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Qingfeng Ke
- Department of Orthopedic, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Jie Xu
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China.,Department of Orthopedic, Fujian Provincial Hospital, Fuzhou, China
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Bratoiu I, Burlui AM, Cardoneanu A, Macovei LA, Richter P, Rusu-Zota G, Rezus C, Badescu MC, Szalontay A, Rezus E. The Involvement of Smooth Muscle, Striated Muscle, and the Myocardium in Scleroderma: A Review. Int J Mol Sci 2022; 23:ijms231912011. [PMID: 36233313 PMCID: PMC9569846 DOI: 10.3390/ijms231912011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 09/24/2022] [Accepted: 10/07/2022] [Indexed: 11/09/2022] Open
Abstract
Systemic sclerosis (SSc) is a complex autoimmune disease characterized by heterogeneous changes involving numerous organs and systems. The currently available data indicate that muscle injury (both smooth and striated muscles) is widespread and leads to significant morbidity, either directly or indirectly. From the consequences of smooth muscle involvement in the tunica media of blood vessels or at the level of the digestive tract, to skeletal myopathy (which may be interpreted strictly in the context of SSc, or as an overlap with idiopathic inflammatory myopathies), muscular injury in scleroderma translates to a number of notable clinical manifestations. Heart involvement in SSc is heterogenous depending on the definition used in the various studies. The majority of SSc patients experience a silent form of cardiac disease. The present review summarizes certain important features of myocardial, as well as smooth and skeletal muscle involvement in SSc. Further research is needed to fully describe and understand the pathogenic pathways and the implications of muscle involvement in scleroderma.
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Affiliation(s)
- Ioana Bratoiu
- Department of Rheumatology and Physiotherapy, “Grigore T. Popa” University of Medicine and Pharmacy, 16 University Street, 700115 Iasi, Romania
| | - Alexandra Maria Burlui
- Department of Rheumatology and Physiotherapy, “Grigore T. Popa” University of Medicine and Pharmacy, 16 University Street, 700115 Iasi, Romania
- Correspondence: (A.M.B.); (C.R.)
| | - Anca Cardoneanu
- Department of Rheumatology and Physiotherapy, “Grigore T. Popa” University of Medicine and Pharmacy, 16 University Street, 700115 Iasi, Romania
| | - Luana Andreea Macovei
- Department of Rheumatology and Physiotherapy, “Grigore T. Popa” University of Medicine and Pharmacy, 16 University Street, 700115 Iasi, Romania
| | - Patricia Richter
- Department of Rheumatology and Physiotherapy, “Grigore T. Popa” University of Medicine and Pharmacy, 16 University Street, 700115 Iasi, Romania
| | - Gabriela Rusu-Zota
- Department of Pharmacology, “Grigore T. Popa” University of Medicine and Pharmacy, 16 University Street, 700115 Iasi, Romania
| | - Ciprian Rezus
- Department of Internal Medicine, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania
- Correspondence: (A.M.B.); (C.R.)
| | - Minerva Codruta Badescu
- Department of Internal Medicine, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania
| | - Andreea Szalontay
- Department of Psychiatry, “Grigore T. Popa” University of Medicine and Pharmacy, 16 University Street, 700115 Iasi, Romania
| | - Elena Rezus
- Department of Rheumatology and Physiotherapy, “Grigore T. Popa” University of Medicine and Pharmacy, 16 University Street, 700115 Iasi, Romania
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Dietzel R, Wiegmann S, Borucki D, Detzer C, Zeiner KN, Schaumburg D, Buehring B, Buttgereit F, Armbrecht G. Prevalence of sarcopenia in patients with rheumatoid arthritis using the revised EWGSOP2 and the FNIH definition. RMD Open 2022; 8:rmdopen-2022-002600. [PMID: 36180102 PMCID: PMC9528715 DOI: 10.1136/rmdopen-2022-002600] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 09/20/2022] [Indexed: 12/04/2022] Open
Abstract
Objective In rheumatoid arthritis (RA), chronic inflammation can enhance the development of sarcopenia with a depletion of muscle mass, strength and performance. Currently, a consensus definition for sarcopenia and solid results for the prevalence of sarcopenia in patients with RA are lacking. Methods In this cross-sectional study, 289 patients ≥18 years with RA were recruited. Dual X-ray absorptiometry was performed to measure appendicular lean mass. Assessment of muscle function included grip strength, gait speed and chair rise time. Prevalence of sarcopenia was defined using the updated European Working Group on Sarcopenia in Older People (EWGSOP2) and the Foundation for the National Institutes of Health (FNIH) definition. In addition, the RA study population was compared with existing data of healthy controls (n=280). Results 4.5% of patients (59.4±11.3 years) and 0.4% of controls (62.9±11.9 years) were affected by sarcopenia according to the EWGSOP2 definition. Body weight (OR 0.92, 95% CI 0.86 to 0.97), body mass index (BMI) (OR 0.70, 95% CI 0.57 to 0.87), C reactive protein (CRP) (OR 1.05, 95% CI 1.01 to 1.10), disease duration (OR 1.08, 95% CI 1.02 to 1.36), current medication with glucocorticoids (OR 5.25, 95% CI 2.14 to 24.18), cumulative dose of prednisone equivalent (OR 1.04, 95% CI 1.02 to 1.05) and Health Assessment Questionnaire (HAQ) (OR 2.50, 95% CI 1.27 to 4.86) were associated with sarcopenia in patients with RA. In contrast, the prevalence was 2.8% in patients compared with 0.7% in controls when applying the FNIH definition, and body height (OR 0.75, 95% CI 0.64 to 0.88), BMI (OR 1.20, 95% CI 1.02 to 1.41), CRP (OR 1.06, 95% CI 1.01 to 1.11) and HAQ (OR 2.77, 95% CI 1.17 to 6.59) were associated with sarcopenia. Conclusion Sarcopenia is significantly more common in patients with RA compared with controls using the EWGSOP2 criteria. The FNIH definition revealed sarcopenia in individuals with high BMI and fat mass, regardless of the presence of RA. Trial registration number It was registered at the German Clinical Trials Registry (DRKS) as well as WHO Clinical Trials Registry (ICTRP) (DRKS00011873, registered on 16 March 2017).
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Affiliation(s)
- Roswitha Dietzel
- Department of Radiology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Sabine Wiegmann
- Department of Radiology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Diana Borucki
- Deutsche Rheuma-Liga Bundesverband e.V, Bonn, Germany
| | | | - Kim Nikola Zeiner
- Department of Rheumatology and Clinical Immunology (CCM), Charité Universitätsmedizin Berlin, Berlin, Germany.,Department of Dermatology, Venereology and Allergology, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Désirée Schaumburg
- Department of Rheumatology and Clinical Immunology (CCM), Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Bjoern Buehring
- Bergisches Rheuma-Zentrum, Krankenhaus St. Josef, Wuppertal, Germany.,Rheumazentrum Ruhrgebiet, Herne, Germany
| | - Frank Buttgereit
- Department of Rheumatology and Clinical Immunology (CCM), Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Gabriele Armbrecht
- Department of Radiology, Charité Universitätsmedizin Berlin, Berlin, Germany
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Shin A, Choi SR, Han M, Ha YJ, Lee YJ, Lee EB, Kang EH. Association between sarcopenia defined as low lean mass by dual-energy X-ray absorptiometry and comorbidities of rheumatoid arthritis: Results of a nationwide cross-sectional health examination. Semin Arthritis Rheum 2022; 57:152090. [DOI: 10.1016/j.semarthrit.2022.152090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 08/26/2022] [Accepted: 08/26/2022] [Indexed: 10/14/2022]
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Huang R, Yang H, Chen L, Su S, Wu X, Zhuang R, Liu Y. T2 mapping and fat quantification of lumbar paraspinal muscle in ankylosing spondylitis: a case control study. BMC Musculoskelet Disord 2022; 23:614. [PMID: 35761300 PMCID: PMC9235229 DOI: 10.1186/s12891-022-05570-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 06/21/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND To compare changes in the composition of paraspinal muscles of patients with ankylosing spondylitis (AS) and matched healthy controls using T2 mapping and T2 IDEAL and correlate the quantitative magnetic resonance imaging (qMRI) results with clinical assessments of AS patients. METHOD In total, 37 AS patients and 37 healthy controls were enrolled in the case control study. T2 mapping with and without fat saturation and IDEAL imaging were used to assess the multifidus (MF) and erector spinae (ES) at the levels of L3/L4 and L4/L5 for all subjects. Mean T2non-fatsat, T2fat, T2fatsat, cross-sectional area (CSA), and fat fraction (FF) were compared between AS and healthy controls. Correlations of qMRI results with clinical assessments were analyzed in AS. RESULTS Significantly elevated mean T2non-fatsat values and the FF of the MF and ES at both levels were observed in AS and compared to the controls (p < 0.05). The mean T2fatsat values of ES and MF were significantly higher only at the level of L3/L4 in AS compared to healthy controls (p < 0.05). A loss of muscle CSA compatible with atrophy was present in MF and ES at both levels in AS compared to the controls (p < 0.05). Weak to moderate positive correlations were found between FF and age and disease duration in AS (r = 0.318-0.415, p < 0.05). However, such positive correlation was not observed between FF and disease duration after adjusting for age (p > 0.05). CONCLUSIONS Our findings indicate that using a combination of IDEAL and T2 mapping may provide deeper insights into the pathophysiological degeneration of paraspinal muscles in AS.
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Affiliation(s)
- Ruibin Huang
- Department of Radiology, First Affiliated Hospital, Shantou University Medical College, Shantou, Guangdong, 515041, People's Republic of China
| | - Hongwu Yang
- Department of Radiology, First Affiliated Hospital, Shantou University Medical College, Shantou, Guangdong, 515041, People's Republic of China
| | - Liujiang Chen
- Department of Radiology, First Affiliated Hospital, Shantou University Medical College, Shantou, Guangdong, 515041, People's Republic of China
| | - Shuyan Su
- Department of Radiology, First Affiliated Hospital, Shantou University Medical College, Shantou, Guangdong, 515041, People's Republic of China
| | - Xiaojia Wu
- Department of Radiology, First Affiliated Hospital, Shantou University Medical College, Shantou, Guangdong, 515041, People's Republic of China
| | - Ruyao Zhuang
- Department of Radiology, First Affiliated Hospital, Shantou University Medical College, Shantou, Guangdong, 515041, People's Republic of China
| | - Yuan Liu
- Department of Radiology, First Affiliated Hospital, Shantou University Medical College, Shantou, Guangdong, 515041, People's Republic of China
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Moga TD, Nistor-Cseppento CD, Bungau SG, Tit DM, Sabau AM, Behl T, Nechifor AC, Bungau AF, Negrut N. The Effects of the 'Catabolic Crisis' on Patients' Prolonged Immobility after COVID-19 Infection. Medicina (Kaunas) 2022; 58:medicina58060828. [PMID: 35744091 PMCID: PMC9231342 DOI: 10.3390/medicina58060828] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 06/15/2022] [Accepted: 06/17/2022] [Indexed: 12/16/2022]
Abstract
Background and Objectives: Quarantine, isolation and bed rest associated with COVID-19 infection favored the loss of muscle and bone mass, especially in elderly patients. The current study aims to compare the presence of sarcopenia and osteoporosis in patients with a recent (one month) history of SARS-CoV-2 infection versus the general population. Materials and Methods: A cross-sectional study was conducted in which 157 patients were enrolled, divided into two groups, comparable in structure. The COVID-19 group (group C) consisted of 86 patients who were diagnosed with SARS-CoV-2 respiratory infection within the last 30 days. The non-COVID-19 group (group NC) consists of 71 patients who had no clinical signs of respiratory infection and were not quarantined/hospitalized in the last 3 months. Muscle strength, incidence of sarcopenia (using SARC-F score) and osteoporosis (DEXA determination) and physical performance (SPPB score) in the two groups were assessed and compared. Results: No statistically significant differences were found between the SPPB scores of the C group versus the NC group. Statistically significant differences were found in the evaluation of three parameters included in the SARC-F score. Patients in the C group had difficulties in standing up from a chair (p = 0.009) and climbing stairs (p = 0.030) due to lower muscle strength (p = 0.002) compared with patients in the NC group. No correlation of the SARC F and SPPB scores with the T score values obtained by osteo-densitometry was found. Conclusions: The sudden and significant reduction in physical activity, through various measures taken in the general population during the pandemic, led to an increased incidence of sarcopenia, both in patients who did not have COVID-19 infection and among those quarantined/hospitalized for this condition.
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Affiliation(s)
- Titus David Moga
- Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania;
| | - Carmen Delia Nistor-Cseppento
- Department of Psycho Neuroscience and Recovery, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania;
- Correspondence: (C.D.N.-C.); (S.G.B.)
| | - Simona Gabriela Bungau
- Doctoral School of Biological and Biomedical Sciences, University of Oradea, 410087 Oradea, Romania;
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 410028 Oradea, Romania
- Correspondence: (C.D.N.-C.); (S.G.B.)
| | - Delia Mirela Tit
- Doctoral School of Biological and Biomedical Sciences, University of Oradea, 410087 Oradea, Romania;
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 410028 Oradea, Romania
| | - Anca Maria Sabau
- Department of Physical Education, Sport and Physical Therapy, Faculty of Geography, Tourism and Sport, University of Oradea, 410087 Oradea, Romania;
| | - Tapan Behl
- Chitkara College of Pharmacy, Chitkara University, Rajpura 140401, India;
| | - Aurelia Cristina Nechifor
- Analytical Chemistry and Environmental Engineering Department, Polytechnic University of Bucharest, 011061 Bucharest, Romania;
| | - Alexa Florina Bungau
- Medicine Program of Study, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania;
| | - Nicoleta Negrut
- Department of Psycho Neuroscience and Recovery, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania;
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Micheli L, Mitidieri E, Turnaturi C, Vanacore D, Ciampi C, Lucarini E, Cirino G, Ghelardini C, Sorrentino R, Di Cesare Mannelli L, d'Emmanuele di Villa Bianca R. Beneficial Effect of H 2S-Releasing Molecules in an In Vitro Model of Sarcopenia: Relevance of Glucoraphanin. Int J Mol Sci 2022; 23:5955. [PMID: 35682634 DOI: 10.3390/ijms23115955] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/19/2022] [Accepted: 05/20/2022] [Indexed: 02/01/2023] Open
Abstract
Sarcopenia is a gradual and generalized skeletal muscle (SKM) syndrome, characterized by the impairment of muscle components and functionality. Hydrogen sulfide (H2S), endogenously formed within the body from the activity of cystathionine-γ-lyase (CSE), cystathionine- β-synthase (CBS), and mercaptopyruvate sulfurtransferase, is involved in SKM function. Here, in an in vitro model of sarcopenia based on damage induced by dexamethasone (DEX, 1 μM, 48 h treatment) in C2C12-derived myotubes, we investigated the protective potential of exogenous and endogenous sources of H2S, i.e., glucoraphanin (30 μM), L-cysteine (150 μM), and 3-mercaptopyruvate (150 μM). DEX impaired the H2S signalling in terms of a reduction in CBS and CSE expression and H2S biosynthesis. Glucoraphanin and 3-mercaptopyruvate but not L-cysteine prevented the apoptotic process induced by DEX. In parallel, the H2S-releasing molecules reduced the oxidative unbalance evoked by DEX, reducing catalase activity, O2− levels, and protein carbonylation. Glucoraphanin, 3-mercaptopyruvate, and L-cysteine avoided the changes in myotubes morphology and morphometrics after DEX treatment. In conclusion, in an in vitro model of sarcopenia, an impairment in CBS/CSE/H2S signalling occurs, whereas glucoraphanin, a natural H2S-releasing molecule, appears more effective for preventing the SKM damage. Therefore, glucoraphanin supplementation could be an innovative therapeutic approach in the management of sarcopenia.
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Walha R, Dagenais P, Gaudreault N, Beaudoin-Côté G, Boissy P. The effects of custom-made foot orthoses on foot pain, foot function, gait function, and free-living walking activities in people with psoriatic arthritis (PsA): a pre-experimental trial. Arthritis Res Ther 2022; 24:124. [PMID: 35614481 PMCID: PMC9130455 DOI: 10.1186/s13075-022-02808-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 05/13/2022] [Indexed: 11/24/2022] Open
Abstract
Introduction Foot involvement is a significant concern in psoriatic arthritis (PsA) as it can lead to severe levels of foot pain and disability and reduced mobility and quality of life. Previous studies have shown moderate efficacy for custom-made foot orthoses (CFO) in reducing foot pain and disability in people with rheumatoid arthritis. However, evidence on the efficacy of CFO in people with PsA is lacking. Objectives To explore the effects of CFO on foot function, foot and lower limb pain, gait function, and free-living walking activities (FWA) in people with PsA. Methods A pre-experimental study including twenty participants with PsA (mean age: 54.10 ± 9.06 years and disease duration: 11.53 ± 10.22 years) was carried out. All the participants received and wore CFO for 7 weeks. Foot and lower limb pain and foot function were measured before and after the intervention using the numerical rating scale (NRS) and the foot function index (FFI). Gait function was assessed by recording spatiotemporal parameters (STPs) during a 10-m walk test using an instrumented gait analysis system (Mobility Lab). Free-living walking activities (step count, free-living cadence, time spent in different ambulatory physical activities (APA)) were recorded over 7 days using an accelerometer-instrumented sock. Results The FFI reported scores demonstrated severe baseline levels of foot pain (54.46 ± 14.58 %) and disability (46.65 ± 16.14%). Statistically and clinically significant improvements in foot pain and foot function and large effect sizes (Cohen’s effect size > 1, p < 0.005) were observed after the intervention period. A strong correlation (r = −0.64, p < 0.01) between the CFO wearing time and foot function was demonstrated. However, no significant changes were found for gait STP or free-living walking activities after 7 weeks of CFO use. Conclusion Results support the clinical and biomechanical plausibility of using CFO in people with PsA to reduce pain and improve foot function. Large-scale and controlled studies are needed to confirm these findings. Moreover, a multidisciplinary approach including the prescription of exercise therapy and physiotherapy combined with CFO could be required to improve STP and promote APA in people with PsA. Trial registration ClinicalTrials.gov, NCT05075343. Retrospectively registered on September 29, 2021 Supplementary Information The online version contains supplementary material available at 10.1186/s13075-022-02808-8.
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Affiliation(s)
- Roua Walha
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada.,Research Center on Aging, CIUSSS de l'Estrie-CHUS, Sherbrooke, QC, Canada
| | - Pierre Dagenais
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Nathaly Gaudreault
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | | | - Patrick Boissy
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada. .,Research Center on Aging, CIUSSS de l'Estrie-CHUS, Sherbrooke, QC, Canada.
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Piętowska Z, Nowicka D, Szepietowski J. Can Biological Drugs Diminish the Risk of Sarcopenia in Psoriatic Patients? Life (Basel) 2022; 12:435. [PMID: 35330186 PMCID: PMC8952562 DOI: 10.3390/life12030435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/11/2022] [Accepted: 03/12/2022] [Indexed: 11/28/2022] Open
Abstract
Sarcopenia and psoriasis are different inflammatory diseases that share common comorbidities (e.g., cardiovascular diseases, metabolic syndrome, obesity, autoimmune diseases, depression). Psoriasis is a dermatosis involving the skin, joints, and nails. Its estimated prevalence is 2–4%, and the possibility of progression to psoriatic arthritis reaches 6–42%. Sarcopenia is defined as reduced muscle strength, muscle quantity, and physical performance due to non-ageing related causes. It affects up to 10% of the general population. We conducted a review of the literature to provide up-to-date information about the risk of sarcopenia in psoriasis and to identify risk factors that increase this risk. The search of the literature allowed us to include 51 publications, but only five cross-sectional studies provided quantitative results on the rates of sarcopenia in psoriasis. The prevalence of sarcopenia in psoriasis varied from 9.1% to 61.7%. This wide range was caused by different definitions of sarcopenia and different cut-off values across studies. Prognostic factors include lean mass and fat mass. Further research based on the European Working Group on Sarcopenia in Older People guidelines is required. Such studies should include not only muscle mass and strength but also other factors that may influence the occurrence of sarcopenia and inflammatory markers.
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Davies K, Dures E, Ng WF. Fatigue in inflammatory rheumatic diseases: current knowledge and areas for future research. Nat Rev Rheumatol 2021; 17:651-664. [PMID: 34599320 DOI: 10.1038/s41584-021-00692-1] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2021] [Indexed: 02/08/2023]
Abstract
Fatigue is a complex phenomenon and an important health concern for many people with chronic inflammatory rheumatic diseases, such as rheumatoid arthritis, psoriatic arthritis, primary Sjögren syndrome and systemic lupus erythematosus. Although some clinical trials have shown the benefits of cognitive behavioural therapy in fatigue management, the effect of this approach is relatively modest, and no curative treatment has been identified. The pathogenesis of fatigue remains unclear. Despite many challenges and limitations, a growing body of research points to roles for the immune system, the central and autonomic nervous systems and the neuroendocrine system in the induction and maintenance of fatigue in chronic diseases. New insights indicate that sleep, genetic susceptibility, metabolic disturbances and other biological and physiological mechanisms contribute to fatigue. Furthermore, understanding of the relationships between psychosocial factors and fatigue is increasing. However, the interrelationships between these diverse mechanisms and fatigue remain poorly defined. In this Review, we outline various biological, physiological and psychosocial determinants of fatigue in inflammatory rheumatic diseases, and propose mechanistic and conceptual models of fatigue to summarize current understanding, stimulate debate and develop further research ideas.
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Affiliation(s)
- Kristen Davies
- Translational and Clinical Research Institute, Newcastle University and NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne, UK.,Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Emma Dures
- Academic Rheumatology, Bristol Royal Infirmary, Bristol, UK.,Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
| | - Wan-Fai Ng
- Translational and Clinical Research Institute, Newcastle University and NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne, UK. .,Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK.
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Ministrini S, Carbone F. PCSK9 and inflammation. Maybe a role in autoimmune diseases? Focus on rheumatoid arthritis and systemic lupus erythematosus. Curr Med Chem 2021; 29:970-979. [PMID: 34375179 DOI: 10.2174/0929867328666210810150940] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 06/17/2021] [Accepted: 06/28/2021] [Indexed: 11/22/2022]
Abstract
Despite a clear epidemiological link between autoimmune disease and cardiovascular (CV) risk exists, pathophysiological explanations are extremely complex and far from being elucidated. Dysregulation of metabolic pathways and chronic low-grade inflammation represent common pathways, but CV risk still remains underestimated in patients with autoimmune diseas. Among different candidate mediators, pro-protein convertase subtilisin/kexin type 9 (PCSK9) is attracting a growing attention, due to a combined effect on lipid metabolism and inflammatory response. Study on PCSK9 inhibitors have established a clear benefit on CV outcome without an established effect on inflammation. Conversely, evidence from sepsis and HIV infection strongly support a pro-inflammatory role of PCSK9. Still uncertain is instead the role of PCSK9 in autoimmune disease. So far reported clinical findings are controversial and likely reflect the poor knowledge of PCSK9 activity on monocyte/macrophage migration and activation. The complex signaling network around PCSK9 synthesis and metabolism may also have a role, especially concerning the involvement of scavenger receptors such as CD36. Such complexity in PCSK9 signaling seems particularly evident in autoimmune disease model. This would also potentially explain the observed independency between lipid profile and PCSK9 levels, the so-called "lipid paradox". In this narrative review we will summarize the current knowledge about the complex network of PCSK9 signaling. We will focus of upstream and downstream pathways with potential implication in autoimmune disease and potential effects of PCSK9 inhibiting strategies.
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Affiliation(s)
- Stefano Ministrini
- Internal Medicine, Angiology and Atherosclerosis; Department of Medicine and Surgery, University of Perugia, p.le Gambuli 1, 06132 Perugia, Italy
| | - Federico Carbone
- First Clinic of internal Medicine, Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132 Genoa, Italy
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Yun HW, Kim CJ, Kim JW, Kim HA, Suh CH, Jung JY. The Assessment of Muscle Mass and Function in Patients with Long-Standing Rheumatoid Arthritis. J Clin Med 2021; 10:jcm10163458. [PMID: 34441751 PMCID: PMC8397223 DOI: 10.3390/jcm10163458] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 07/27/2021] [Accepted: 07/31/2021] [Indexed: 12/14/2022] Open
Abstract
Muscular dysfunction in rheumatoid arthritis (RA) can affect the quality of life and comorbidities. We enrolled 320 patients with RA, and evaluated their muscle mass, grip strength, and physical performance. Seven (2.2%) and 21 RA patients (6.6%) had sarcopenia, as defined by the European and Asian Working Group for Sarcopenia (EWGS and AWGS), respectively; 54 patients (16.9%) were determined to have low muscle mass with normal muscle function, as defined by the EWGS; 38 patients (11.9%) reported sarcopenia by SARC-F questionnaire. Male sex (odds ratio (OR) 140.65), low body mass index (BMI) (OR 0.41), and use of tumor necrosis factor (TNF) inhibitors (OR 4.84) were associated with a low muscle mass as defined by the EWGS, while male sex, old age, and low BMI were associated with sarcopenia as defined by the AWGS. Old age (OR 1.11), high BMI (OR 1.13), and a high Disease Activity Score 28 (OR 1.95) were associated with sarcopenia as reported on the SARC-F. Male, low BMI, and use of TNF inhibitors were associated with a low muscle mass, while male sex, old age, and low BMI were associated with sarcopenia in patients with long-standing RA.
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Affiliation(s)
- Hye-Won Yun
- Department of Nursing, Andong Science College of Nursing, 189 Seoseon-gil, Seohu-myeon, Andong 36616, Korea;
| | - Chun-Ja Kim
- College of Nursing and Research Institute of Nursing Science, Ajou University, 206 Worldcup-ro, Yeongtong-gu, Suwon 16499, Korea;
| | - Ji-Won Kim
- Department of Rheumatology, Department of Nursing, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon 16499, Korea; (J.-W.K.); (H.-A.K.); (C.-H.S.)
| | - Hyoun-Ah Kim
- Department of Rheumatology, Department of Nursing, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon 16499, Korea; (J.-W.K.); (H.-A.K.); (C.-H.S.)
| | - Chang-Hee Suh
- Department of Rheumatology, Department of Nursing, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon 16499, Korea; (J.-W.K.); (H.-A.K.); (C.-H.S.)
| | - Ju-Yang Jung
- Department of Rheumatology, Department of Nursing, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon 16499, Korea; (J.-W.K.); (H.-A.K.); (C.-H.S.)
- Correspondence: ; Tel.: +82-31-219-5134; Fax: +82-31-219-5157
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Park S, Yuan H, Zhang T, Wu X, Huang SK, Cho SM. Long-term silk peptide intake promotes skeletal muscle mass, reduces inflammation, and modulates gut microbiota in middle-aged female rats. Biomed Pharmacother 2021; 137:111415. [PMID: 33761619 DOI: 10.1016/j.biopha.2021.111415] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 02/10/2021] [Accepted: 02/16/2021] [Indexed: 12/22/2022] Open
Abstract
Aging alters body composition to induce sarcopenia, particularly in women, but the mechanism remains unclear. We hypothesized that silk peptide(SP) intake could prevent an age-related decrease in muscle mass and strength in middle-aged female rats and explored the action mechanism. After the acute intake of SP and defatted soybean peptides, serum concentrations of amino acids were measured in ten middle-aged rats in each group. Forty 12-month-old female Sprague-Dawley rats were fed a high-fat and high-carbohydrate diet for 12 weeks including 0.5 g casein/kg body weight(BW)/day(Aged), 0.15 g SP plus 0.35 g casein/kg BW/day(Low-SP), 0.5 g SP/kg BW/day(High-SP), or 40 mg metformin plus 0.5 g casein/kg BW/day(Metformin). Ten rats aged 7-week old(Young) had the same treatment as the Aged-group. The body composition, grip strength, glucose metabolism, intestinal tissue morphology, and gut microbiota were also determined. After an acute consumption, total amino acids were more quickly absorbed and maintained at higher levels in SP than soybean peptides. Lean body mass(LBM) and grip strength were lower in the Aged-group than the Young and Low-SP groups, and the High-SP regimen increased these parameters as much as the Young-group. Serum concentrations and mRNA expression of TNF-α in the gastrocnemius and quadriceps muscles were higher in the Aged-group than the Young-group, whereas SP intake reduced their serum levels and skeletal muscles. Glucose and insulin tolerance indicated that insulin resistance was elevated in the Aged-group compared to the Young-group, while Low-SP and High-SP alleviated them as much as the Young-group. High-SP increased serum propionate and butyrate concentrations compared to the Aged-group. SP intake increased the relative abundance of Bacteroides and Prevotella and decreased Blautia and Clostridium in the feces. In conclusion, SP intake protects against a decrease in lean body mass and grip strength in middle-aged female rats. The protection was partly related to maintaining higher serum concentrations of total amino acids after SP consumption and decreasing inflammation and insulin resistance through gut microbiota modulation.
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Affiliation(s)
- Sunmin Park
- Department of Food and Nutrition, Obesity/Diabetes Research Center, Hoseo University, Asan 31499, Republic of Korea; Department of Bio-Convergence System, Hoseo University, Asan 31499, Republic of Korea.
| | - Heng Yuan
- Department of Bio-Convergence System, Hoseo University, Asan 31499, Republic of Korea
| | - Ting Zhang
- Department of Bio-Convergence System, Hoseo University, Asan 31499, Republic of Korea
| | - Xuangao Wu
- Department of Bio-Convergence System, Hoseo University, Asan 31499, Republic of Korea
| | - Shao Kai Huang
- Department of Bio-Convergence System, Hoseo University, Asan 31499, Republic of Korea
| | - Song Mee Cho
- Department of Food and Nutrition, Obesity/Diabetes Research Center, Hoseo University, Asan 31499, Republic of Korea
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Yurdakul OV, Ince OE, Bagcier F, Kara M, Kultur E, Aydin T. Evaluating the strength of spinal and proximal girdle muscles in patients with axial spondyloarthritis: Correlation with activity, disability, and functionality. Int J Rheum Dis 2021; 24:701-710. [PMID: 33750032 DOI: 10.1111/1756-185x.14102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 02/15/2021] [Accepted: 03/01/2021] [Indexed: 01/01/2023]
Abstract
AIM To compare the muscle strength of muscle groups in axial spondyloarthritis (axSpA) patients with the muscle powers of healthy volunteers and to examine the relationship of muscle strengths with disease activity, functionality, and disability. METHOD One hundred males (50 axSpA, 50 healthy) were included in the study. Bath Disease Activity Index (BASDAI), Functional Index (BASFI), and Health Assessment Questionnaire-Disability Index (HAQ-DI) scores were recorded. The maximum (max) and mean cervical flexion, extension, lateral flexion (CF, CE, CLF), truncal flexion, extension (TF, TE), root joint flexion, extension, abduction, internal and external rotation (SF, SE, SAB, SIR and SER for the shoulder; HF, HE, HAB, HIR and HER for the hip) muscle strengths of the patients in both groups were measured by a handheld dynamometer. Total muscle strength (CT, TT, ST, HT) was found according to the sum of the max and mean values for each region. RESULTS All muscle strengths were lower in the axSpA group compared to the healthy volunteers. The symptom duration was found to have a weak-moderate negative correlation with CT, TT, ST, HT and all individual muscle strengths except for the TE, CF, HIR, and HER. BASDAI and HAQ-DI had weak-moderate negative correlations with HIR and HER. BASFI had a weak-moderate negative correlation with cervical measurements, TE, TF, SF, SER, SIR, and hip measurements. CONCLUSION All muscle strengths were lower in patients compared to healthy volunteers. Strengthening specific muscle groups for the desired goal can be a reasonable strategy. The study is prospectively registered and available at www.clinicaltrials.gov (NCT04435860).
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Affiliation(s)
- Ozan Volkan Yurdakul
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Bezmialem Vakıf University, Istanbul, Turkey
| | - Ozlenen Eylul Ince
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Bezmialem Vakıf University, Istanbul, Turkey
| | - Fatih Bagcier
- Cam and Sakura State Hospital, Physical Medicine and Rehabilitation Clinic, Istanbul, Turkey
| | - Mert Kara
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Bezmialem Vakıf University, Istanbul, Turkey
| | - Esra Kultur
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Bezmialem Vakıf University, Istanbul, Turkey
| | - Teoman Aydin
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Bezmialem Vakıf University, Istanbul, Turkey
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Picca A, Calvani R. Molecular Mechanism and Pathogenesis of Sarcopenia: An Overview. Int J Mol Sci 2021; 22:3032. [PMID: 33809723 DOI: 10.3390/ijms22063032] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 03/08/2021] [Indexed: 02/07/2023] Open
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Hax V, do Espírito Santo RC, dos Santos LP, Farinon M, de Oliveira MS, Três GL, Gasparin AA, de Andrade NPB, Bredemeier M, Xavier RM, Chakr RMDS. Practical screening tools for sarcopenia in patients with systemic sclerosis. PLoS One 2021; 16:e0245683. [PMID: 33481872 PMCID: PMC7822499 DOI: 10.1371/journal.pone.0245683] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 01/05/2021] [Indexed: 11/26/2022] Open
Abstract
Introduction In view of the method of diagnosing sarcopenia being complex and considered to be difficult to introduce into routine practice, the European Working Group on Sarcopenia in Older People (EWGSOP) recommends the use of the SARC-F questionnaire as a way to introduce assessment and treatment of sarcopenia into clinical practice. Only recently, some studies have turned their attention to the presence of sarcopenia in systemic sclerosis (SSc).There is no data about performance of SARC-F and other screening tests for sarcopenia in this population. Objective To compare the accuracy of SARC-F, SARC-CalF, SARC-F+EBM, and Ishii test as screening tools for sarcopenia in patients with SSc. Methods Cross-sectional study of 94 patients with SSc assessed by clinical and physical evaluation. Sarcopenia was defined according to the revised 2019 EWGSOP diagnostic criteria (EWGSOP2) with assessments of dual-energy X-ray absorptiometry, handgrip strength, and short physical performance battery (SPPB). As case finding tools, SARC-F, SARC-CalF, SARC-F+EBM and Ishii test were applied, including data on calf circumference, body mass index, limitations in strength, walking ability, rising from a chair, stair climbing, and self reported number of falls in the last year. The screening tests were evaluated through receiver operating characteristic (ROC) curves. Standard measures of diagnostic accuracy were computed using the EWGSOP2 criteria as the gold standard for diagnosis of sarcopenia. Results Sarcopenia was identified in 15 (15.9%) patients with SSc by the EWGSOP2 criteria. Area under the ROC curve of SARC-F screening for sarcopenia was 0.588 (95% confidence interval (CI) 0.420–0.756, p = 0.283). The results of sensitivity, specificity, positive likelihood ratio (+LR), negative likelihood ratio (-LR) and diagnostic Odds Ratio (DOR) with the EWGSOP2 criteria as the gold standard were 40.0% (95% CI, 19.8–64.2), 81.0% (95% CI, 71.0–88.1), 2.11 (95% CI, 0.98–4.55), 0.74 (95% CI, 0.48–1.13) and 2.84 (95% CI, 0.88–9.22), respectively. SARC-CalF and SARC-F+EBM showed better sensitivity (53.3%, 95% CI 30.1–75.2 and 60.0%, 95% CI 35.7–80.2, respectively) and specificity (84.8%, 95% CI 75.3–91.1 and 86.1%, 95% CI 76.8–92.0, respectively) compared with SARC-F. The best sensitivity was obtained with the Ishii test (86.7%, 95% CI 62.1–96.3), at the expense of a small loss of specificity (73.4%, 95% CI 62.7–81.9). Comparing the ROC curves, SARC-F performed worse than SARC-CalF, SARC-F+EBM and Ishii test as a sarcopenia screening tool in this population (AUCs 0.588 vs. 0.718, 0.832, and 0.862, respectively). Direct comparisons between tests revealed differences only between SARC-F and Ishii test for sensitivity (p = 0.013) and AUC (p = 0.031). Conclusion SARC-CalF, SARC-F+EBM, and Ishii test performed better than SARC-F alone as screening tools for sarcopenia in patients with SSc. Considering diagnostic accuracy and feasibility aspects, SARC-F+EBM seems to be the most suitable screening tool to be adopted in routine care of patients with SSc.
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Affiliation(s)
- Vanessa Hax
- Department of Internal Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
- Division of Rheumatology, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Rio Grande do Sul, Brazil
- * E-mail:
| | | | | | - Mirian Farinon
- Division of Rheumatology, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Rio Grande do Sul, Brazil
| | | | - Guilherme Levi Três
- Division of Rheumatology, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Andrese Aline Gasparin
- Department of Internal Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
- Division of Rheumatology, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Nicole Pamplona Bueno de Andrade
- Department of Internal Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
- Division of Rheumatology, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Markus Bredemeier
- Division of Rheumatology, Hospital Nossa Senhora da Conceição, Grupo Hospitalar Conceição, Porto Alegre, Rio Grande do Sul, Brazil
| | - Ricardo Machado Xavier
- Department of Internal Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
- Division of Rheumatology, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Rafael Mendonça da Silva Chakr
- Department of Internal Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
- Division of Rheumatology, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Rio Grande do Sul, Brazil
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