1
|
Borda MG, Baldera JP, Samuelsson J, Zettergren A, Rydén L, Westman E, Pérez-Zepeda MU, Kern S, Venegas LC, Duque G, Skoog I, Aarsland D. Temporal Muscle Thickness: A Practical Approximation for Assessing Muscle Mass in Older Adults. J Am Med Dir Assoc 2024; 25:664-670.e3. [PMID: 38307124 DOI: 10.1016/j.jamda.2023.12.009] [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: 10/03/2023] [Revised: 12/04/2023] [Accepted: 12/09/2023] [Indexed: 02/04/2024]
Abstract
OBJECTIVE Ongoing research has evidenced the importance of muscle measurement in predicting adverse outcomes. Measurement of other muscles is promising in current research. This study aimed to determine the correlation between temporal muscle thickness (TMT) and appendicular lean soft tissue (ALSTI) in older adults. DESIGN Cross-sectional study. SETTINGS AND PARTICIPANTS Single cohort gathered in Gothenburg, Sweden, consisting of individuals born in 1944 (n = 1203). METHODS We studied 657 magnetic resonance images to measure TMT. Comparisons of TMT with dual-energy X-ray absorptiometry ALSTI (kg/m2) as a reference standard were performed. Finally, TMT associations with cognition evaluated using the Mini-Mental State Examination (MMSE), gait speed, and handgrip strength were explored with linear regressions. RESULTS The correlation between TMT and ALSTI was weak yet significant (r = 0.277, P < .001). TMT exhibited significant associations with MMSE (estimate = 0.168, P = .002), gait speed (estimate = 1.795, P < .001), and ALSTI (estimate = 0.508, P < .001). These associations varied when analyzed by sex. In women, TMT was significantly associated with gait speed (estimate = 1.857, P = .005) and MMSE (estimate = 0.223, P = .003). In men, TMT scores were significantly correlated with ALSTI scores (estimate = 0.571, P < .001). CONCLUSION AND IMPLICATIONS Repurposing head images can be an accessible alternative to detect muscle mass and ultimately detect sarcopenia. These studies have the potential to trigger interventions or further evaluation to improve the muscle and overall health of individuals. However, additional research is warranted before translating these findings into clinical practice.
Collapse
Affiliation(s)
- Miguel German Borda
- Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger, Norway; Semillero de Neurociencias y Envejecimiento, Ageing Institute, Medical School, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Jonathan Patricio Baldera
- Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger, Norway; Escuela de Estadística de la Universidad Autónoma de Santo Domingo, Santo Domingo, República Dominicana
| | - Jessica Samuelsson
- Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anna Zettergren
- Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lina Rydén
- Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Eric Westman
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden
| | - Mario Ulises Pérez-Zepeda
- Dirección de Investigación, Instituto Nacional de Geriatría, Mexico City, Mexico; Centro de Investigación en Ciencias de la Salud (CICSA), FCS, Universidad Anáhuac México Campus Norte, Huixquilucan Edo. de México, Mexico.
| | - Silke Kern
- Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Psychiatry, Cognition and Old Age Psychiatry, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Luis Carlos Venegas
- Hospital Universitario Maryor-Méderi, Universidad del Rosario, Bogotá, Colombia
| | - Gustavo Duque
- Bone, Muscle & Geroscience Research Group, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada; Dr. Joseph Kaufmann Chair in Geriatric Medicine, Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Ingmar Skoog
- Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Psychiatry, Cognition and Old Age Psychiatry, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Dag Aarsland
- Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger, Norway; Department of Old Age Psychiatry, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom
| |
Collapse
|
2
|
Jones AR, Currie D, Peng C, Ebeling PR, Center JR, Duque G, Lybrand S, Lyubomirsky G, Mitchell RJ, Pearson S, Seibel MJ, Occhipinti JA. Expanding access to fracture liaison services in Australia for people with minimal trauma fractures: a system dynamics modelling study. Med J Aust 2024; 220:243-248. [PMID: 38409791 DOI: 10.5694/mja2.52241] [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: 01/11/2023] [Accepted: 12/07/2023] [Indexed: 02/28/2024]
Abstract
OBJECTIVES To project how many minimal trauma fractures could be averted in Australia by expanding the number and changing the operational characteristics of fracture liaison services (FLS). STUDY DESIGN System dynamics modelling. SETTING, PARTICIPANTS People aged 50 years or more who present to hospitals with minimal trauma fractures, Australia, 2020-31. MAIN OUTCOME MEASURES Numbers of all minimal trauma fractures and of hip fractures averted by increasing the FLS number (from 29 to 58 or 100), patient screening rate (from 30% to 60%), and capacity for accepting new patients (from 40 to 80 per service per month), and reducing the proportion of eligible patients who do not attend FLS (from 30% to 15%); cost per fracture averted. RESULTS Our model projected a total of 2 441 320 minimal trauma fractures (258 680 hip fractures; 2 182 640 non-hip fractures) in people aged 50 years or older during 2020-31, including 1 211 646 second or later fractures. Increasing the FLS number to 100 averted a projected 5405 fractures (0.22%; $39 510 per fracture averted); doubling FLS capacity averted a projected 3674 fractures (0.15%; $35 835 per fracture averted). Our model projected that neither doubling the screening rate nor reducing by half the proportion of eligible patients who did not attend FLS alone would reduce the number of fractures. Increasing the FLS number to 100, the screening rate to 60%, and capacity to 80 new patients per service per month would together avert a projected 13 672 fractures (0.56%) at a cost of $42 828 per fracture averted. CONCLUSION Our modelling indicates that increasing the number of hospital-based FLS and changing key operational characteristics would achieve only moderate reductions in the number of minimal trauma fractures among people aged 50 years or more, and the cost would be relatively high. Alternatives to specialist-led, hospital-based FLS should be explored.
Collapse
Affiliation(s)
- Alicia R Jones
- Monash Centre for Health Research and Implementation, Monash University, Melbourne, VIC
- Monash Health, Melbourne, VIC
| | | | | | | | - Jackie R Center
- Garvan Institute of Medical Research, Sydney, NSW
- St Vincent's Hospital Sydney, Sydney, NSW
| | - Gustavo Duque
- Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne and Western Health, Melbourne, VIC
- Western Health, Melbourne, VIC
| | | | | | - Rebecca J Mitchell
- Australian Institute of Health Innovation, Macquarie University, Sydney, NSW
| | - Sallie Pearson
- Centre for Big Data Research in Health, University of New South Wales, Sydney, NSW
- Centre of Research Excellence in Medicines Intelligence, University of New South Wales, Sydney, NSW
| | - Markus J Seibel
- Concord Clinical School, University of Sydney, Sydney, NSW
- ANZAC Research Institute, University of Sydney, Sydney, NSW
| | - Jo-An Occhipinti
- Brain and Mind Centre, University of Sydney, Sydney, NSW
- Computer Simulation and Advanced Research Technologies (CSART), Sydney, NSW
| |
Collapse
|
3
|
Gurholt TP, Borda MG, Parker N, Fominykh V, Kjelkenes R, Linge J, van der Meer D, Sønderby IE, Duque G, Westlye LT, Aarsland D, Andreassen OA. Linking sarcopenia, brain structure and cognitive performance: a large-scale UK Biobank study. Brain Commun 2024; 6:fcae083. [PMID: 38510210 PMCID: PMC10953622 DOI: 10.1093/braincomms/fcae083] [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] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 12/15/2023] [Accepted: 03/06/2024] [Indexed: 03/22/2024] Open
Abstract
Sarcopenia refers to age-related loss of muscle mass and function and is related to impaired somatic and brain health, including cognitive decline and Alzheimer's disease. However, the relationships between sarcopenia, brain structure and cognition are poorly understood. Here, we investigate the associations between sarcopenic traits, brain structure and cognitive performance. We included 33 709 UK Biobank participants (54.2% female; age range 44-82 years) with structural and diffusion magnetic resonance imaging, thigh muscle fat infiltration (n = 30 561) from whole-body magnetic resonance imaging (muscle quality indicator) and general cognitive performance as indicated by the first principal component of a principal component analysis across multiple cognitive tests (n = 22 530). Of these, 1703 participants qualified for probable sarcopenia based on low handgrip strength, and we assigned the remaining 32 006 participants to the non-sarcopenia group. We used multiple linear regression to test how sarcopenic traits (probable sarcopenia versus non-sarcopenia and percentage of thigh muscle fat infiltration) relate to cognitive performance and brain structure (cortical thickness and area, white matter fractional anisotropy and deep and lower brain volumes). Next, we used structural equation modelling to test whether brain structure mediated the association between sarcopenic and cognitive traits. We adjusted all statistical analyses for confounders. We show that sarcopenic traits (probable sarcopenia versus non-sarcopenia and muscle fat infiltration) are significantly associated with lower cognitive performance and various brain magnetic resonance imaging measures. In probable sarcopenia, for the included brain regions, we observed widespread significant lower white matter fractional anisotropy (77.1% of tracts), predominantly lower regional brain volumes (61.3% of volumes) and thinner cortical thickness (37.9% of parcellations), with |r| effect sizes in (0.02, 0.06) and P-values in (0.0002, 4.2e-29). In contrast, we observed significant associations between higher muscle fat infiltration and widespread thinner cortical thickness (76.5% of parcellations), lower white matter fractional anisotropy (62.5% of tracts) and predominantly lower brain volumes (35.5% of volumes), with |r| effect sizes in (0.02, 0.07) and P-values in (0.0002, 1.9e-31). The regions showing the most significant effect sizes across the cortex, white matter and volumes were of the sensorimotor system. Structural equation modelling analysis revealed that sensorimotor brain regions mediate the link between sarcopenic and cognitive traits [probable sarcopenia: P-values in (0.0001, 1.0e-11); muscle fat infiltration: P-values in (7.7e-05, 1.7e-12)]. Our findings show significant associations between sarcopenic traits, brain structure and cognitive performance in a middle-aged and older adult population. Mediation analyses suggest that regional brain structure mediates the association between sarcopenic and cognitive traits, with potential implications for dementia development and prevention.
Collapse
Affiliation(s)
- Tiril P Gurholt
- Norwegian Centre for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital and University of Oslo, Oslo 0424, Norway
| | - Miguel Germán Borda
- Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger 4068, Norway
- Faculty of Health Sciences, University of Stavanger, Stavanger 4036, Norway
- Semillero de Neurociencias y Envejecimiento, Ageing Institute, Medical School, Pontificia Universidad Javeriana, Bogota 111611, Colombia
| | - Nadine Parker
- Norwegian Centre for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital and University of Oslo, Oslo 0424, Norway
| | - Vera Fominykh
- Norwegian Centre for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital and University of Oslo, Oslo 0424, Norway
| | - Rikka Kjelkenes
- Norwegian Centre for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital and University of Oslo, Oslo 0424, Norway
- Department of Psychology, University of Oslo, Oslo 0373, Norway
| | - Jennifer Linge
- AMRA Medical AB, Linköping 58222, Sweden
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping 58183, Sweden
| | - Dennis van der Meer
- Norwegian Centre for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital and University of Oslo, Oslo 0424, Norway
- School of Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht 6200MD, The Netherlands
| | - Ida E Sønderby
- Norwegian Centre for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital and University of Oslo, Oslo 0424, Norway
- Department of Medical Genetics, Oslo University Hospital, Oslo 0424, Norway
| | - Gustavo Duque
- Dr. Joseph Kaufmann Chair in Geriatric Medicine, Department of Medicine and Research Institute of the McGill University Health Centre, McGill University, Montreal, QC H4A 3J1, Canada
| | - Lars T Westlye
- Norwegian Centre for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital and University of Oslo, Oslo 0424, Norway
- Department of Psychology, University of Oslo, Oslo 0373, Norway
| | - Dag Aarsland
- Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger 4068, Norway
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London WC2R 2LS, UK
| | - Ole A Andreassen
- Norwegian Centre for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital and University of Oslo, Oslo 0424, Norway
| |
Collapse
|
4
|
Kirk B, Cawthon PM, Arai H, Ávila-Funes JA, Barazzoni R, Bhasin S, Binder EF, Bruyere O, Cederholm T, Chen LK, Cooper C, Duque G, Fielding RA, Guralnik J, Kiel DP, Landi F, Reginster JY, Sayer AA, Visser M, von Haehling S, Woo J, Cruz-Jentoft AJ. The Conceptual Definition of Sarcopenia: Delphi Consensus from the Global Leadership Initiative in Sarcopenia (GLIS). Age Ageing 2024; 53:afae052. [PMID: 38520141 PMCID: PMC10960072 DOI: 10.1093/ageing/afae052] [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: 01/31/2024] [Indexed: 03/25/2024] Open
Abstract
IMPORTANCE Sarcopenia, the age-related loss of muscle mass and strength/function, is an important clinical condition. However, no international consensus on the definition exists. OBJECTIVE The Global Leadership Initiative in Sarcopenia (GLIS) aimed to address this by establishing the global conceptual definition of sarcopenia. DESIGN The GLIS steering committee was formed in 2019-21 with representatives from all relevant scientific societies worldwide. During this time, the steering committee developed a set of statements on the topic and invited members from these societies to participate in a two-phase International Delphi Study. Between 2022 and 2023, participants ranked their agreement with a set of statements using an online survey tool (SurveyMonkey). Statements were categorised based on predefined thresholds: strong agreement (>80%), moderate agreement (70-80%) and low agreement (<70%). Statements with strong agreement were accepted, statements with low agreement were rejected and those with moderate agreement were reintroduced until consensus was reached. RESULTS 107 participants (mean age: 54 ± 12 years [1 missing age], 64% men) from 29 countries across 7 continents/regions completed the Delphi survey. Twenty statements were found to have a strong agreement. These included; 6 statements on 'general aspects of sarcopenia' (strongest agreement: the prevalence of sarcopenia increases with age (98.3%)), 3 statements on 'components of sarcopenia' (muscle mass (89.4%), muscle strength (93.1%) and muscle-specific strength (80.8%) should all be a part of the conceptual definition of sarcopenia)) and 11 statements on 'outcomes of sarcopenia' (strongest agreement: sarcopenia increases the risk of impaired physical performance (97.9%)). A key finding of the Delphi survey was that muscle mass, muscle strength and muscle-specific strength were all accepted as 'components of sarcopenia', whereas impaired physical performance was accepted as an 'outcome' rather than a 'component' of sarcopenia. CONCLUSION AND RELEVANCE The GLIS has created the first global conceptual definition of sarcopenia, which will now serve to develop an operational definition for clinical and research settings.
Collapse
Affiliation(s)
- Ben Kirk
- Department of Medicine, Western Health, Melbourne Medical School, University of Melbourne, Melbourne, VIC, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne and Western Health, Melbourne, VIC, Australia
| | - Peggy M Cawthon
- California Pacific Medical Center, Research Institute, 550 16th Street, Second Floor, San Francisco, CA 94143USA
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CAUSA
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, Obu, AichiJapan
| | - José A Ávila-Funes
- Department of Geriatrics, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
- Bordeaux Population Health Research Center, UMR 1219, University of Bordeaux, Inserm, Bordeaux F-33000, France
| | - Rocco Barazzoni
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Shalender Bhasin
- Boston Claude D. Pepper Older Americans Independence Center, Brigham and Women’s Hospital, Harvard Medical School, Boston, MAUSA
| | - Ellen F Binder
- Division of General Medicine and Geriatrics, School of Medicine, Washington University in St. Louis, St. Louis MO, USA
| | - Olivier Bruyere
- WHO Collaborating Center for Public Health Aspects of Musculo-Skeletal Health and Ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
- Department of Sport and Rehabilitation Sciences, University of Liège, Liège, Belgium
| | - Tommy Cederholm
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
- Theme Inflammation and Ageing, Karolinska University Hospital, Stockholm, Sweden
| | - Liang-Kung Chen
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan
- Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- Department of Epidemiology, University of Oxford, Oxford, OXUK
| | - Gustavo Duque
- Bone, Muscle & Geroscience Group, Research Institute of the McGill University Health Centre, Montreal, QC, Canada
- Dr Joseph Kaufmann Chair in Geriatric Medicine, Department of Medicine, McGill University, Montreal, QC, Canada
| | - Roger A Fielding
- Nutrition Exercise, Physiology, and Sarcopenia Laboratory, Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MAUSA
| | - Jack Guralnik
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MDUSA
| | - Douglas P Kiel
- Department of Medicine Beth Israel Deaconess Medical Center and Harvard Medical School, Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MAUSA
| | - Francesco Landi
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, Rome 00168, Italy
| | - Jean-Yves Reginster
- WHO Collaborating Center for Epidemiology of Musculoskeletal Health and Aging, Liège, Belgium
- Chair for Biomarkers of Chronic Diseases, College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Avan A Sayer
- AGE Research Group, NIHR Newcastle Biomedical Research Centre, Newcastle Hospitals and Faculty of Medical Sciences Newcastle University, Newcastle, UK
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- The Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Stephan von Haehling
- Department of Cardiology and Pneumology, University Medicine Göttingen (UMG), Göttingen, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany
| | - Jean Woo
- Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
| | | | | |
Collapse
|
5
|
Gruneisen E, Kremer R, Duque G. Fat as a Friend or Foe of the Bone. Curr Osteoporos Rep 2024:10.1007/s11914-024-00864-4. [PMID: 38416274 DOI: 10.1007/s11914-024-00864-4] [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] [Accepted: 02/12/2024] [Indexed: 02/29/2024]
Abstract
PURPOSE OF REVIEW The objective of this review is to summarize the literature on the prevalence and diagnosis of obesity and its metabolic profile, including bone metabolism, focusing on the main inflammatory and turnover bone mediators that better characterize metabolically healthy obesity phenotype, and to summarize the therapeutic interventions for obesity with their effects on bone health. RECENT FINDINGS Osteoporosis and fracture risk not only increase with age and menopause but also with metabolic diseases, such as diabetes mellitus. Thus, patients with high BMI may have a higher bone fragility and fracture risk. However, some obese individuals with healthy metabolic profiles seem to be less at risk of bone fracture. Obesity has become an alarming disease with growing prevalence and multiple metabolic comorbidities, resulting in a significant burden on healthcare and increased mortality. The imbalance between increased food ingestion and decreased energy expenditure leads to pathological adipose tissue distribution and function, with increased secretion of proinflammatory markers and harmful consequences for body tissues, including bone tissue. However, some obese individuals seem to have a healthy metabolic profile and may not develop cardiometabolic disease during their lives. This healthy metabolic profile also benefits bone turnover and is associated with lower fracture risk.
Collapse
Affiliation(s)
- Elodie Gruneisen
- Division of Endocrinology & Metabolism, Department of Medicine, McGill University Health Centre, Montréal, QC, Canada
| | - Richard Kremer
- Division of Endocrinology & Metabolism, Department of Medicine, McGill University Health Centre, Montréal, QC, Canada
- Bone, Muscle & Geroscience Group, Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - Gustavo Duque
- Bone, Muscle & Geroscience Group, Research Institute of the McGill University Health Centre, Montreal, QC, Canada.
- Dr. Joseph Kaufmann Chair in Geriatric Medicine, Department of Medicine, McGill University, Montreal, QC, Canada.
| |
Collapse
|
6
|
Borda MG, Samuelsson J, Cederholm T, Baldera JP, Pérez-Zepeda MU, Barreto GE, Zettergren A, Kern S, Rydén L, Gonzalez-Lara M, Salazar-Londoño S, Duque G, Skoog I, Aarsland D. Nutrient Intake and Its Association with Appendicular Total Lean Mass and Muscle Function and Strength in Older Adults: A Population-Based Study. Nutrients 2024; 16:568. [PMID: 38398892 PMCID: PMC10892025 DOI: 10.3390/nu16040568] [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: 01/03/2024] [Revised: 02/12/2024] [Accepted: 02/14/2024] [Indexed: 02/25/2024] Open
Abstract
Treatment options for sarcopenia are currently limited, and primarily rely on two main therapeutic approaches: resistance-based physical activity and dietary interventions. However, details about specific nutrients in the diet or supplementation are unclear. We aim to investigate the relationship between nutrient intake and lean mass, function, and strength. Data were derived from the Gothenburg H70 birth cohort study in Sweden, including 719,70-year-olds born in 1944 (54.1% females). For independent variables, the diet history method (face-to-face interviews) was used to estimate habitual food intake during the preceding three months. Dependent variables were gait speed (muscle performance), hand grip strength (muscle strength), and the appendicular lean soft tissue index (ALSTI). Linear regression analyses were performed to analyze the relationship between the dependent variables and each of the covariates. Several nutrients were positively associated with ALSTI, such as polyunsaturated fatty acids (DHA, EPA), selenium, zinc, riboflavin, niacin equivalent, vitamin B12, vitamin D, iron, and protein. After correction for multiple comparisons, there were no remaining correlations with handgrip and gait speed. Findings of positive correlations for some nutrients with lean mass suggest a role for these nutrients in maintaining muscle volume. These results can be used to inform clinical trials to expand the preventive strategies and treatment options for individuals at risk of muscle loss and sarcopenia.
Collapse
Affiliation(s)
- Miguel Germán Borda
- Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, 4011 Stavanger, Norway; (M.G.B.); (J.P.B.); (D.A.)
- Semillero de Neurociencias y Envejecimiento, Ageing Institute, Medical School, Pontificia Universidad Javeriana, Bogotá 110231, Colombia;
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 14186 Stockholm, Sweden
| | - Jessica Samuelsson
- Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, 41345 Gothenburg, Sweden; (J.S.); (A.Z.); (S.K.); (L.R.); (I.S.)
| | - Tommy Cederholm
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, 62167 Uppsala, Sweden;
- Theme Inflammation & Aging, Karolinska University Hospital, 14186 Stockholm, Sweden
| | - Jonathan Patricio Baldera
- Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, 4011 Stavanger, Norway; (M.G.B.); (J.P.B.); (D.A.)
- Escuela de Estadística, Universidad Autónoma de Santo Domingo, Santo Domingo 10103, Dominican Republic
| | - Mario Ulises Pérez-Zepeda
- Instituto Nacional de Geriatría, Dirección de Investigación, Mexico City 10200, Mexico;
- Centro de Investigación en Ciencias de la Salud (CICSA), Facultad de Ciencias de la Salud, Universidad Anáhuac México Campus Norte, Huixquilucan 52786, Mexico
| | - George E. Barreto
- Department of Biological Sciences, University of Limerick, V94 PH61 Limerick, Ireland;
| | - Anna Zettergren
- Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, 41345 Gothenburg, Sweden; (J.S.); (A.Z.); (S.K.); (L.R.); (I.S.)
| | - Silke Kern
- Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, 41345 Gothenburg, Sweden; (J.S.); (A.Z.); (S.K.); (L.R.); (I.S.)
- Department of Psychiatry, Cognition and Old Age Psychiatry, Sahlgrenska University Hospital, SE-413 45 Mölndal, Sweden
| | - Lina Rydén
- Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, 41345 Gothenburg, Sweden; (J.S.); (A.Z.); (S.K.); (L.R.); (I.S.)
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, 62167 Uppsala, Sweden;
- Theme Inflammation & Aging, Karolinska University Hospital, 14186 Stockholm, Sweden
| | | | - Salomón Salazar-Londoño
- Semillero de Neurociencias y Envejecimiento, Ageing Institute, Medical School, Pontificia Universidad Javeriana, Bogotá 110231, Colombia;
| | - Gustavo Duque
- Dr. Joseph Kaufmann Chair in Geriatric Medicine, Department of Medicine, McGill University, Montreal, QC H3A 2B4, Canada
- Bone, Muscle & Geroscience Group, Research Institute of the McGill University Health Centre, Montreal, QC H4A 3J1, Canada
| | - Ingmar Skoog
- Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, 41345 Gothenburg, Sweden; (J.S.); (A.Z.); (S.K.); (L.R.); (I.S.)
- Department of Psychiatry, Cognition and Old Age Psychiatry, Sahlgrenska University Hospital, SE-413 45 Mölndal, Sweden
| | - Dag Aarsland
- Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, 4011 Stavanger, Norway; (M.G.B.); (J.P.B.); (D.A.)
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London SE1 9RT, UK
| |
Collapse
|
7
|
Debruin DA, Miksa K, Vogrin S, Duque G, Sales M, Hayes A. Exploring new balance and gait factors that are associated with osteosarcopenia in patients with a previous fall and/or fracture history. Arch Gerontol Geriatr 2024; 117:105221. [PMID: 37832464 DOI: 10.1016/j.archger.2023.105221] [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: 07/19/2023] [Revised: 10/02/2023] [Accepted: 10/05/2023] [Indexed: 10/15/2023]
Abstract
Osteosarcopenic individuals have poor muscle function and increased bone fragility, which results in a severe detriment to health outcomes. Hence, there is a necessity to discover easily accessible factors associated with osteosarcopenia to develop timely interventions. This study aimed to determine new sensitive balance and/or gait variables that are associated with osteosarcopenia in a population of older people with a history of falls and/or fractures. In a cross-sectional cohort study, 306 men and women aged ≥65 years completed a series of questionnaires, clinical assessments and muscle strength and function tests. Subsequently, participants were separated into osteopenia, osteoporosis and osteosarcopenia, groups for comparison and further analysis. Osteosarcopenia performed worse than osteopenia and osteoporosis in grip strength, gait speed, physical function scores and in multiple gait and balance indices (p<0.001). During posturography testing, there were larger elliptical areas with eyes open (p = 0.003), and eyes closed (p = 0.043) and increased sway velocity on a firm platform (p = 0.007) in the osteosarcopenia group, compared to osteoporosis. Limits of stability and eyes open ellipse area significantly contributed to the multivariable model (p = 0.029 and p = 0.038, respectively), suggesting that these balance parameters, along with grip strength, may be useful in identifying older adults with osteosarcopenia from those with only osteopenia/osteoporosis. Older adults with osteosarcopenia and a history of falls and/or fractures demonstrated inferior strength, function, and gait characteristics. This study identified indices of balance that were sensitive discriminators for osteosarcopenia and could be easily implemented into routine assessment.
Collapse
Affiliation(s)
- Danielle A Debruin
- Australian Institute for Musculoskeletal Science (AIMSS), Western Health, Melbourne, VIC, Australia; Institute of Health and Sport (IHeS), Victoria University, Melbourne, VIC, Australia; Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, Melbourne, VIC, Australia; Department of Biochemical and Physiological Sciences, School of Biosciences, Faculty of Health and Medical Science, University of Surrey, Guildford, Surrey, United Kingdom
| | - Kayley Miksa
- Australian Institute for Musculoskeletal Science (AIMSS), Western Health, Melbourne, VIC, Australia; Institute of Health and Sport (IHeS), Victoria University, Melbourne, VIC, Australia
| | - Sara Vogrin
- Australian Institute for Musculoskeletal Science (AIMSS), Western Health, Melbourne, VIC, Australia; Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, Melbourne, VIC, Australia
| | - Gustavo Duque
- Australian Institute for Musculoskeletal Science (AIMSS), Western Health, Melbourne, VIC, Australia; Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, Melbourne, VIC, Australia; Research Institute of the McGill University Health Centre, Montreal, QC, Canada; Dr. Joseph Kaufmann Chair in Geriatric Medicine, Department of Medicine, McGill University, Montreal, QC, Canada
| | - Myrla Sales
- Australian Institute for Musculoskeletal Science (AIMSS), Western Health, Melbourne, VIC, Australia
| | - Alan Hayes
- Australian Institute for Musculoskeletal Science (AIMSS), Western Health, Melbourne, VIC, Australia; Institute of Health and Sport (IHeS), Victoria University, Melbourne, VIC, Australia; Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, Melbourne, VIC, Australia.
| |
Collapse
|
8
|
Borda MG, Duque G, Pérez-Zepeda MU, Baldera JP, Westman E, Zettergren A, Samuelsson J, Kern S, Rydén L, Skoog I, Aarsland D. Using magnetic resonance imaging to measure head muscles: An innovative method to opportunistically determine muscle mass and detect sarcopenia. J Cachexia Sarcopenia Muscle 2024; 15:189-197. [PMID: 38050325 PMCID: PMC10834349 DOI: 10.1002/jcsm.13362] [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: 05/12/2023] [Revised: 08/04/2023] [Accepted: 09/20/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND Sarcopenia is associated with multiple adverse outcomes. Traditional methods to determine low muscle mass for the diagnosis of sarcopenia are mainly based on dual-energy X-ray absorptiometry (DXA), whole-body magnetic resonance imaging (MRI) and bioelectrical impedance analysis. These tests are not always available and are rather time consuming and expensive. However, many brain and head diseases require a head MRI. In this study, we aim to provide a more accessible way to detect sarcopenia by comparing the traditional method of DXA lean mass estimation versus the tongue and masseter muscle mass assessed in a standard brain MRI. METHODS The H70 study is a longitudinal study of older people living in Gothenburg, Sweden. In this cross-sectional analysis, from 1203 participants aged 70 years at baseline, we included 495 with clinical data and MRI images available. We used the appendicular lean soft tissue index (ALSTI) in DXA images as our reference measure of lean mass. Images from the masseter and tongue were analysed and segmented using 3D Slicer. For the statistical analysis, the Spearman correlation coefficient was used, and concordance was estimated with the Kappa coefficient. RESULTS The final sample consisted of 495 participants, of which 52.3% were females. We found a significant correlation coefficient between both tongue (0.26) and masseter (0.33) with ALSTI (P < 0.001). The sarcopenia prevalence confirmed using the alternative muscle measure in MRI was calculated using the ALSTI (tongue = 2.0%, masseter = 2.2%, ALSTI = 2.4%). Concordance between sarcopenia with masseter and tongue versus sarcopenia with ALSTI as reference has a Kappa of 0.989 (P < 0.001) for masseter and a Kappa of 1 for the tongue muscle (P < 0.001). Comorbidities evaluated with the Cumulative Illness Rating Scale were significantly associated with all the muscle measurements: ALSTI (odds ratio [OR] 1.16, 95% confidence interval [CI] 1.07-1.26, P < 0.001), masseter (OR 1.16, 95% CI 1.07-1.26, P < 0.001) and tongue (OR 1.13, 95% CI 1.04-1.22, P = 0.002); the higher the comorbidities, the higher the probability of having abnormal muscle mass. CONCLUSIONS ALSTI was significantly correlated with tongue and masseter muscle mass. When performing the sarcopenia diagnostic algorithm, the prevalence of sarcopenia calculated with head muscles did not differ from sarcopenia calculated using DXA, and almost all participants were correctly classified using both methods.
Collapse
Affiliation(s)
- Miguel German Borda
- Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger, Norway
- Semillero de Neurociencias y Envejecimiento, Ageing Institute, Medical School, Pontificia Universidad Javeriana, Bogotá, Colombia
- Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Gustavo Duque
- Research Institute of the McGill University Health Centre, Montreal, Québec, Canada
- Dr. Joseph Kaufmann Chair in Geriatric Medicine, Department of Medicine, McGill University, Montreal, Québec, Canada
| | - Mario Ulises Pérez-Zepeda
- Instituto Nacional de Geriatría, Dirección de Investigación, Ciudad de México, México
- Centro de Investigación en Ciencias de la Salud (CICSA), FCS, Universidad Anáhuac México Campus Norte, Huixquilucan, México
| | - Jonathan Patricio Baldera
- Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger, Norway
- Escuela de Estadística de la Universidad Autónoma de Santo Domingo, Santo Domingo, República Dominicana
| | - Eric Westman
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Anna Zettergren
- Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Jessica Samuelsson
- Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Silke Kern
- Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Psychiatry, Cognition and Old Age Psychiatry, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Lina Rydén
- Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ingmar Skoog
- Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Psychiatry, Cognition and Old Age Psychiatry, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Dag Aarsland
- Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger, Norway
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| |
Collapse
|
9
|
Xiang M, Pilling LC, Melzer D, Kirk B, Duque G, Liu R, Kuchel GA, Wood AR, Metcalf B, Diniz BS, Hillsdon M, Kuo CL. Does physical activity moderate the association between shorter leukocyte telomere length and incident coronary heart disease? Data from 54,180 UK Biobank participants. GeroScience 2024; 46:1331-1342. [PMID: 37544968 PMCID: PMC10828302 DOI: 10.1007/s11357-023-00890-7] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 07/24/2023] [Indexed: 08/08/2023] Open
Abstract
Telomere shortening is a biological aging hallmark. The effect of short telomere length may be targeted by increased physical activity to reduce the risk of multiple aging-related diseases, including coronary heart disease (CHD). The objective was to assess the moderation effect of accelerometer-based physical activity (aPA) on the association between shorter leukocyte telomere length (LTL) relatively in the population sample and incident CHD. Data were from the UK Biobank participants with well-calibrated accelerometer data for at least 6.5 days (n = 54,180). Relative mean LTL at baseline (5-6 years prior to aPA assessment) was measured in T/S ratio, using a multiplex quantitative polymerase chain reaction (qPCR) technology, by comparing the amount of the telomere amplification product (T) to that of a single-copy gene (S). aPA measures included total number of events (at least 10-s continued physical activity > 32 milligravities [mg]), total volume, mean duration, mean intensity, and peak intensity of all events. LTL, aPA measures, and their interactions were associated with incident CHD (mean follow-up 6.8 years) using Cox proportional hazards models adjusting for covariates. Longer LTL (relative to the sample distribution) was associated with reduced incidence of CHD (adjusted hazard ratio [aHR] = 0.94 per standard deviation [SD] increase in LTL, [95% CI, 0.90 to 0.99], P = .010). Incidence of CHD was reduced by higher total volume of aPA (aHR = 0.82 per SD increase in LTL, [95% CI, 0.71 to 0.95], P = .010) but increased by higher total number of events (aHR = 1.11 per SD increase in LTL, [95% CI, 1.02 to 1.21], P = .020) after controlling for other aPA measures and covariates. However, none of the interactions between LTL and aPA measures was statistically significant (P = .171).
Collapse
Affiliation(s)
- Meiruo Xiang
- Connecticut Convergence Institute for Translation in Regenerative Engineering, University of Connecticut Health Center, 195 Farmington Avenue, Suite 2080, Farmington, CT, USA
| | - Luke C Pilling
- Epidemiology and Public Health Group, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - David Melzer
- Epidemiology and Public Health Group, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Ben Kirk
- Department of Medicine - Western Health, The University of Melbourne Australian Institute for Musculoskeletal Science (AIMSS), Saint Albans, Victoria, Australia
| | - Gustavo Duque
- Department of Medicine - Western Health, The University of Melbourne Australian Institute for Musculoskeletal Science (AIMSS), Saint Albans, Victoria, Australia
- Research Institute of the McGill University Health Centre, Montreal, Canada
| | - Rui Liu
- Department of Health Sciences, Sacred Heart University, Fairfield, CT, USA
| | - George A Kuchel
- UConn Center On Aging, University of Connecticut Health Center, Farmington, CT, USA
| | - Andrew R Wood
- Genetics of Complex Traits, College of Medicine and Health, University of Exeter, Exeter, UK
| | - Brad Metcalf
- College of Life and Environmental Sciences, Sport and Health Sciences, University of Exeter, Exeter, UK
| | - Breno S Diniz
- UConn Center On Aging, University of Connecticut Health Center, Farmington, CT, USA
| | - Melvyn Hillsdon
- College of Life and Environmental Sciences, Sport and Health Sciences, University of Exeter, Exeter, UK
| | - Chia-Ling Kuo
- Connecticut Convergence Institute for Translation in Regenerative Engineering, University of Connecticut Health Center, 195 Farmington Avenue, Suite 2080, Farmington, CT, USA.
- UConn Center On Aging, University of Connecticut Health Center, Farmington, CT, USA.
- Department of Public Health Sciences, University of Connecticut Health Center, Farmington, CT, USA.
| |
Collapse
|
10
|
Hurtado Y, Hernández OA, De Leon DPA, Duque G. Challenges in Delivering Effective Care for Older Persons with Fragility Fractures. Clin Interv Aging 2024; 19:133-140. [PMID: 38283764 PMCID: PMC10822128 DOI: 10.2147/cia.s433999] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 01/19/2024] [Indexed: 01/30/2024] Open
Abstract
Fragility fractures occur because of low-impact trauma or even spontaneously in individuals with osteoporosis. Caring for older persons with fragility fractures can present several challenges due to the unique needs and vulnerabilities of this population. Older individuals commonly have multiple medical conditions, such as osteoporosis, arthritis, cardiovascular diseases, and diabetes. These comorbidities can complicate fracture management and increase the risk of complications. Fracture repair through surgery may be more complex in older patients due to poor bone quality, decreased tissue elasticity, and higher chances of anesthesia complications. In addition, mobility and functional limitations post-fracture are highly prevalent in this population, affecting their independence and increasing their risk of institutionalization. Addressing these challenges requires a multidisciplinary approach involving orthopedic surgeons, geriatricians, physical and rehabilitation physicians, physiotherapists, occupational therapists, dieticians, social workers, and caregivers. Preventive measures, such as fall prevention strategies and osteoporosis management, can also play a vital role in reducing the incidence of fragility fractures in older persons.
Collapse
Affiliation(s)
- Yesid Hurtado
- Division of Endocrinology, Hospital San José, Bogotá, Colombia
| | | | | | - Gustavo Duque
- Bone, Muscle & Geroscience Research Group, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- Dr. Joseph Kaufmann Chair in Geriatric Medicine, Department of Medicine, McGill University, Montreal, Quebec, Canada
| |
Collapse
|
11
|
Vazquez-Guajardo M, Rivas D, Duque G. Exercise as a Therapeutic Tool in Age-Related Frailty and Cardiovascular Disease: Challenges and Strategies. Can J Cardiol 2024:S0828-282X(24)00013-8. [PMID: 38215969 DOI: 10.1016/j.cjca.2024.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 12/12/2023] [Accepted: 01/07/2024] [Indexed: 01/14/2024] Open
Abstract
Understanding the link between heart disease and frailty in older adults is crucial. Although medical progress has extended life, it has not fully addressed the decline in function and quality of life in frail older people. Frailty is a state of vulnerability to health stressors that needs comprehensive solutions. Its assessment within health care, especially in cardiology, is important owing to its association with worse clinical outcomes. Recent evidence and guidelines suggest that the prescription of a comprehensive exercise regimen, tailored to progressively include strength, balance, mobility, and endurance training improves adherence, functionality, and health-related quality of life, in both acute and chronic cardiovascular diseases. In addition, exercise is a vital tool that improves function, targets frailty, and holistically affects the body's systems. Still, many frail people do not exercise enough, and when they do, they usually do not follow an appropriate plan tailored for better functional outcomes. Overcoming barriers and limitations in exercise enrollment and adherence through strategies such as automated cardiac rehabilitation referral, patient education, and eHealth tools can notably improve clinical outcomes.
Collapse
Affiliation(s)
| | - Daniel Rivas
- Bone, Muscle and Geroscience Research Group, Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
| | - Gustavo Duque
- Bone, Muscle and Geroscience Research Group, Research Institute of the McGill University Health Centre, Montréal, Québec, Canada; Geriatric Medicine, Faculty of Medicine, McGill University, Montréal, Québec, Canada.
| |
Collapse
|
12
|
Smith C, Sim M, Dalla Via J, Levinger I, Duque G. The Interconnection Between Muscle and Bone: A Common Clinical Management Pathway. Calcif Tissue Int 2024; 114:24-37. [PMID: 37922021 DOI: 10.1007/s00223-023-01146-4] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 09/26/2023] [Indexed: 11/05/2023]
Abstract
Often observed with aging, the loss of skeletal muscle (sarcopenia) and bone (osteoporosis) mass, strength, and quality, is associated with reduced physical function contributing to falls and fractures. Such events can lead to a loss of independence and poorer quality of life. Physical inactivity (mechanical unloading), especially in older adults, has detrimental effects on the mass and quality of bone as well as muscle, while increases in activity (mechanical loading) have positive effects. Emerging evidence suggests that the relationship between bone and muscle is driven, at least in part, by bone-muscle crosstalk. Bone and muscle are closely linked anatomically, mechanically, and biochemically, and both have the capacity to function with paracrine and endocrine-like action. However, the exact mechanisms involved in this crosstalk remain only partially explored. Given older adults with lower bone mass are more likely to present with impaired muscle function, and vice versa, strategies capable of targeting both bone and muscle are critical. Exercise is the primary evidence-based prevention strategy capable of simultaneously improving muscle and bone health. Unfortunately, holistic treatment plans including exercise in conjunction with other allied health services to prevent or treat musculoskeletal disease remain underutilized. With a focus on sarcopenia and osteoporosis, the aim of this review is to (i) briefly describe the mechanical and biochemical interactions between bone and muscle; (ii) provide a summary of therapeutic strategies, specifically exercise, nutrition and pharmacological approaches; and (iii) highlight a holistic clinical pathway for the assessment and management of sarcopenia and osteoporosis.
Collapse
Affiliation(s)
- Cassandra Smith
- School of Medical and Health Sciences, Nutrition and Health Innovation Research Institute, Edith Cowan University, Joondalup, WA, Australia
- Medical School, The University of Western Australia, Perth, WA, Australia
| | - Marc Sim
- School of Medical and Health Sciences, Nutrition and Health Innovation Research Institute, Edith Cowan University, Joondalup, WA, Australia
- Medical School, The University of Western Australia, Perth, WA, Australia
| | - Jack Dalla Via
- School of Medical and Health Sciences, Nutrition and Health Innovation Research Institute, Edith Cowan University, Joondalup, WA, Australia
| | - Itamar Levinger
- Institute for Health and Sport (IHES), Victoria University, Melbourne, VIC, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne and Western Health, St Albans, VIC, Australia
| | - Gustavo Duque
- Bone, Muscle & Geroscience Research Group, Research Institute of the MUHC, Montreal, QC, Canada.
- Dr. Joseph Kaufmann Chair in Geriatric Medicine, Department of Medicine, McGill University, Montreal, QC, Canada.
| |
Collapse
|
13
|
Sanchez-Trigo H, Kemmler W, Duque G, Sañudo B. Assessment of Osteogenic Exercise Efficacy via Bone Turnover Markers in Premenopausal Women: A Randomized Controlled Trial. Int J Sport Nutr Exerc Metab 2024; 34:20-29. [PMID: 37917954 DOI: 10.1123/ijsnem.2023-0104] [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: 05/22/2023] [Revised: 08/06/2023] [Accepted: 08/20/2023] [Indexed: 11/04/2023]
Abstract
Assessing bone's response to physical activity interventions is challenging. This randomized controlled trial investigates if changes in bone turnover markers can offer an early evaluation of a physical activity intervention's effectiveness in improving bone mineral density (BMD) in premenopausal women. Participants in the intervention group (n = 27, with 24 completing the trial) were instructed to walk at least 10,000 steps every day on a brisk walk and to execute 60 jumps daily, each surpassing 4g of acceleration, using an accelerometer-based wearable device. Meanwhile, the control group (n = 26, with 18 completing the trial) continued with their usual lifestyle. Bone turnover markers, comprising of C-terminal telopeptide of Type I collagen, procollagen Type 1 N-terminal propeptide, and total osteocalcin (carboxylated and undercarboxylated) were measured at baseline and midway through the intervention (3 months). Dual-energy X-ray absorptiometry scans of the hip and lumbar spine were conducted at baseline and the end of the intervention (6 months) to estimate BMD. Analysis of covariance exhibited significant differences between groups in procollagen Type 1 N-terminal propeptide (-6.74 μg/L, p = .023) and C-terminal telopeptide of Type I collagen (-83 ng/L, p = .043) after 3 months, and in femoral neck BMD (+0.024 g/cm2, p = .016), total hip BMD (+0.036 g/cm2, p = .004), and lumbar spine BMD (+0.026 g/cm2, p = .020) after 6 months. A significant correlation (r = -.73; p < .001) was detected between reductions in C-terminal telopeptide of Type I collagen and increases in femoral neck BMD. In conclusion, this intervention improved BMD in premenopausal women, with bone turnover markers potentially useful for early intervention assessment, though further research is needed.
Collapse
Affiliation(s)
| | - Wolfgang Kemmler
- Institute of Medical Physics, Friedrich-Alexander-University of Erlangen-Nürnberg, Erlangen, Germany
| | - Gustavo Duque
- Research Institute of the McGill University Health Center, Montreal, QC, Canada
- Division of Geriatric Medicine, Department of Medicine, McGill University, Montreal, QC, Canada
| | - Borja Sañudo
- Physical Education and Sports Department, University of Seville, Seville, Spain
| |
Collapse
|
14
|
Lee A, McArthur C, Ioannidis G, Duque G, Adachi JD, Griffith LE, Thabane L, Papaioannou A. Associations between Osteosarcopenia and Falls, Fractures, and Frailty in Older Adults: Results From the Canadian Longitudinal Study on Aging (CLSA). J Am Med Dir Assoc 2024; 25:167-176.e6. [PMID: 37925161 DOI: 10.1016/j.jamda.2023.09.027] [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: 06/06/2023] [Revised: 09/22/2023] [Accepted: 09/25/2023] [Indexed: 11/06/2023]
Abstract
OBJECTIVE To explore if older adults with osteosarcopenia are at a greater risk of falls, fractures, frailty, and worsening life satisfaction and activities of daily living (ADL) compared to those with normal bone mineral density (BMD) and without sarcopenia. DESIGN The baseline and 3-year follow-up of a longitudinal study. SETTING AND PARTICIPANTS Community-dwelling people aged 65 years or older in Canada. METHODS Caucasian participants 65 years or older that completed the Canadian Longitudinal Study on Aging (CLSA) 2015 baseline interview, physical measurements and 3-year follow-up were included. Osteopenia/osteoporosis was defined as BMD T score below -1 SD according to the World Health Organization, and sarcopenia was defined as low grip strength and/or low gait speed according to the Sarcopenia Definition Outcomes Consortium. Osteosarcopenia was defined as the coexistence of osteopenia/osteoporosis and sarcopenia. Self-reported incident falls and fractures in the last 12 months before the 3-year follow-up were measured. Frailty was assessed through the Rockwood Frailty Index (FI); life satisfaction through the Satisfaction With Life Scale (SWLS); and ADL through the Older American Resources and Services modules. Multivariable logistic and linear regression, including subgroup analyses by sex, were conducted. RESULTS The sample of 8888 participants (49.1% females) had a mean age (SD) of 72.7 (5.6) years. At baseline, neither osteopenia/osteoporosis nor sarcopenia (reference group) was present in 30.1%, sarcopenia only in 18.4%, osteopenia/osteoporosis only in 29.2%, and osteosarcopenia in 22.3%. Osteosarcopenia was significantly associated with incident falls and fractures in males [adjusted odds ratio (aOR), 1.90, 95% CI 1.15, 3.14, and aOR 2.60, 95% CI 1.14, 5.91, respectively] compared to males without osteopenia/osteoporosis or sarcopenia. Participants with osteosarcopenia had worsening ADL of 0.110 (estimated β coefficient 0.110, 95% CI 0.029, 0.192) and a decrease in their SWLS by 0.660 (estimated β coefficient -0.660, 95% CI -1.133, -0.187), compared to those without. Osteosarcopenia was not associated with frailty for both males and females. CONCLUSIONS AND IMPLICATIONS Osteosarcopenia was associated with self-reported incident falls and fractures in males and worse life satisfaction and ADL for all participants. Assessing and identifying osteosarcopenia is essential for preventing falls and fractures. Furthermore, it improves life satisfaction and ADL.
Collapse
Affiliation(s)
- Ahreum Lee
- Geras Centre for Aging Research, Hamilton, Ontario, Canada; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Caitlin McArthur
- School of Physiotherapy, Dalhousie University, Halifax, Nova Scotia, Canada
| | - George Ioannidis
- Geras Centre for Aging Research, Hamilton, Ontario, Canada; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Gustavo Duque
- Joseph Kaufmann Chair in Geriatric Medicine, Department of Medicine, McGill University, Montreal, Quebec, Canada; Research Institute of the McGill university Health Centre, Montreal, Quebec, Canada
| | - Jonathan D Adachi
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Lauren E Griffith
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada; McMaster Institute for Research on Aging, Hamilton, Ontario, Canada
| | - Lehana Thabane
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada; Biostatistics Unit, St Joseph's Healthcare, Hamilton, Ontario, Canada
| | - Alexandra Papaioannou
- Geras Centre for Aging Research, Hamilton, Ontario, Canada; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
| |
Collapse
|
15
|
Duque G, Feehan J, Tripodi N, Kondrikov D, Wijeratne T, Gimble J, Hill W, Apostolopoulos V. Differential responses to aging amongst the transcriptome and proteome of mesenchymal progenitor populations. Res Sq 2023:rs.3.rs-3755129. [PMID: 38168272 PMCID: PMC10760299 DOI: 10.21203/rs.3.rs-3755129/v1] [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] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
The biological aging of mesenchymal stem cells is proposed to contribute to the development of a range of musculoskeletal and systemic diseases associated with older adults, such as osteoporosis, sarcopenia, and frailty. Despite this, little is understood about the specific mechanisms which drive this stem cell exhaustion, with most studies evaluating indirect effects of other aging changes, such as DNA damage, senescence, and inflammaging. In this study, we assess the transcriptomic and proteomic changes in three different populations of mesenchymal progenitor cells from older (50-70 years) and younger (20-40 years) individuals to uncover potential mechanisms driving stem cell exhaustion in mesenchymal tissues. To do this, we harvested primary bone marrow mesenchymal stem and progenitor cells (MPCs), circulating osteoprogenitors (COP), and adipose-derived stem cells (ADSCs) from younger and older donors, with an equal number of samples from males and females. These samples underwent RNA sequencing and label-free proteomic analysis, comparing the younger samples to the older ones. There was a distinct transcriptomic phenotype associated with the pooled older stem cells, indicative of suppressed proliferation and differentiation; however, there was no consistent change in the proteome of the cells. Older MPCs had a distinct phenotype in both the transcriptome and proteome, again consistent with altered differentiation and proliferation, but also a pro-inflammatory immune shift in older adults. COP cells showed a strong transcriptomic shift to pro-inflammatory signaling but no consistent proteomic phenotype. Similarly, ADSCs displayed transcriptomic shift in physiologies associated with cell migration, adherence, and immune activation, but no consistent proteomic change with age. These results show that there are underlying transcriptomic changes with stem cell aging that likely contribute to a decline in tissue regeneration; however, contextual factors such as the microenvironment and general health status also have a strong role in this.
Collapse
|
16
|
de Souto Barreto P, Rolland Y, Ferrucci L, Arai H, Bischoff-Ferrari H, Duque G, Fielding RA, Beard JR, Muscedere J, Sierra F, Vellas B, LeBrasseur NK. Looking at frailty and intrinsic capacity through a geroscience lens: the ICFSR & Geroscience Task Force. Nat Aging 2023; 3:1474-1479. [PMID: 37985720 DOI: 10.1038/s43587-023-00531-w] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Affiliation(s)
- Philipe de Souto Barreto
- IHU HealthAge, Toulouse, France.
- CERPOP, Inserm 1295, Université de Toulouse, UPS, Toulouse, France.
- Institute on Aging of the Toulouse University Hospital (CHU-Toulouse), Toulouse, France.
| | - Yves Rolland
- IHU HealthAge, Toulouse, France
- CERPOP, Inserm 1295, Université de Toulouse, UPS, Toulouse, France
- Institute on Aging of the Toulouse University Hospital (CHU-Toulouse), Toulouse, France
| | - Luigi Ferrucci
- Intramural Research Program of the National Institute on Aging
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, Obu, Japan
| | - Heike Bischoff-Ferrari
- IHU HealthAge, Toulouse, France
- Department of Geriatrics and Aging Research, University of Zurich, Zurich, Switzerland
| | - Gustavo Duque
- Bone, Muscle & Geroscience Research Program, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Roger A Fielding
- Nutrition, Exercise Physiology, and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - John R Beard
- International Longevity Center-USA, Columbia University, New York, NY, USA
| | - John Muscedere
- Department of Critical Care Medicine, Queen's University, Kingston, Ontario, Canada
| | | | - Bruno Vellas
- IHU HealthAge, Toulouse, France
- CERPOP, Inserm 1295, Université de Toulouse, UPS, Toulouse, France
- Institute on Aging of the Toulouse University Hospital (CHU-Toulouse), Toulouse, France
| | - Nathan K LeBrasseur
- Robert and Arlene Kogod Center on Aging, Mayo Clinic, Rochester, MN, USA
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, USA
| |
Collapse
|
17
|
Zanker J, Scott D, Szoeke C, Vogrin S, Patel S, Blackwell T, Bird S, Kirk B, Center J, Alajlouni DA, Gill T, Jones G, Pasco JA, Waters DL, Cawthon PM, Duque G. Predicting Slow Walking Speed From a Pooled Cohort Analysis: Sarcopenia Definitions, Agreement, and Prevalence in Australia and New Zealand. J Gerontol A Biol Sci Med Sci 2023; 78:2415-2425. [PMID: 37428864 PMCID: PMC10692428 DOI: 10.1093/gerona/glad165] [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: 12/08/2022] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND Recent operational definitions of sarcopenia have not been replicated and compared in Australia and New Zealand (ANZ) populations. We aimed to identify sarcopenia measures that discriminate ANZ adults with slow walking speed (<0.8 m/s) and determine the agreement between the Sarcopenia Definitions and Outcomes Consortium (SDOC) and revised European Working Group for Sarcopenia in Older People (EWGSOP2) operational definitions of sarcopenia. METHODS Eight studies comprising 8 100 ANZ community-dwelling adults (mean age ± standard deviation, 62.0 ± 14.4 years) with walking speed, grip strength (GR), and lean mass data were combined. Replicating the SDOC methodology, 15 candidate variables were included in sex-stratified classification and regression tree models and receiver operating characteristic curves on a pooled cohort with complete data to identify variables and cut points discriminating slow walking speed (<0.8 m/s). Agreement and prevalence estimates were compared using Cohen's Kappa (CK). RESULTS Receiver operating characteristic curves identified GR as the strongest variable for discriminating slow from normal walking speed in women (GR <20.50 kg, area under curve [AUC] = 0.68) and men (GR <31.05 kg, AUC = 0.64). Near-perfect agreement was found between the derived ANZ cut points and SDOC cut points (CK 0.8-1.0). Sarcopenia prevalence ranged from 1.5% (EWGSOP2) to 37.2% (SDOC) in women and 1.0% (EWGSOP2) to 9.1% (SDOC) in men, with no agreement (CK <0.2) between EWGSOP2 and SDOC. CONCLUSIONS Grip strength is the primary discriminating characteristic for slow walking speed in ANZ women and men, consistent with findings from the SDOC. Sarcopenia Definitions and Outcomes Consortium and EWGSOP2 definitions showed no agreement suggesting these proposed definitions measure different characteristics and identify people with sarcopenia differently.
Collapse
Affiliation(s)
- Jesse Zanker
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St. Albans, Victoria, Australia
- Department of Medicine, Western Health, The University of Melbourne, St. Albans, Victoria, Australia
| | - David Scott
- Institute for Physical Activity and Nutrition, Deakin University, Burwood, Victoria, Australia
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Cassandra Szoeke
- Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Sara Vogrin
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St. Albans, Victoria, Australia
- Department of Medicine, Western Health, The University of Melbourne, St. Albans, Victoria, Australia
| | - Sheena Patel
- Research Institute, California Pacific Medical Center, San Francisco, California, USA
| | - Terri Blackwell
- Research Institute, California Pacific Medical Center, San Francisco, California, USA
| | - Stefanie Bird
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St. Albans, Victoria, Australia
- Institute for Physical Activity and Nutrition, Deakin University, Burwood, Victoria, Australia
| | - Ben Kirk
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St. Albans, Victoria, Australia
- Department of Medicine, Western Health, The University of Melbourne, St. Albans, Victoria, Australia
| | - Jacqueline Center
- Skeletal Diseases Program, Garvan Institute of Medical Research, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Dima A Alajlouni
- Skeletal Diseases Program, Garvan Institute of Medical Research, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Tiffany Gill
- Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
| | - Graeme Jones
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Julie A Pasco
- Department of Medicine, Western Health, The University of Melbourne, St. Albans, Victoria, Australia
- IMPACT-Institute for Mental and Physical Health and Clinical Translation, Barwon HealthDeakin University, Geelong, Victoria, Australia
| | - Debra L Waters
- Department of Medicine, School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand
- Department of Internal Medicine/Geriatrics, University of New Mexico, Albuquerque, New Mexico, USA
| | - Peggy M Cawthon
- Research Institute, California Pacific Medical Center, San Francisco, California, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | - Gustavo Duque
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St. Albans, Victoria, Australia
- Department of Medicine, Research Institute of the McGill University Health Centre, McGill University, Montreal, Quebec, Canada
| |
Collapse
|
18
|
Cacciatore S, Duque G, Marzetti E. Osteosarcopenic obesity: a triple threat for older adults? Eur Geriatr Med 2023; 14:1191-1193. [PMID: 37721690 DOI: 10.1007/s41999-023-00857-z] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/19/2023]
Affiliation(s)
- Stefano Cacciatore
- Department of Geriatrics, Orthopaedics and Rheumatology, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168, Rome, Italy.
| | - Gustavo Duque
- Research Institute of the McGill University Health Centre, Montreal, QC, H4A 3J1, Canada
- Faculty of Medicine, Dr. Joseph Kaufmann Chair in Geriatric Medicine, McGill University, Montreal, QC, H4A 3J1, Canada
| | - Emanuele Marzetti
- Department of Geriatrics, Orthopaedics and Rheumatology, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168, Rome, Italy
- Fondazione Policlinico Universitario "A. Gemelli" IRCCS, L.go A. Gemelli 8, 00168, Rome, Italy
| |
Collapse
|
19
|
Senanayake D, Seneviratne S, Imani M, Harijanto C, Sales M, Lee P, Duque G, Ackland DC. Classification of Fracture Risk in Fallers Using Dual-Energy X-Ray Absorptiometry (DXA) Images and Deep Learning-Based Feature Extraction. JBMR Plus 2023; 7:e10828. [PMID: 38130762 PMCID: PMC10731096 DOI: 10.1002/jbm4.10828] [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: 02/07/2023] [Revised: 08/29/2023] [Accepted: 09/11/2023] [Indexed: 12/23/2023] Open
Abstract
Dual-energy X-ray absorptiometry (DXA) scans are one of the most frequently used imaging techniques for calculating bone mineral density, yet calculating fracture risk using DXA image features is rarely performed. The objective of this study was to combine deep neural networks, together with DXA images and patient clinical information, to evaluate fracture risk in a cohort of adults with at least one known fall and age-matched healthy controls. DXA images of the entire body as, well as isolated images of the hip, forearm, and spine (1488 total), were obtained from 478 fallers and 48 non-faller controls. A modeling pipeline was developed for fracture risk prediction using the DXA images and clinical data. First, self-supervised pretraining of feature extractors was performed using a small vision transformer (ViT-S) and a convolutional neural network model (VGG-16 and Resnet-50). After pretraining, the feature extractors were then paired with a multilayer perceptron model, which was used for fracture risk classification. Classification was achieved with an average area under the receiver-operating characteristic curve (AUROC) score of 74.3%. This study demonstrates ViT-S as a promising neural network technique for fracture risk classification using DXA scans. The findings have future application as a fracture risk screening tool for older adults at risk of falls. © 2023 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
Collapse
Affiliation(s)
- Damith Senanayake
- Department of Biomedical EngineeringUniversity of MelbourneParkvilleVICAustralia
- Department of Mechanical EngineeringUniversity of MelbourneParkvilleVICAustralia
| | - Sachith Seneviratne
- Department of Mechanical EngineeringUniversity of MelbourneParkvilleVICAustralia
- Melbourne School of DesignUniversity of MelbourneParkvilleVICAustralia
| | - Mahdi Imani
- Australian Institute for Musculoskeletal Science (AIMSS), Geroscience & Osteosarcopenia Research ProgramUniversity of Melbourne and Western HealthSt AlbansVICAustralia
- Department of Medicine‐Western HealthMelbourne Medical SchoolSt AlbansVICAustralia
| | - Christel Harijanto
- Department of Medicine‐Western HealthMelbourne Medical SchoolSt AlbansVICAustralia
| | - Myrla Sales
- Australian Institute for Musculoskeletal Science (AIMSS), Geroscience & Osteosarcopenia Research ProgramUniversity of Melbourne and Western HealthSt AlbansVICAustralia
- Department of Medicine‐Western HealthMelbourne Medical SchoolSt AlbansVICAustralia
| | - Peter Lee
- Department of Biomedical EngineeringUniversity of MelbourneParkvilleVICAustralia
| | - Gustavo Duque
- Bone, Muscle & Geroscience Group, Research Institute of the McGill University Health CentreMontrealQCCanada
- Dr. Joseph Kaufmann Chair in Geriatric Medicine, Department of MedicineMcGill UniversityMontrealQCCanada
| | - David C. Ackland
- Department of Biomedical EngineeringUniversity of MelbourneParkvilleVICAustralia
| |
Collapse
|
20
|
Feehan J, Jacques M, Kondrikov D, Eynon N, Wijeratne T, Apostolopoulos V, Gimble JM, Hill WD, Duque G. Circulating Osteoprogenitor Cells Have a Mixed Immune and Mesenchymal Progenitor Function in Humans. Stem Cells 2023; 41:1060-1075. [PMID: 37609930 PMCID: PMC10631805 DOI: 10.1093/stmcls/sxad064] [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: 04/04/2023] [Accepted: 07/24/2023] [Indexed: 08/24/2023]
Abstract
BACKGROUND Circulating osteoprogenitors (COP) are a population of cells in the peripheral circulation that possess functional and phenotypical characteristics of multipotent stromal cells (MSCs). This population has a solid potential to become an abundant, accessible, and replenishable source of MSCs with multiple potential clinical applications. However, a comprehensive functional characterization of COP cells is still required to test and fully develop their use in clinical settings. METHODS This study characterized COP cells by comparing them to bone marrow-derived MSCs (BM-MSCs) and adipose-derived MSCs (ASCs) through detailed transcriptomic and proteomic analyses. RESULTS We demonstrate that COP cells have a distinct gene and protein expression pattern with a significantly stronger immune footprint, likely owing to their hematopoietic lineage. In addition, regarding progenitor cell differentiation and proliferation pathways, COP cells have a similar expression pattern to BM-MSCs and ASCs. CONCLUSION COP cells are a unique but functionally similar population to BM-MSCs and ASCs, sharing their proliferation and differentiation capacity, thus presenting an accessible source of MSCs with strong potential for translational regenerative medicine strategies.
Collapse
Affiliation(s)
- Jack Feehan
- Department of Medicine - Western Health, The University of Melbourne, Melbourne, Victoria (VIC), Australia
- Australian Institute for Musculoskeletal Science (AIMSS), Western Health, Victoria University and University of Melbourne, Melbourne, Victoria (VIC), Australia
- Institute for Health and Sport, Victoria University, Melbourne, Victoria (VIC), Australia
| | - Macsue Jacques
- Institute for Health and Sport, Victoria University, Melbourne, Victoria (VIC), Australia
| | - Dmitry Kondrikov
- Department of Pathology and Laboratory Medicine, The Medical University of South Carolina, Charleston, SC, USA
| | - Nir Eynon
- Institute for Health and Sport, Victoria University, Melbourne, Victoria (VIC), Australia
- Australian Regenerative Medicine Institute, Monash University, Clayton, Victoria, Australia
| | - Tissa Wijeratne
- Australian Institute for Musculoskeletal Science (AIMSS), Western Health, Victoria University and University of Melbourne, Melbourne, Victoria (VIC), Australia
- Institute for Health and Sport, Victoria University, Melbourne, Victoria (VIC), Australia
| | - Vasso Apostolopoulos
- Australian Institute for Musculoskeletal Science (AIMSS), Western Health, Victoria University and University of Melbourne, Melbourne, Victoria (VIC), Australia
- Institute for Health and Sport, Victoria University, Melbourne, Victoria (VIC), Australia
| | - Jeffrey M Gimble
- Center for Stem Cell Research and Regenerative Medicine, Tulane University School of Medicine, New Orleans, LA, USA
| | - William D Hill
- Department of Pathology and Laboratory Medicine, The Medical University of South Carolina, Charleston, SC, USA
- Department of Veterans Affairs, Ralph H Johnson VA Medical Center, Charleston, SC, USA
| | - Gustavo Duque
- Department of Medicine - Western Health, The University of Melbourne, Melbourne, Victoria (VIC), Australia
- Australian Institute for Musculoskeletal Science (AIMSS), Western Health, Victoria University and University of Melbourne, Melbourne, Victoria (VIC), Australia
- Institute for Health and Sport, Victoria University, Melbourne, Victoria (VIC), Australia
- Bone, Muscle and Geroscience Research Group, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- Dr. Joseph Kaufmann Chair in Geriatric Medicine, Department of Medicine, McGill University, Montreal, Quebec, Canada
| |
Collapse
|
21
|
Zanker J, Scott D, Alajlouni D, Kirk B, Bird S, DeBruin D, Vogrin S, Bliuc D, Tran T, Cawthon P, Duque G, Center JR. Mortality, falls and slow walking speed are predicted by different muscle strength and physical performance measures in women and men. Arch Gerontol Geriatr 2023; 114:105084. [PMID: 37290229 DOI: 10.1016/j.archger.2023.105084] [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: 02/16/2023] [Revised: 05/21/2023] [Accepted: 05/29/2023] [Indexed: 06/10/2023]
Abstract
BACKGROUND Different measures of muscle strength, physical performance and body size/composition are used in various sarcopenia definitions. This study investigated which baseline measures best predict incident mortality and falls, and prevalent slow walking speed in older women and men. MATERIALS AND METHODS Data for 899 women (mean age±standard deviation, 68.7 ± 4.3 years) and 497 men (69.4 ± 3.9 years) from the Dubbo Osteoporosis Epidemiology Study 2, comprising sixty variables for muscle strength (quadriceps strength), physical performance (walking speed, timed up and go (TUG) test, sit to stand (STS) test), body size (weight, height, body mass index) and body composition (lean mass, body fat) were included. Sex-stratified Classification and Regression Tree (CART) analyses calculated baseline variable accuracy for predicting incident mortality and falls, and prevalent slow walking speed (<0.8 m/s). RESULTS Over 14.5 years, 103/899 (11.5%) women and 96/497 (19.3%) men died, 345/899 (38.4%) women and 172/497 (34.6%) men had ≥1 fall, and 304/860 (35.3%) women and 172/461 (31.7%) had baseline slow walking speed (<0.8 m/s). CART models identified age and walking speed adjusted for height as the most important predictors for mortality in women, and quadriceps strength (with adjustments) as the most important predictor for mortality in men. In both sexes, STS (with adjustments) was the most important predictor for incident falls, and TUG test was the most important predictor for prevalent slow walking speed. Body composition measures were not important predictors for any outcome. CONCLUSIONS Muscle strength and physical performance variables and cut points predict falls and mortality differently in women and men, suggesting targeted sex-specific application of selected measures may improve outcome prediction in older adults.
Collapse
Affiliation(s)
- Jesse Zanker
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St. Albans, Victoria, Australia; Department of Medicine - Western Health, The University of Melbourne, St. Albans, Victoria, Australia.
| | - David Scott
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia; Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Dima Alajlouni
- Skeletal Diseases Program, Garvan Institute of Medical Research, Sydney, New South Wales, Australia; Clinical School, St Vincent's Hospital, Faculty of Medicine and Health, University of New South Wales Sydney, Sydney, Australia
| | - Ben Kirk
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St. Albans, Victoria, Australia; Department of Medicine - Western Health, The University of Melbourne, St. Albans, Victoria, Australia
| | - Stefanie Bird
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St. Albans, Victoria, Australia; Department of Medicine - Western Health, The University of Melbourne, St. Albans, Victoria, Australia; Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia
| | - Danielle DeBruin
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St. Albans, Victoria, Australia; Department of Medicine - Western Health, The University of Melbourne, St. Albans, Victoria, Australia; Institute of Health and Sport (IHeS), Victoria University, Melbourne, VIC, Australia
| | - Sara Vogrin
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St. Albans, Victoria, Australia; Department of Medicine - Western Health, The University of Melbourne, St. Albans, Victoria, Australia
| | - Dana Bliuc
- Skeletal Diseases Program, Garvan Institute of Medical Research, Sydney, New South Wales, Australia; Clinical School, St Vincent's Hospital, Faculty of Medicine and Health, University of New South Wales Sydney, Sydney, Australia
| | - Thach Tran
- Skeletal Diseases Program, Garvan Institute of Medical Research, Sydney, New South Wales, Australia; Clinical School, St Vincent's Hospital, Faculty of Medicine and Health, University of New South Wales Sydney, Sydney, Australia
| | - Peggy Cawthon
- Research Institute, California Pacific Medical Center, San Francisco, USA; Department of Epidemiology and Biostatistics, University of California, San Francisco, USA
| | - Gustavo Duque
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St. Albans, Victoria, Australia; Department of Medicine - Western Health, The University of Melbourne, St. Albans, Victoria, Australia; Research Institute of the McGill University Health Centre, Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Jacqueline R Center
- Skeletal Diseases Program, Garvan Institute of Medical Research, Sydney, New South Wales, Australia; Clinical School, St Vincent's Hospital, Faculty of Medicine and Health, University of New South Wales Sydney, Sydney, Australia
| |
Collapse
|
22
|
Tencerova M, Duque G, Beekman KM, Corsi A, Geurts J, Bisschop PH, Paccou J. The Impact of Interventional Weight Loss on Bone Marrow Adipose Tissue in People Living with Obesity and Its Connection to Bone Metabolism. Nutrients 2023; 15:4601. [PMID: 37960254 PMCID: PMC10650495 DOI: 10.3390/nu15214601] [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: 09/25/2023] [Revised: 10/25/2023] [Accepted: 10/26/2023] [Indexed: 11/15/2023] Open
Abstract
This review focuses on providing physicians with insights into the complex relationship between bone marrow adipose tissue (BMAT) and bone health, in the context of weight loss through caloric restriction or metabolic and bariatric surgery (MBS), in people living with obesity (PwO). We summarize the complex relationship between BMAT and bone health, provide an overview of noninvasive imaging techniques to quantify human BMAT, and discuss clinical studies measuring BMAT in PwO before and after weight loss. The relationship between BMAT and bone is subject to variations based on factors such as age, sex, menopausal status, skeletal sites, nutritional status, and metabolic conditions. The Bone Marrow Adiposity Society (BMAS) recommends standardizing imaging protocols to increase comparability across studies and sites, they have identified both water-fat imaging (WFI) and spectroscopy (1H-MRS) as accepted standards for in vivo quantification of BMAT. Clinical studies measuring BMAT in PwO are limited and have shown contradictory results. However, BMAT tends to be higher in patients with the highest visceral adiposity, and inverse associations between BMAT and bone mineral density (BMD) have been consistently found in PwO. Furthermore, BMAT levels tend to decrease after caloric restriction-induced weight loss. Although weight loss was associated with overall fat loss, a reduction in BMAT did not always follow the changes in fat volume in other tissues. The effects of MBS on BMAT are not consistent among the studies, which is at least partly related to the differences in the study population, skeletal site, and duration of the follow-up. Overall, gastric bypass appears to decrease BMAT, particularly in patients with diabetes and postmenopausal women, whereas sleeve gastrectomy appears to increase BMAT. More research is necessary to evaluate changes in BMAT and its connection to bone metabolism, either in PwO or in cases of weight loss through caloric restriction or MBS, to better understand the role of BMAT in this context and determine the local or systemic factors involved.
Collapse
Affiliation(s)
- Michaela Tencerova
- Molecular Physiology of Bone, Institute of Physiology of the Czech Academy of Sciences, 14220 Prague, Czech Republic;
| | - Gustavo Duque
- Department of Medicine, Research Institute of the McGill University Health Centre, Montreal, QC H4A 3J1, Canada;
| | - Kerensa M. Beekman
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands;
| | - Alessandro Corsi
- Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy;
| | - Jeroen Geurts
- Rheumatology, Department of Musculoskeletal Medicine, Lausanne University Hospital, 1011 Lausanne, Switzerland;
| | - Peter H. Bisschop
- Department of Endocrinology, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands;
| | - Julien Paccou
- Department of Rheumatology, MABLab ULR 4490, CHU Lille, University Lille, 59000 Lille, France
| |
Collapse
|
23
|
Kirk B, Harrison SL, Zanker J, Burghardt AJ, Orwoll E, Duque G, Cawthon PM. Interactions Between HR-pQCT Bone Density and D 3 Cr Muscle Mass (or HR-pQCT Bone Structure and HR-pQCT Muscle Density) in Predicting Fractures: The Osteoporotic Fractures in Men Study. J Bone Miner Res 2023; 38:1245-1257. [PMID: 37351915 PMCID: PMC10528106 DOI: 10.1002/jbmr.4874] [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: 02/21/2023] [Revised: 06/16/2023] [Accepted: 06/22/2023] [Indexed: 06/24/2023]
Abstract
We examined if an interaction exists between bone and muscle in predicting fractures in older men. Prospective data from the Osteoporotic Fractures in Men study was used to build Cox proportional hazards models. Predictors included HR-pQCT total volumetric BMD (Tt.BMD), trabecular BMD (Tb.BMD), cortical BMD (Ct.BMD) and cortical area (Ct.Ar) at distal radius/tibia, HR-pQCT muscle volume and density (diaphyseal tibia), D3 -creatine dilution (D3 Cr) muscle mass, and grip strength and leg force, analyzed as continuous variables and as quartiles. Incident fractures were self-reported every 4 months via questionnaires and centrally adjudicated by physician review of radiology reports. Potential confounders (demographics, comorbidities, lifestyle factors, etc.) were considered. A total of 1353 men (mean age 84.2 ± 4.0 years, 92.7% white) were followed for 6.03 ± 2.11 years. In the unadjusted (continuous) model, there were no interactions (p > 0.05) between any muscle variable (D3 Cr muscle mass, muscle volume, muscle density, grip strength or leg force) and Tt.BMD at distal radius/tibia for fractures (all: n = 182-302; nonvertebral: n = 149-254; vertebral: n = 27-45). No consistent interactions were observed when interchanging Tt.BMD for Tb.BMD/Ct.BMD or for Ct.Ar (bone structure) at the distal radius/tibia in the unadjusted (continuous) models. Compared with men in quartiles (Q) 2-4 of D3 Cr muscle mass and Q2-4 of distal tibia Tt.BMD, men in Q1 of both had increased risk for all fractures (hazard ratio (HR) = 2.00; 95% confidence interval [CI] 1.24-3.23, p = 0.005) and nonvertebral fractures (HR = 2.10; 95% CI 1.25-3.52, p < 0.001) in the multivariable-adjusted model. Confidence intervals overlapped (p > 0.05) when visually inspecting other quartile groups in the multivariable-adjusted model. In this prospective cohort study of older men, there was no consistent interactions between bone and muscle variables on fracture risk. Larger sample sizes and longer follow-up may be needed to clarify if there is an interaction between bone and muscle on fracture risk in men. © 2023 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
Collapse
Affiliation(s)
- Ben Kirk
- Department of Medicine, Western Health, Melbourne Medical School, The University of Melbourne, St Albans, Melbourne, VIC, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St Albans, Melbourne, VIC, Australia
| | | | - Jesse Zanker
- Department of Medicine, Western Health, Melbourne Medical School, The University of Melbourne, St Albans, Melbourne, VIC, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St Albans, Melbourne, VIC, Australia
| | - Andrew J. Burghardt
- Department of Radiology & Biomedical Imaging, University of California, San Francisco, CA, USA
| | - Eric Orwoll
- Division of Endocrinology, Diabetes and Clinical Nutrition, School of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Gustavo Duque
- Department of Medicine, Western Health, Melbourne Medical School, The University of Melbourne, St Albans, Melbourne, VIC, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St Albans, Melbourne, VIC, Australia
- Research Institute of the McGill University Health Centre, Montreal, QC, Canada
- Dr. Joseph Kaufmann Chair in Geriatric Medicine, McGill University, Montreal, QC, Canada
| | - Peggy M Cawthon
- Research Institute, California Pacific Medical Center, San Francisco, CA, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| |
Collapse
|
24
|
Buratto J, Kirk B, Phu S, Vogrin S, Duque G. Safety and Efficacy of Testosterone Therapy on Musculoskeletal Health and Clinical Outcomes in Men: A Systematic Review and Meta-Analysis of Randomized Placebo-Controlled Trials. Endocr Pract 2023; 29:727-734. [PMID: 37164187 DOI: 10.1016/j.eprac.2023.04.013] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 04/27/2023] [Accepted: 04/29/2023] [Indexed: 05/12/2023]
Abstract
OBJECTIVE Age-related declines in muscle and bone, alongside a shift toward greater adiposity, contribute to falls and fracture risk. Testosterone is osteogenic, myogenic, and catabolic to fat. As such, we examined the effects of testosterone therapy on musculoskeletal health and clinical outcomes in men. METHODS Electronic databases (Medline, Embase, Web of Science, Central) were systematically searched for randomized controlled trials (RCTs) reporting on the effects of testosterone therapy versus placebo on any primary outcome (bone density, muscle mass, fat mass, muscle strength/physical performance) or secondary outcome (falls, fractures, disability, adverse events) in men (≥18 years). A random effects meta-regression examined the effects of testosterone on prespecified outcomes. RESULTS One thousand seven hundred twenty-eight men across 16 RCTs were included (mean age: 77.1 ± 7.6 years). Baseline mean serum testosterone ranged from 7.5 ± 0.3 to 18.9 ± 1.2 nmol/L. Compared to placebo, 6 months of testosterone therapy increased hip bone density and total lean mass, but effects for handgrip and total fat mass did not reach statistical significance. No significant effects of testosterone therapy on musculoskeletal outcomes were evident at 12 months. The limited number of RCTs reporting on adverse events/clinical outcomes, and the low incidence of these events across RCTs, prohibited statistical comparisons. CONCLUSION After 6 months, testosterone effectively increases hip bone density and total lean mass in men, but its effects are unclear for lumbar spine bone density and handgrip strength. Further, RCTs are needed to clarify the safety and efficacy of testosterone on musculoskeletal health and clinical outcomes.
Collapse
Affiliation(s)
- Jared Buratto
- Department of Medicine, Western Health, Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia; Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, Melbourne, Victoria, Australia
| | - Ben Kirk
- Department of Medicine, Western Health, Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia; Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, Melbourne, Victoria, Australia
| | - Steven Phu
- Department of Medicine, Western Health, Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia; Falls, Balance and Injury Research Centre, Neuroscience Research Australia (NeuRA), Randwick, New South Wales, Australia; Faculty of Medicine and Health, School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Sara Vogrin
- Department of Medicine, Western Health, Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia; Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, Melbourne, Victoria, Australia
| | - Gustavo Duque
- Department of Medicine, Western Health, Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia; Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, Melbourne, Victoria, Australia; Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada; Dr. Joseph Kaufmann Chair in Geriatric Medicine, McGill University, Montreal, Quebec, Canada.
| |
Collapse
|
25
|
Freitas RVDM, de Freitas DLD, de Oliveira IRD, Dos Santos Gomes C, Guerra GCB, Dantas PMS, da Silva TG, Duque G, de Lima KMG, Guerra RO. Fourier-Transform Infrared Spectroscopy as a Screening Tool for Osteosarcopenia in Community-Dwelling Older Women. J Gerontol A Biol Sci Med Sci 2023; 78:1543-1549. [PMID: 36905160 DOI: 10.1093/gerona/glad081] [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: 07/09/2022] [Indexed: 03/12/2023] Open
Abstract
Osteosarcopenia is a complex geriatric syndrome characterized by the presence of both sarcopenia and osteopenia/osteoporosis. This condition increases rates of disability, falls, fractures, mortality, and mobility impairments in older adults. The purpose of this study was to analyze the Fourier-transform infrared (FTIR) spectroscopy diagnostic power for osteosarcopenia in community-dwelling older women (n = 64; 32 osteosarcopenic and 32 non-osteosarcopenia). FTIR is a fast and reproducible technique highly sensitive to biological tissues, and a mathematical model was created using multivariate classification techniques that denoted the graphic spectra of the molecular groups. Genetic algorithm and support vector machine regression (GA-SVM) was the most feasible model, achieving 80.0% of accuracy. GA-SVM identified 15 wave numbers responsible for class differentiation, in which several amino acids (responsible for the proper activation of the mammalian target of rapamycin) and hydroxyapatite (an inorganic bone component) were observed. Imaging tests and low availability of instruments that allow the observation of osteosarcopenia involve high health costs for patients and restrictive indications. Therefore, FTIR can be used to diagnose osteosarcopenia due to its efficiency and low cost and to enable early detection in geriatric services, contributing to advances in science and technology that are potential "conventional" methods in the future.
Collapse
Affiliation(s)
| | | | | | | | | | - Paulo Moreira Silva Dantas
- Postgraduation Program in Health Sciences, Federal University of Rio Grande do Norte, Natal, Brazil
- Postgraduation Program in Physical Education, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Tales Gomes da Silva
- Institute of Chemistry, Biological Chemistry and Chemometrics, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Gustavo Duque
- Department of Medicine, McGill University, Montreal, Quebec, Canada
- Bone, Muscle & Geroscience Group, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Kassio Michell Gomes de Lima
- Institute of Chemistry, Biological Chemistry and Chemometrics, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Ricardo Oliveira Guerra
- Postgraduation Program in Health Sciences, Federal University of Rio Grande do Norte, Natal, Brazil
- Postgraduation Program in Physiotherapy, Federal University of Rio Grande do Norte, Natal, Brazil
| |
Collapse
|
26
|
Moles RJ, Perry L, Naylor JM, Center J, Ebeling P, Duque G, Major G, White C, Yates C, Jennings M, Kotowicz M, Tran T, Bliuc D, Si L, Gibson K, Basger BJ, Bolton P, Barnett S, Hassett G, Kelly A, Bazarnik B, Ezz W, Luckie K, Carter SR. Safer medicines To reduce falls and refractures for OsteoPorosis (#STOP): a study protocol for a randomised controlled trial of medical specialist-initiated pharmacist-led medication management reviews in primary care. BMJ Open 2023; 13:e072050. [PMID: 37620274 PMCID: PMC10450068 DOI: 10.1136/bmjopen-2023-072050] [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: 01/29/2023] [Accepted: 07/31/2023] [Indexed: 08/26/2023] Open
Abstract
INTRODUCTION Minimal trauma fractures (MTFs) often occur in older patients with osteoporosis and may be precipitated by falls risk-increasing drugs. One category of falls risk-increasing drugs of concern are those with sedative/anticholinergic properties. Collaborative medication management services such as Australia's Home Medicine Review (HMR) can reduce patients' intake of sedative/anticholinergics and improve continuity of care. This paper describes a protocol for an randomised controlled trial to determine the efficacy of an HMR service for patients who have sustained MTF. METHOD AND ANALYSIS Eligible participants are as follows: ≥65 years of age, using ≥5 medicines including at least one falls risk-increasing drug, who have sustained an MTF and under treatment in one of eight Osteoporosis Refracture Prevention clinics in Australia. Consenting participants will be randomised to control (standard care) or intervention groups. For the intervention group, medical specialists will refer to a pharmacist for HMR focused on reducing falls risk predominately through making recommendations to reduce falls risk medicines, and adherence to antiosteoporosis medicines. Twelve months from treatment allocation, comparisons between groups will be made. The main outcome measure is participants' cumulative exposure to sedative and anticholinergics, using the Drug Burden Index. Secondary outcomes include medication adherence, emergency department visits, hospitalisations, falls and mortality. Economic evaluation will compare the intervention strategy with standard care. ETHICS AND DISSEMINATION Approval was obtained via the New South Wales Research Ethics and Governance Information System (approval number: 2021/ETH12003) with site-specific approvals granted through Human Research Ethics Committees for each research site. Study outcomes will be published in peer-reviewed journals. It will provide robust insight into effectiveness of a pharmacist-based intervention on medicine-related falls risk for patients with osteoporosis. We anticipate that this study will take 2 years to fully accrue including follow-up. TRIAL REGISTRATION NUMBER ACTRN12622000261718.
Collapse
Affiliation(s)
- Rebekah Jane Moles
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Lin Perry
- School of Nursing and Midwifery, University of Technology Sydney Faculty of Health, Sydney, New South Wales, Australia
| | - Justine M Naylor
- Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
- Southwestern Clinical School, University of New South Wales, Sydney, New South Wales, Australia
| | - Jacqueline Center
- Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia
| | - Peter Ebeling
- Department of Medicine, School of Clinical Sciences, Monash University, Clayton, Victoria, Australia
| | - Gustavo Duque
- Australian Institute for Musculoskeletal Science, The University of Melbourne, Melbourne, Victoria, Australia
| | - Gabor Major
- Department of Rheumatology, Bone and Joint Centre, Royal Newcastle Centre, John Hunter Hospital, New Lambton Heights, New South Wales, Australia
- School of Medicine and Public Health, The University of Newcastle Faculty of Health and Medicine, Callaghan, New South Wales, Australia
| | - Christopher White
- Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
- Prince of Wales Hospital and Community Health Services, Randwick, New South Wales, Australia
| | - Christopher Yates
- Department of Diabetes and Endocrinology, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Matthew Jennings
- Physiotherapy, Liverpool Hospital, Liverpool, New South Wales, Australia
| | - Mark Kotowicz
- Epi-Centre for Healthy Ageing, Deakin University - Geelong Campus at Waurn Ponds, Geelong, Victoria, Australia
- Barwon Health, Geelong, Victoria, Australia
| | - Thach Tran
- Bone Biology Division, Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia
| | - Dana Bliuc
- Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia
| | - Lei Si
- The George Institute for Global Health, Newtown, New South Wales, Australia
| | - Kathryn Gibson
- Liverpool Hospital, Liverpool, New South Wales, Australia
- Ingham Institute, Liverpool, New South Wales, Australia
| | - Benjamin Joseph Basger
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Patrick Bolton
- Public Health and Community Medicine, University of New South Wales, Randwick, New South Wales, Australia
| | - Stephen Barnett
- GP Academic Unit, University of Wollongong, Wollongong, New South Wales, Australia
| | - Geraldine Hassett
- Ingham Institute, Liverpool, New South Wales, Australia
- Department of Rheumatology, Liverpool Hospital, Liverpool, New South Wales, Australia
| | - Ayano Kelly
- Liverpool Hospital, Liverpool, New South Wales, Australia
| | - Barbara Bazarnik
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Wafaa Ezz
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Kate Luckie
- Musculoskeletal Clinical Group, University of New South Wales, Sydney, New South Wales, Australia
| | - Stephen Ross Carter
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| |
Collapse
|
27
|
Ballesteros J, Rivas D, Duque G. The Role of the Kynurenine Pathway in the Pathophysiology of Frailty, Sarcopenia, and Osteoporosis. Nutrients 2023; 15:3132. [PMID: 37513550 PMCID: PMC10383689 DOI: 10.3390/nu15143132] [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: 05/25/2023] [Revised: 06/30/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023] Open
Abstract
Tryptophan is an essential nutrient required to generate vitamin B3 (niacin), which is mainly involved in energy metabolism and DNA production. Alterations in tryptophan metabolism could have significant effects on aging and musculoskeletal health. The kynurenine pathway, essential in tryptophan catabolism, is modulated by inflammatory factors that are increased in older persons, a process known as inflammaging. Osteoporosis, sarcopenia, osteosarcopenia, and frailty have also been linked with chronically increased levels of inflammatory factors. Due to the disruption of the kynurenine pathway by chronic inflammation and/or changes in the gut microbiota, serum levels of toxic metabolites are increased and are associated with the pathophysiology of those conditions. In contrast, anabolic products of this pathway, such as picolinic acid, have demonstrated a positive effect on skeletal muscle and bone. In addition, physical activity can modulate this pathway by promoting the secretion of anabolic kynurenines. According to the evidence collected, kynurenines could have a promising role as biomarkers for osteoporosis sarcopenia, osteosarcopenia, and frailty in older persons. In addition, some of these metabolites could become important targets for developing new pharmacological treatments for these conditions.
Collapse
Affiliation(s)
- Juan Ballesteros
- Servicio de Geriatría, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain
- Research Institute of the McGill University Health Centre, Montreal, QC H4A 3J1, Canada
| | - Daniel Rivas
- Research Institute of the McGill University Health Centre, Montreal, QC H4A 3J1, Canada
| | - Gustavo Duque
- Research Institute of the McGill University Health Centre, Montreal, QC H4A 3J1, Canada
- Dr. Joseph Kaufmann Chair in Geriatric Medicine, Faculty of Medicine, McGill University, Montreal, QC H4A 3J1, Canada
| |
Collapse
|
28
|
Duque G, Lipsitz LA, Ferrucci L, Addie S, Carrington-Lawrence S, Kohanski R. Geroscience for the Next Chapter of Medicine. J Gerontol A Biol Sci Med Sci 2023; 78:791-792. [PMID: 36915943 PMCID: PMC10413809 DOI: 10.1093/gerona/glad083] [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: 03/09/2023] [Indexed: 03/16/2023] Open
Affiliation(s)
- Gustavo Duque
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- Dr. Joseph Kaufmann Chair in Geriatric Medicine, Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Lewis A Lipsitz
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Roslindale, Massachusetts, USA
- Division of Gerontology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Luigi Ferrucci
- Longitudinal Studies Section, National Institute on Aging, National Institutes of Health, Baltimore, Maryland, USA
| | - Siobhan Addie
- Division of Aging Biology, National Institute on Aging, National Institutes of Health, Bethesda, Maryland, USA
| | - Stacy Carrington-Lawrence
- Division of Aging Biology, National Institute on Aging, National Institutes of Health, Bethesda, Maryland, USA
| | - Ronald Kohanski
- Division of Aging Biology, National Institute on Aging, National Institutes of Health, Bethesda, Maryland, USA
| |
Collapse
|
29
|
Duque G, Kirk B, Arai H. Strong muscles lead to strong bones: The connection between osteoporosis, sarcopenia, falls and fractures. Bone 2023; 173:116789. [PMID: 37164216 DOI: 10.1016/j.bone.2023.116789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Affiliation(s)
- Gustavo Duque
- Dr. Joseph Kaufmann Chair in Geriatric Medicine, Department of Medicine, McGill University, Montreal, Quebec, Canada; Bone, Muscle & Geroscience Group, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada.
| | - Ben Kirk
- Department of Medicine-Western Health, Melbourne Medical School, University of Melbourne, Victoria, Australia; Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, Victoria, Australia
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, Obu, Japan
| |
Collapse
|
30
|
Kirk B, French C, Gebauer M, Vogrin S, Zanker J, Sales M, Duque G. Diagnostic power of relative sit-to-stand muscle power, grip strength, and gait speed for identifying a history of recurrent falls and fractures in older adults. Eur Geriatr Med 2023:10.1007/s41999-023-00778-x. [PMID: 37058233 DOI: 10.1007/s41999-023-00778-x] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 03/31/2023] [Indexed: 04/15/2023]
Abstract
PURPOSE To compare the diagnostic value of relative sit-to-stand muscle power with grip strength or gait speed for identifying a history of recurrent falls and fractures in older adults. METHODS Data from an outpatient clinic included anthropometry (height/weight), bone density, 5 times sit-to-stand time (stopwatch and standardized chair), grip strength (hydraulic dynamometer), and gait speed (4 m). Relative sit-to-stand muscle power (W.kg-1, normalised to body mass) was calculated using a validated equation. Outcomes of falls (past 1 year) and fractures (past 5 years) were self-reported and verified by medical records wherever possible. Binary logistic regression considering for potential confounders (age, sex, BMI, Charlson comorbidity index, femoral neck bone density) and receiver operating characteristics (ROC) curves were used in statistical analysis. RESULTS 508 community-dwelling older adults (median age: 78 years, interquartile range: 72, 83, 75.2% women) were included. Compared to greater relative sit-to-stand muscle power (1.62-3.78W.kg-1 for women; 2.03-3.90W.kg-1 for men), those with extremely low relative sit-to-stand muscle power were 2.35 (95% CI 1.54, 3.60, p < 0.001) and 2.41 (95% CI 1.25, 4.65, p = 0.009) times more likely to experience recurrent falls and fractures, respectively, in fully adjusted model. Compared to grip strength or gait speed, relative sit-to-stand muscle power showed the highest area under the ROC curve for identifying recurrent falls (AUC: 0.64) and fractures (AUC: 0.62). All tests showed low diagnostic power (AUC: < 0.7). CONCLUSION Relative sit-to-stand muscle power performed slightly (but not statistically) better than grip strength or gait speed for identifying a history of recurrent falls and fractures in older adults. However, all tests showed low diagnostic power.
Collapse
Affiliation(s)
- Ben Kirk
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St Albans, VIC, 3021, Australia
- Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, St Albans, VIC, 3021, Australia
| | - Chloe French
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St Albans, VIC, 3021, Australia
- Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, St Albans, VIC, 3021, Australia
- School of Health Sciences, University of Manchester, Manchester, UK
| | - Maria Gebauer
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St Albans, VIC, 3021, Australia
- Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, St Albans, VIC, 3021, Australia
- University Hospital of Guadalajara, Guadalajara, Spain
| | - Sara Vogrin
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St Albans, VIC, 3021, Australia
- Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, St Albans, VIC, 3021, Australia
| | - Jesse Zanker
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St Albans, VIC, 3021, Australia
- Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, St Albans, VIC, 3021, Australia
| | - Myrla Sales
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St Albans, VIC, 3021, Australia
- Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, St Albans, VIC, 3021, Australia
| | - Gustavo Duque
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St Albans, VIC, 3021, Australia.
- Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, St Albans, VIC, 3021, Australia.
- Research Institute of the McGill University Health Centre, Montreal, QC, H4A 3J1, Canada.
- Dr. Joseph Kaufmann Chair in Geriatric Medicine, Department of Medicine, McGill University, Montreal, QC, Canada.
| |
Collapse
|
31
|
Brusco NK, Hill KD, Haines T, Dunn J, Panisset MG, Dow B, Batchelor F, Biddle SJH, Duque G, Levinger P. Cost-Effectiveness of the ENJOY Seniors Exercise Park for Older People: A Pre-Post Intervention Study. J Phys Act Health 2023; 20:555-565. [PMID: 37024105 DOI: 10.1123/jpah.2022-0380] [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: 07/15/2022] [Revised: 02/19/2023] [Accepted: 02/21/2023] [Indexed: 04/08/2023]
Abstract
BACKGROUND The Exercise interveNtion outdoor proJect in the cOmmunitY (ENJOY) Seniors Exercise Park program uses specialized outdoor equipment and a physical activity program to engage older people in physical activity, with multiple health benefits. We determined the cost-effectiveness of the ENJOY program. METHODS The economic evaluation compared health care utilization costs 6 months prior to and 6 months post ENJOY program participation. Incremental cost-utility analysis for the primary aim (quality of life) and incremental cost-effectiveness analysis for the secondary aim (falls) were used. Analyses took a societal perspective inclusive of Australian government-funded health care and pharmaceuticals in addition to hospitalizations, community-based nursing and allied health, and community services. Productivity costs were also calculated. RESULTS Fifty participants (average age 72.8 y [SD 7.4] and 78.0% [n = 39/50] women) were included. Participation in the ENJOY program reduced health care costs in the 6 months following the program: preintervention, $9764.49 (SD $26,033.35); postintervention, $5179.30 (SD $3826.64); observed postintervention reduction -$4.585.20 (95% confidence interval, -$12,113.99 to $2943.59; P = .227) without compromising quality of life (mean difference [MD] 0.011; 95% confidence interval, -0.034 to 0.056; P = .631) or increasing the likelihood of a fall (-0.5; 95% confidence interval, 0.00 to -0.50; P = .160). The ENJOY intervention is likely cost-effective. CONCLUSIONS Planning for shared community spaces should consider the benefits of a Seniors Exercise Park as part of the built environment.
Collapse
Affiliation(s)
- Natasha K Brusco
- Rehabilitation, Ageing and Independent Living Research Centre, Monash University, Melbourne, VIC,Australia
| | - Keith D Hill
- Rehabilitation, Ageing and Independent Living Research Centre, Monash University, Melbourne, VIC,Australia
| | - Terry Haines
- School of Primary and Allied Health Care, Monash University, Melbourne, VIC,Australia
| | - Jeremy Dunn
- National Ageing Research Institute, Melbourne, VIC,Australia
| | - Maya G Panisset
- Department of Medicine, University of Melbourne, Melbourne, VIC,Australia
| | - Briony Dow
- National Ageing Research Institute, Melbourne, VIC,Australia
- Centre for Health Policy, University of Melbourne, Melbourne, VIC,Australia
- School of Nursing and Midwifery, Deakin University, Melbourne, VIC,Australia
| | - Frances Batchelor
- National Ageing Research Institute, Melbourne, VIC,Australia
- School of Nursing and Midwifery, Deakin University, Melbourne, VIC,Australia
- Department of Physiotherapy, The University of Melbourne, Melbourne, VIC,Australia
| | - Stuart J H Biddle
- Centre for Health Research, University of Southern Queensland, Springfield, QLD,Australia
| | - Gustavo Duque
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, Melbourne, VIC,Australia
| | - Pazit Levinger
- Rehabilitation, Ageing and Independent Living Research Centre, Monash University, Melbourne, VIC,Australia
- National Ageing Research Institute, Melbourne, VIC,Australia
- Institute for Health and Sport, Victoria University, Melbourne, VIC,Australia
| |
Collapse
|
32
|
Prokopidis K, Giannos P, Ispoglou T, Kirk B, Witard OC, Dionyssiotis Y, Scott D, Macpherson H, Duque G, Isanejad M. Handgrip strength is associated with learning and verbal fluency in older men without dementia: insights from the NHANES. GeroScience 2023; 45:1049-1058. [PMID: 36449219 PMCID: PMC9886698 DOI: 10.1007/s11357-022-00703-3] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 11/24/2022] [Indexed: 12/03/2022] Open
Abstract
Low handgrip strength, a hallmark measure of whole-body strength, has been linked with greater odds of cognitive decline and dementia; however, conflicting findings, which could be due to population characteristics and choice of tools, such for the assessment of handgrip strength and cognitive function domains, also exist. Therefore, we examined the relationship of handgrip strength with a comprehensive list of tests to assess domains of cognitive function using a representative sample of US older men and women without neurodegenerative disorders such as dementia. We analyzed cross-sectional data from the US National Health and Nutrition Examination Survey (NHANES) between 2011 and 2014, with a study cohort of 777 older adults (380 men and 397 women) above 60 years of age. Handgrip strength was assessed using a handgrip dynamometer, while cognitive function was assessed through the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) Word List Learning Test (WLLT), Word List Recall Test (WLRT), Intrusion Word Count Test (WLLT-IC and WLRT-IC), the Animal Fluency Test (AFT), and the Digit Symbol Substitution Test (DSST). Sex-stratified multiple linear regression analyses were performed upon covariate adjustment for age, ethnicity, socio-economic status, education, medical history, body mass index, physical activity, energy, protein, and alcohol intake. Maximal handgrip strength was positively associated with cognitive function scores, including CERAD WLLT (P = 0.009, R2 = 0.146) and AFT (P = 0.022, R2 = 0.024) in older men, but not in women (CERAD WLLT: P = 0.253, AFT: P = 0.370). No significant associations with CERAD WLLRT (men: P = 0.057, women: P = 0.976), WLLT-IC (men: P = 0.671, women: P = 0.869), WLLRT-IC (men: P = 0.111, women: P = 0.861), and DSST (men: P = 0.108, women: P = 0.091) were observed. Dose-response curves exhibited a prominent linear relationship between all significant associations after covariate adjustment, with no indication of a plateau in these relationships. In conclusion, higher handgrip strength was independently associated with better learning ability for novel verbal information and verbal fluency in US men over the age of 60 and without dementia. Longitudinal studies are required to confirm whether muscle strength independently predicts cognitive function changes in older adults in a sex-specific manner, and whether this connection is affirmed to the possibility of reverse causation due to declines in physical activity levels in the preclinical phase of dementia.
Collapse
Affiliation(s)
- Konstantinos Prokopidis
- Department of Musculoskeletal Biology, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK.
- Society of Meta-Research and Biomedical Innovation, London, UK.
| | - Panagiotis Giannos
- Society of Meta-Research and Biomedical Innovation, London, UK
- Department of Life Sciences, Faculty of Natural Sciences, Imperial College London, London, UK
| | | | - Ben Kirk
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St Albans, VIC, 3021, Australia
- Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, St Albans, VIC, 3021, Australia
| | - Oliver C Witard
- Faculty of Life Sciences and Medicine, Centre for Human and Applied Physiological Sciences, King's College London, London, UK
| | - Yannis Dionyssiotis
- Laboratory for Research of the Musculoskeletal System, National and Kapodistrian University of Athens, Kifissia, Greece
- 1st Physical Medicine and Rehabilitation Department, National Rehabilitation Center EKA, Athens, Greece
| | - David Scott
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Burwood, VIC, Australia
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia
| | - Helen Macpherson
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Gustavo Duque
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St Albans, VIC, 3021, Australia
- Research Institute of the McGill University Health Centre, Department of Medicine, McGill University, Montreal, QC, Canada
| | - Masoud Isanejad
- Department of Musculoskeletal Biology, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
| |
Collapse
|
33
|
Lin X, Smith C, Moreno-Asso A, Zarekookandeh N, Brennan-Speranza TC, Duque G, Hayes A, Levinger I. Undercarboxylated osteocalcin and ibandronate combination ameliorates hindlimb immobilization-induced muscle wasting. J Physiol 2023; 601:1851-1867. [PMID: 36999349 DOI: 10.1113/jp283990] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 03/21/2023] [Indexed: 04/01/2023] Open
Abstract
Immobilization leads to muscle wasting and insulin resistance, particularly during aging. Undercarboxylated osteocalcin (ucOC) has been suggested to improve muscle mass and glucose metabolism. Bisphosphonates, an anti-osteoporosis treatment, might protect muscle wasting independent of ucOC. We hypothesize that the combination of ucOC and ibandronate (IBN) treatments has superior protective effects against immobilization-induced muscle wasting and insulin resistance than either treatment alone. C57BL/6J mice were hindlimb-immobilized for two weeks, with injections of vehicle, ucOC (90 ng/g daily) and/or IBN (2 μg/g weekly). Insulin/oral glucose tolerance tests (ITT/OGTT) were performed. Immediately after immobilization, muscles (extensor digitorum longus [EDL], soleus, tibialis anterior [TA], gastrocnemius, and quadriceps) were isolated and measured for muscle mass. Insulin-stimulated glucose uptake (EDL and soleus) was examined. Phosphorylation/expression of proteins in anabolic/catabolic pathways were examined in quadriceps. Primary human myotubes derived from older adult muscle biopsies were treated with ucOC and/or IBN, then signaling proteins were analyzed. Combined treatment, but not individual treatments, significantly increased muscle weight/body weight ratio in immobilized soleus (31.7 %; p = 0.013) and quadriceps (20.0 %; p = 0.0008) muscles, concomitant with elevated p-Akt (S473)/Akt ratio (p = 0.0047). Combined treatment also enhanced whole-body glucose tolerance (16.6 %; p = 0.0011). In human myotubes, combined treatment stimulated greater activation of ERK1/2 (p = 0.0067 and 0.0072) and mTOR (p = 0.036), and led to a lesser expression of Fbx32 (p = 0.049) and MuRF1 (p = 0.048), than individual treatments. These findings suggest a potential therapeutic role of ucOC and bisphosphonates combination in protecting against muscle wasting induced by immobilization and aging. KEY POINTS: Undercarboxylated osteocalcin (ucOC) has been suggested to improve muscle mass and glucose metabolism. Bisphosphonates, an anti-osteoporosis treatment, might protect muscle wasting independent of ucOC. The combination treatment of ucOC and ibandronate was shown to exert greater therapeutic effect against immobilization-induced muscle wasting, and lead to greater activation of anabolic pathway and less expression of catabolic signaling proteins in myotubes derived from older adults, compared to individual treatments. The combination treatment was found to improve whole-body glucose tolerance. Our findings suggest a potential therapeutic role of ucOC and bisphosphonates combination in protecting against muscle wasting induced by immobilization and aging. Abstract figure legend Undercarboxylated osteocalcin (ucOC) and ibandronate (IBN) combination improves muscle mass and glucose disposal. Two weeks of hindlimb immobilization in mice led to leg muscle atrophy as well as muscle insulin resistance. Injections of both undercarboxylated osteocalcin (intraperitoneal [IP]) and ibandronate (subcutaneous [SC]) alleviated muscle wasting in a muscle type-specific manner. In addition, this combination treatment improved glucose disposal in mice. In both immobilized mouse muscle and human primary myotubes derived from older adults, the combination treatment with ucOC and IBN resulted in greater activation of proteins involved in anabolic signaling pathway, including Akt and mTORC1. In primary myotubes, this treatment reduced expression of proteins involved in catabolic signaling pathway, such as Fbx32 and MuRF1. These findings suggest that ucOC and bisphosphonates combination has a potential in treating muscle wasting and insulin resistance induced by immobilization and aging. This article is protected by copyright. All rights reserved.
Collapse
Affiliation(s)
- Xuzhu Lin
- Centre for Cancer Research, Hudson Institute of Medical Research, Clayton, VIC, Australia
| | - Cassandra Smith
- Institute for Nutrition Research, School of Health and Medical Sciences, Edith Cowan University, Perth, Western Australia, Australia
| | - Alba Moreno-Asso
- Institute for Health and Sport (IHES), Victoria University, Melbourne, Victoria, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne, Victoria University and Western Health, Melbourne, VIC, Australia
| | - Navabeh Zarekookandeh
- Institute for Health and Sport (IHES), Victoria University, Melbourne, Victoria, Australia
| | | | - Gustavo Duque
- Dr Joseph Kaufmann Chair in Geriatric Medicine, Department of Medicine, McGill University, Montreal, QC, Canada
- Research Institute of thr McGill University Health Centre, Montreal, QC, Canada
| | - Alan Hayes
- Institute for Health and Sport (IHES), Victoria University, Melbourne, Victoria, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne, Victoria University and Western Health, Melbourne, VIC, Australia
| | - Itamar Levinger
- Institute for Health and Sport (IHES), Victoria University, Melbourne, Victoria, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne, Victoria University and Western Health, Melbourne, VIC, Australia
| |
Collapse
|
34
|
Kuo CL, Kirk B, Xiang M, Pilling LC, Kuchel GA, Kremer R, Duque G. Very Low and High Levels of Vitamin D Are Associated with Shorter Leukocyte Telomere Length in 148,321 UK Biobank Participants. Nutrients 2023; 15:nu15061474. [PMID: 36986204 PMCID: PMC10059691 DOI: 10.3390/nu15061474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 03/08/2023] [Accepted: 03/17/2023] [Indexed: 03/22/2023] Open
Abstract
Background: Shorter leukocyte telomere length (LTL) is observed in multiple age-related diseases, which are also associated with vitamin D deficiency (i.e., osteosarcopenia, neurocognitive disorders, cancer, osteoarthritis, etc.), suggesting a close association between vitamin D and LTL. In this study, we examined the relationship between vitamin D levels and LTL in older participants of the UK Biobank. Methods: Data were collected from the UK Biobank. Participants aged 60 and older (n = 148,321) were included. Baseline LTL was measured using a multiplex qPCR technique and expressed as the ratio of the telomere amplification product (T) to that of a single-copy gene (S) (T/S ratio). Serum 25-hydroxyvitamin D (25OHD) was stratified by z score and linked to LTL in a linear regression model adjusting for covariates. Results: Compared to the medium level, a low (in the range of 16.6 nmol/L, 29.7 nmol/L) or extremely low (≤16.6 nmol/L) level of serum 25OHD was associated with shorter LTL: 0.018 SD (standardized β = −0.018, 95% CI −0.033 to −0.003, p = 0.022) and 0.048 SD (standardized β = −0.048, 95% CI −0.083 to −0.014, p = 0.006), respectively. Additionally, the high serum 25OHD groups (>95.9 nmol/L) had 0.038 SD (standardized β = −0.038, 95% CI −0.072 to −0.004, p = 0.030) shorter mean LTL than the group with medium 25OHD levels. The associations above were adjusted for multiple variables. Conclusions: In this population-based study, we identified an inverted U-shape relationship between LTL and vitamin D status. Our findings could be affected by unmeasured confounders. Whether high or low vitamin D-associated shorter LTL is mechanistically related to age-related conditions remains to be elucidated.
Collapse
Affiliation(s)
- Chia-Ling Kuo
- Connecticut Convergence Institute for Translation in Regenerative Engineering, University of Connecticut Health, Farmington, CT 06030, USA
- Center on Aging, University of Connecticut Health, Farmington, CT 06030, USA
| | - Ben Kirk
- Department of Medicine, Western Health, Melbourne Medical School, University of Melbourne, St Albans, Melbourne, VIC 3021, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne and Western Health, St Albans, Melbourne, VIC 3021, Australia
| | - Meiruo Xiang
- Connecticut Convergence Institute for Translation in Regenerative Engineering, University of Connecticut Health, Farmington, CT 06030, USA
| | - Luke C. Pilling
- Epidemiology and Public Health Group, Faculty of Health and Life Sciences, University of Exeter, Exeter EX4 4PY, UK
| | - George A. Kuchel
- Center on Aging, University of Connecticut Health, Farmington, CT 06030, USA
| | - Richard Kremer
- Research Institute of the McGill University Health Centre, Montreal, QC H4A 3J1, Canada
| | - Gustavo Duque
- Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne and Western Health, St Albans, Melbourne, VIC 3021, Australia
- Research Institute of the McGill University Health Centre, Montreal, QC H4A 3J1, Canada
- Dr. Joseph Kaufmann Chair in Geriatric Medicine, Department of Medicine, McGill University, Montreal, QC H4A 3J1, Canada
- Correspondence:
| |
Collapse
|
35
|
Duque G. Community implementation of evidence-based interventions in geriatric medicine: Time to translate research into practice. Arch Gerontol Geriatr 2023; 106:104914. [PMID: 36592556 DOI: 10.1016/j.archger.2022.104914] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Gustavo Duque
- Director - Simone & Edouard Shouela RUISSS McGill Centre of Excellence for Sustainable Health of Seniors (CEDurable), Canada; Dr. Joseph Kaufmann Chair in Geriatric Medicine, Faculty of Medicine, McGill University, Montreal, QC, Canada; Division of Geriatric Medicine, Department of Medicine, McGill University, Montreal, Canada; Research Institute of the McGill University Health Centre, Montreal, QC, Canada.
| |
Collapse
|
36
|
Kirk B, Zhang S, Vogrin S, Harijanto C, Sales M, Duque G. Comparing the Fracture Profile of Osteosarcopenic Older Adults with Osteopenia/Osteoporosis Alone. Calcif Tissue Int 2023; 112:297-307. [PMID: 36436030 DOI: 10.1007/s00223-022-01044-1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 11/13/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE To determine whether osteosarcopenia is associated with a greater likelihood of recurrent fractures, as well as type of fracture, than osteopenia/osteoporosis or sarcopenia alone. METHODS Anthropometry (height/weight; scales and stadiometer), body composition (bone mineral density [BMD] and appendicular lean mass; dual-energy x-ray absorptiometry), grip strength (hydraulic dynamometer), and gait speed (4 m) were measured in an outpatient clinic. WHO definition for osteopenia/osteoporosis (BMD T-score below -1 SDs) while sarcopenia was defined by SDOC or EWGSOP2. Number and location of fractures within the past 5 years were self-reported and verified by medical records (unverified fractures excluded). Univariable and multivariable regressions were used to examine the association between the exposure and outcome while adjusting for confounders. RESULTS 481 community-dwelling older adults (median age: 78, IQR: 72, 83; 75.9% women) were included. Prevalence of osteosarcopenia depended on the definition (SDOC: 179 (37.2%); EWGSOP2: 123 (25.6%)). In multivariable analysis adjusting for age, sex, alcohol, smoking, BMI, lowest BMD T-score, physical activity, and comorbidities, the likelihood of recurrent fractures (≥ 2 vs 0-1) was significantly higher in those with osteosarcopenia versus osteopenia/osteoporosis irrespective of the definition (SDOC: odds ratio [OR]: 1.63, 95% CI: 1.03, 2.59, p = 0.037; EWGSOP2: OR: 1.83, 95% CI: 1.12, 3.01, p = 0.016]. Associations with sarcopenia alone (SDOC: 10; EWGSOP2: 7) were not possible due to the extremely low prevalence of this condition in those with normal BMD. CONCLUSION Our data suggest osteosarcopenia is associated with a greater likelihood of recurrent fractures versus osteopenia/osteoporosis alone. Further studies are needed to evaluate the relationship with sarcopenia alone.
Collapse
Affiliation(s)
- Ben Kirk
- Department of Medicine, Melbourne Medical School, University of Melbourne, Western Health, St Albans, Melbourne, VIC, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne and Western Health, St Albans, Melbourne, VIC, Australia
| | - Simon Zhang
- Department of Medicine, Melbourne Medical School, University of Melbourne, Western Health, St Albans, Melbourne, VIC, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne and Western Health, St Albans, Melbourne, VIC, Australia
| | - Sara Vogrin
- Department of Medicine, Melbourne Medical School, University of Melbourne, Western Health, St Albans, Melbourne, VIC, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne and Western Health, St Albans, Melbourne, VIC, Australia
| | - Christel Harijanto
- Department of Medicine, Melbourne Medical School, University of Melbourne, Western Health, St Albans, Melbourne, VIC, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne and Western Health, St Albans, Melbourne, VIC, Australia
| | - Myrla Sales
- Department of Medicine, Melbourne Medical School, University of Melbourne, Western Health, St Albans, Melbourne, VIC, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne and Western Health, St Albans, Melbourne, VIC, Australia
| | - Gustavo Duque
- Department of Medicine, Melbourne Medical School, University of Melbourne, Western Health, St Albans, Melbourne, VIC, Australia.
- Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne and Western Health, St Albans, Melbourne, VIC, Australia.
- Department of Medicine and Research Institute, McGill University Health Centre, 1001 Decarie Boulevard, Montreal, QC, H4A 3J1, Canada.
| |
Collapse
|
37
|
Vlietstra L, Kirk B, Duque G, Qualls C, Vellas B, Andrieu S, Morley JE, Waters DL. Using minimal clinically important differences to measure long-term transitions of osteosarcopenia: The New Mexico Aging Process Study. Exp Gerontol 2023; 173:112106. [PMID: 36708751 DOI: 10.1016/j.exger.2023.112106] [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: 09/20/2022] [Revised: 01/16/2023] [Accepted: 01/23/2023] [Indexed: 01/27/2023]
Abstract
BACKGROUND/OBJECTIVE By having a better understanding of transitions in osteosarcopenia, interventions to reduce morbidity and mortality can be better targeted. The aim of this study was to show the rationale and method of using minimal clinically important differences (MCID's) to classify transitions, and the effects of demographic variables on transitions in a 9-year follow-up data from the New Mexico Aging Process Study (NMAPS). METHODS Transitions were identified in four aspects of osteosarcopenia: bone mineral density (BMD), appendicular skeletal muscle mass/body mass index ratio (ASM/BMI), grip strength and gait speed. Transitions were identified using a MCID score. As there is currently no available MCID for BMD and ASM/BMI, those were determined using a distribution-based and an anchor-based method. Total transitions were calculated for all four measures of osteosarcopenia in all transition categories (maintaining a health status, beneficial transition, harmful transitions). Poisson regression was used to test for effects of demographic variables, including age, sex, physical activity, medication, and health status, on transitions. RESULTS Over the 9-year follow-up, a total of 2163 MCID-derived BMD transitions were reported, 1689 ASM/BMI transitions, 2339 grip strength transitions, and 2151 gait speed transitions. Additionally, some MCID-derived transition categories were associated with sex, age, and health status. CONCLUSION Use of MCID-derived transitions reflected the fluctuation and the dynamic nature of health in older adults. Future research should focus on transitions of modifiable markers in osteosarcopenia to design intervention trials.
Collapse
Affiliation(s)
- Lara Vlietstra
- School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand
| | - Ben Kirk
- Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, St Albans, Melbourne, VIC, Australia; Australian Institute for Musculoskeletal Science (AIMSS), Geroscience & Osteosarcopenia Research Program, The University of Melbourne and Western Health, St Albans, Melbourne, VIC, Australia
| | - Gustavo Duque
- Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, St Albans, Melbourne, VIC, Australia; Australian Institute for Musculoskeletal Science (AIMSS), Geroscience & Osteosarcopenia Research Program, The University of Melbourne and Western Health, St Albans, Melbourne, VIC, Australia; Research Institute of the McGill University Health Centre, McGill University, Montreal, QC H4A 3J1, Canada
| | - Clifford Qualls
- Department of Mathematics & Statistics and School of Medicine, University of New Mexico, Albuquerque, NM 87131, USA
| | - Bruno Vellas
- Department of Internal and Geriatrics Medicine, Gerontopole, CHU de Toulouse, UMR 1295 INSERM, University Toulouse III, Toulouse, France; Department of Internal Medicine, Division of General Internal and Geriatric Medicine, University of New Mexico, USA
| | - Sandrine Andrieu
- Department of Clinical Epidemiology and Public Health, CHU de Toulouse, UMR 1295 INSERM, University Toulouse III, Toulouse, France; Department of Internal Medicine, Division of General Internal and Geriatric Medicine, University of New Mexico, USA
| | - John E Morley
- Division of Geriatric Medicine, Saint Louis University, 1402, South Grand Blvd, RoomM238, St. Louis, MO 63110-0250, USA
| | - Debra L Waters
- School of Physiotherapy, University of Otago, Dunedin, New Zealand; Department of Medicine, University of Otago, Dunedin, New Zealand; Department of Internal Medicine, Division of General Internal and Geriatric Medicine, University of New Mexico, USA.
| |
Collapse
|
38
|
Zanker J, Sim M, Anderson K, Balogun S, Brennan‐Olsen S, Dent E, Duque G, Girgis C, Grossmann M, Hayes A, Henwood T, Hirani V, Inderjeeth C, Iuliano S, Keogh J, Lewis JR, Lynch GS, Pasco JA, Phu S, Reijnierse EM, Russell N, Vlietstra L, Visvanathan R, Walker T, Waters DL, Yu S, Maier AB, Daly RM, Scott D. The Australian and New Zealand Society for Sarcopenia and Frailty Research (ANZSSFR) sarcopenia diagnosis and management task force: Findings from the consumer expert Delphi process. Australas J Ageing 2023; 42:251-257. [PMID: 36480154 PMCID: PMC10947359 DOI: 10.1111/ajag.13164] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 11/09/2022] [Accepted: 11/16/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To develop guidelines, informed by health-care consumer values and preferences, for sarcopenia prevention, assessment and management for use by clinicians and researchers in Australia and New Zealand. METHODS A three-phase Consumer Expert Delphi process was undertaken between July 2020 and August 2021. Consumer experts included adults with lived experience of sarcopenia or health-care utilisation. Phase 1 involved a structured meeting of the Australian and New Zealand Society for Sarcopenia and Frailty Research (ANZSSFR) Sarcopenia Diagnosis and Management Task Force and consumer representatives from which the Phase 2 survey was developed. In Phase 2, consumers from Australia and New Zealand were surveyed online with opinions sought on sarcopenia outcome priorities, consultation preferences and interventions. Findings were confirmed and disseminated in Phase 3. Descriptive statistical analyses were performed. RESULTS Twenty-four consumers (mean ± standard deviation age 67.5 ± 12.8 years, 18 women) participated in Phase 2. Ten (42%) identified as being interested in sarcopenia, 7 (29%) were health-care consumers and 6 (25%) self-reported having/believing they have sarcopenia. Consumers identified physical performance, living circumstances, morale, quality of life and social connectedness as the most important outcomes related to sarcopenia. Consumers either had no preference (46%) or preferred their doctor (40%) to diagnose sarcopenia and preferred to undergo assessments at least yearly (54%). For prevention and treatment, 46% of consumers preferred resistance exercise, 2-3 times per week (54%). CONCLUSIONS Consumer preferences reported in this study can inform the implementation of sarcopenia guidelines into clinical practice at local, state and national levels across Australia and New Zealand.
Collapse
Grants
- Australian Government Research Training Program (TRP) Scholarship.
- Australian Medical REsearch Future Fund
- Dairy Australia, California Dairy Research Foundation, National Dairy Council, Aarhus University Hospital and Danish Dairy Research Foundation, Fonterra Co-operative Group Ltd, Dutch Dairy Association, Dairy Council of California, Dairy Farmers of Canada, the Centre national interprofessionnel de l'economie laitiere, University of Melbourne, Austin Hospital Medical Research Foundation and Sir Edward Dunlop Medical Research Foundation.
- Deakin University, Amgen, Department of Health and Human Services (DHHS), and the Norman Beischer Foundation.
- National Health and Medical Research Council
- National Heart Foundation Future Leader Fellowship (ID: 102817).
- NHMRC CRE 1102208 and Hospital Research Foundation.
- NHMRC Postgraduate Scholarship, grant number 2003179.
- NHMRC project grant (APP1099173).
- Royal Perth Hospital Career Advancement Fellowship (CAF 130/2020),
- National Health and Medical Research Council
Collapse
Affiliation(s)
- Jesse Zanker
- Australian Institute for Musculoskeletal Science (AIMSS)The University of Melbourne and Western HealthMelbourneVictoriaAustralia
- Department of Medicine – Western HealthThe University of MelbourneMelbourneVictoriaAustralia
| | - Marc Sim
- Nutrition and Health Innovation Research Institute, School of Medical and Health SciencesEdith Cowan UniversityJoondalupWestern AustraliaAustralia
- School of MedicineUniversity of Western AustraliaPerthWestern AustraliaAustralia
| | - Kate Anderson
- Institute for Health Transformation – Determinants of Health, Faculty of HealthDeakin UniversityMelbourneVictoriaAustralia
- School of Health and Social Development, Faculty of HealthDeakin UniversityMelbourneVictoriaAustralia
| | - Saliu Balogun
- College of Health and MedicineAustralian National UniversityCanberraAustralian Capital TerritoryAustralia
- Menzies Institute for Medical ResearchUniversity of TasmaniaHobartTasmaniaAustralia
| | - Sharon L. Brennan‐Olsen
- Australian Institute for Musculoskeletal Science (AIMSS)The University of Melbourne and Western HealthMelbourneVictoriaAustralia
- Department of Medicine – Western HealthThe University of MelbourneMelbourneVictoriaAustralia
- School of Health and Social Development, Faculty of HealthDeakin UniversityMelbourneVictoriaAustralia
- Institute for Health TransformationDeakin UniversityMelbourneVictoriaAustralia
| | - Elsa Dent
- Torrens University AustraliaAdelaideSouth AustraliaAustralia
| | - Gustavo Duque
- Australian Institute for Musculoskeletal Science (AIMSS)The University of Melbourne and Western HealthMelbourneVictoriaAustralia
- Department of Medicine – Western HealthThe University of MelbourneMelbourneVictoriaAustralia
- Department of MedicineResearch Institute of the McGill University Health CentreMcGill UniversityMontrealQuebecCanada
| | - Christian M. Girgis
- Faculty of Medicine and HealthUniversity of SydneySydneyNew South WalesAustralia
- Department of Diabetes and EndocrinologyWestmead HospitalSydneyNew South WalesAustralia
| | - Mathis Grossmann
- Department of Medicine – Austin HealthThe University of MelbourneMelbourneVictoriaAustralia
- Department of EndocrinologyAustin HealthMelbourneVictoriaAustralia
| | - Alan Hayes
- Australian Institute for Musculoskeletal Science (AIMSS)The University of Melbourne and Western HealthMelbourneVictoriaAustralia
- Institute for Health and Sport (IHeS)Victoria UniversityMelbourneVictoriaAustralia
| | - Tim Henwood
- Human Movement and Nutritional ScienceUniversity of QueenslandBrisbaneQueenslandAustralia
| | - Vasant Hirani
- Nutrition and Dietetics Group, School of Life and Environmental Sciences Charles Perkins CentreUniversity of SydneySydneyNew South WalesAustralia
| | - Charles Inderjeeth
- North Metropolitan Health Service and University of Western AustraliaPerthWestern AustraliaAustralia
| | - Sandra Iuliano
- Australian Institute for Musculoskeletal Science (AIMSS)The University of Melbourne and Western HealthMelbourneVictoriaAustralia
- Department of Medicine – Western HealthThe University of MelbourneMelbourneVictoriaAustralia
| | - Justin Keogh
- Faculty of Health Sciences and MedicineBond UniversityGold CoastQueenslandAustralia
- Human Potential CentreAuckland University of TechnologyAucklandNew Zealand
- Cluster for Health Improvement, Faculty of Science, Health, Education and EngineeringUniversity of the Sunshine CoastSunshine CoastQueenslandAustralia
- Kasturba Medical College, MangaloreManipal Academy of Higher EducationManipalKarnatakaIndia
| | - Joshua R. Lewis
- Nutrition and Health Innovation Research Institute, School of Medical and Health SciencesEdith Cowan UniversityJoondalupWestern AustraliaAustralia
- School of MedicineUniversity of Western AustraliaPerthWestern AustraliaAustralia
- Centre for Kidney Research, Children's Hospital at Westmead School of Public Health, Sydney Medical SchoolThe University of SydneySydneyAustralia
| | - Gordon S. Lynch
- Centre for Muscle Research, Department of Anatomy and Physiology, School of Biomedical SciencesThe University of MelbourneMelbourneVictoriaAustralia
| | - Julie A. Pasco
- Department of Medicine – Western HealthThe University of MelbourneMelbourneVictoriaAustralia
- IMPACT‐Institute for Mental and Physical Health and Clinical Translation, Barwon HealthDeakin UniversityMelbourneVictoriaAustralia
| | - Steven Phu
- Department of Medicine – Western HealthThe University of MelbourneMelbourneVictoriaAustralia
- Falls, Balance, and Injury Research CentreNeuroscience Research Australia (NeuRA)SydneyNew South WalesAustralia
| | - Esmee M. Reijnierse
- Department of Medicine and Aged Care, The Royal Melbourne HospitalThe University of MelbourneMelbourneVictoriaAustralia
- Amsterdam UMC, Vrije Universiteit Amsterdam, Rehabilitation MedicineAmsterdamThe Netherlands
- Amsterdam Movement Sciences, Ageing and VitalityAmsterdamThe Netherlands
| | - Nicholas Russell
- Department of Medicine – Austin HealthThe University of MelbourneMelbourneVictoriaAustralia
- Department of EndocrinologyAustin HealthMelbourneVictoriaAustralia
| | - Lara Vlietstra
- School of Physical Education, Sport and Exercise SciencesUniversity of OtagoDunedinNew Zealand
| | - Renuka Visvanathan
- Adelaide Geriatrics Training and Research with Aged Care (GTRAC) Centre, School of Medicine, Faculty of Health and Medical SciencesUniversity of AdelaideAdelaideSouth AustraliaAustralia
- Aged and Extended Care Services, Acute and Urgent Care, The Queen Elizabeth Hospital, Central Adelaide Local Health NetworkAdelaideSouth AustraliaAustralia
| | - Troy Walker
- Institute for Health Transformation, Global Obesity CentreDeakin UniversityMelbourneVictoriaAustralia
| | - Debra L. Waters
- Department of Medicine, School of PhysiotherapyUniversity of OtagoDunedinNew Zealand
| | - Solomon Yu
- Adelaide Geriatrics Training and Research with Aged Care (GTRAC) Centre, School of Medicine, Faculty of Health and Medical SciencesUniversity of AdelaideAdelaideSouth AustraliaAustralia
- Aged and Extended Care Services, Acute and Urgent Care, The Queen Elizabeth Hospital, Central Adelaide Local Health NetworkAdelaideSouth AustraliaAustralia
| | - Andrea B. Maier
- Department of Medicine and Aged Care, The Royal Melbourne HospitalThe University of MelbourneMelbourneVictoriaAustralia
- Healthy Longevity Translational Research Program, Yong Loo Lin School of MedicineNational University of SingaporeSingapore
- Centre for Healthy LongevityNational University Health SystemSingapore
- Department of Human Movement Sciences, Faculty of Behavioural and Movement SciencesVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Robin M. Daly
- Institute for Physical Activity and NutritionDeakin UniversityMelbourneVictoriaAustralia
| | - David Scott
- Institute for Physical Activity and NutritionDeakin UniversityMelbourneVictoriaAustralia
- Department of Medicine, School of Clinical Sciences at Monash HealthMonash UniversityMelbourneVictoriaAustralia
| |
Collapse
|
39
|
Duval GT, Schott AM, Rolland Y, Gautier J, Blain H, Duque G, Annweiler C. Orthostatic hypotension and neurocognitive disorders in older women: Results from the EPIDOS cohort study. PLoS One 2023; 18:e0281634. [PMID: 36827394 PMCID: PMC9955614 DOI: 10.1371/journal.pone.0281634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 01/27/2023] [Indexed: 02/26/2023] Open
Abstract
BACKGROUND Although it is well-admitted that cardiovascular health affects cognition, the association between orthostatic hypotension (OH) and cognition remains unclear. The objectives of the present study were i) to determine among the EPIDOS cohort (EPIdémiologie de l'OStéoporose) whether OH was cross-sectionally associated with cognitive impairment at baseline, and ii) whether baseline OH could predict incident cognitive decline after 7 years of follow-up. METHODS Systolic and Diastolic Blood Pressure (SBP and DBP) changes while standing (ie, ΔSBP and ΔDBP, in %) were measured at baseline among 2,715 community-dwelling older women aged 75 years and older using no antihypertensive drugs from the French EPIDOS cohort. OH was defined as a decrease in SBP ≥20 mmHg and/or a decrease in DBP ≥10 mmHg within 3 min after standing. Cognitive impairment was defined as a Short Portable Mental Status Questionnaire (SPMSQ) score <8 (/10). Among those without cognitive impairment at baseline, a possible incident onset of cognitive decline was then sought after 7 years of follow-up among 257 participants. RESULTS Baseline ΔSBP was associated with baseline cognitive impairment (adjusted OR = 1.01, p = 0.047), but not with incident onset of cognitive decline after 7 years (adjusted OR = 0.98, p = 0.371). Neither baseline OH nor baseline ΔDBP were associated with cognitive impairment neither at baseline (p = 0.426 and p = 0.325 respectively) nor after 7 years (p = 0.180 and p = 0.345 respectively). CONCLUSIONS SBP drop while standing, but neither OH per se nor DBP drop while standing, was associated with baseline cognitive impairment in older women. The relationship between OH and cognitive impairment appears more complex than previously expected.
Collapse
Affiliation(s)
- Guillaume T. Duval
- Department of Geriatric Medicine, University Memory Center, Research Center on Autonomy and Longevity (CeRAL), Angers University Hospital, Angers, France
- School of Medicine and UPRES EA 4638, University of Angers, Angers, France
- * E-mail:
| | - Anne-Marie Schott
- Research on Healthcare Performance (RESHAPE), INSERM U1290, Université Claude Bernard Lyon 1, Lyon, France
- Hospices Civils de Lyon, Pôle de Santé Publique, Service de Recherche et D’épidémiologie Cliniques, Lyon, France
| | - Yves Rolland
- Department of Geriatrics, Toulouse University Hospital, INSERM U1027, University of Toulouse III, Toulouse, France
| | - Jennifer Gautier
- Department of Geriatric Medicine, University Memory Center, Research Center on Autonomy and Longevity (CeRAL), Angers University Hospital, Angers, France
| | - Hubert Blain
- Department of Internal Medicine and Geriatrics, Montpellier University Hospital, University of Montpellier 1, Montpellier, France
| | - Gustavo Duque
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St. Albans, Victoria, Australia
- Department of Medicine, Melbourne Medical School–Western Precinct, The University of Melbourne, St. Albans, Victoria, Australia
| | - Cedric Annweiler
- Department of Geriatric Medicine, University Memory Center, Research Center on Autonomy and Longevity (CeRAL), Angers University Hospital, Angers, France
- School of Medicine and UPRES EA 4638, University of Angers, Angers, France
- Robarts Research Institute, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada
| |
Collapse
|
40
|
Duque G. A Golden Age for Biogerontology and Geroscience Is Approaching: Our Journal Is Here to Disseminate the Best of That New Knowledge. J Gerontol A Biol Sci Med Sci 2023; 78:175-176. [PMID: 36626581 DOI: 10.1093/gerona/glac246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Affiliation(s)
- Gustavo Duque
- Research Institute of the McGill University Health Centre, Montreal, Québec, Canada.,Department of Medicine, McGill University, Montreal, Québec, Canada
| |
Collapse
|
41
|
Frisoli A, Duque G, Paes AT, Diniz AR, Lima E, Azevedo E, Moises VA. Sarcopenic obesity definitions and their associations with physical frailty in older Brazilian adults: data from the SARCOS study. Archives of Endocrinology and Metabolism 2023; 67:361-371. [PMID: 37011371 DOI: 10.20945/2359-3997000000587] [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] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Objective To identify the obesity diagnosis with the highest association with physical frailty associated with sarcopenia EWGSOP II (sarcopenic obesity). Subjects and methods We performed a cross-sectional analysis of 371 community-dwelling older adults. Appendicular skeletal lean mass and total body fat (TBF) were assessed using dual-energy x-ray absorptiometry, and physical frailty was defined using Fried's criteria. The phenotypes were identified according to the presence of sarcopenia by EWGSOP II and obesity, which was diagnosed using two concepts: BMI obesity (BMI ≥ 30 kg/m2) and TBF obesity (percentage of TBF ≥ 35% for women and ≥ 25% for men). Finally, the association of each group with physical frailty was evaluated. Results The mean age was 78.15 ± 7.22 years. Sarcopenia EWGSOP II was diagnosed in 19.8% (n = 73), body mass index obesity was identified in 21.8% (n = 81), TBF obesity was identified in 67.7% (n = 251), and physical frailty was identified in 38.5% (n = 142). In a regression analysis for frailty, sarcopenic TBF obesity presented an odds ratio of 6.88 (95% confidence interval 2.60-18.24; p < 0.001). Conclusion In older Brazilian adults, sarcopenic obesity diagnosed by TBF obesity has a robust association with frailty and is independent of body mass index.
Collapse
|
42
|
Zanker J, Sim M, Anderson K, Balogun S, Brennan-Olsen SL, Dent E, Duque G, Girgis CM, Grossmann M, Hayes A, Henwood T, Hirani V, Inderjeeth C, Iuliano S, Keogh J, Lewis JR, Lynch GS, Pasco JA, Phu S, Reijnierse EM, Russell N, Vlietstra L, Visvanathan R, Walker T, Waters DL, Yu S, Maier AB, Daly RM, Scott D. Consensus guidelines for sarcopenia prevention, diagnosis and management in Australia and New Zealand. J Cachexia Sarcopenia Muscle 2023; 14:142-156. [PMID: 36349684 PMCID: PMC9891980 DOI: 10.1002/jcsm.13115] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 08/18/2022] [Accepted: 09/19/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Sarcopenia is an age-associated skeletal muscle condition characterized by low muscle mass, strength, and physical performance. There is no international consensus on a sarcopenia definition and no contemporaneous clinical and research guidelines specific to Australia and New Zealand. The Australian and New Zealand Society for Sarcopenia and Frailty Research (ANZSSFR) Sarcopenia Diagnosis and Management Task Force aimed to develop consensus guidelines for sarcopenia prevention, assessment, management and research, informed by evidence, consumer opinion, and expert consensus, for use by health professionals and researchers in Australia and New Zealand. METHODS A four-phase modified Delphi process involving topic experts and informed by consumers, was undertaken between July 2020 and August 2021. Phase 1 involved a structured meeting of 29 Task Force members and a systematic literature search from which the Phase 2 online survey was developed (Qualtrics). Topic experts responded to 18 statements, using 11-point Likert scales with agreement threshold set a priori at >80%, and five multiple-choice questions. Statements with moderate agreement (70%-80%) were revised and re-introduced in Phase 3, and statements with low agreement (<70%) were rejected. In Phase 3, topic experts responded to six revised statements and three additional questions, incorporating results from a parallel Consumer Expert Delphi study. Phase 4 involved finalization of consensus statements. RESULTS Topic experts from Australia (n = 62, 92.5%) and New Zealand (n = 5, 7.5%) with a mean ± SD age of 45.7 ± 11.8 years participated in Phase 2; 38 (56.7%) were women, 38 (56.7%) were health professionals and 27 (40.3%) were researchers/academics. In Phase 2, 15 of 18 (83.3%) statements on sarcopenia prevention, screening, assessment, management and future research were accepted with strong agreement. The strongest agreement related to encouraging a healthy lifestyle (100%) and offering tailored resistance training to people with sarcopenia (92.5%). Forty-seven experts participated in Phase 3; 5/6 (83.3%) revised statements on prevention, assessment and management were accepted with strong agreement. A majority of experts (87.9%) preferred the revised European Working Group for Sarcopenia in Older Persons (EWGSOP2) definition. Seventeen statements with strong agreement (>80%) were confirmed by the Task Force in Phase 4. CONCLUSIONS The ANZSSFR Task Force present 17 sarcopenia management and research recommendations for use by health professionals and researchers which includes the recommendation to adopt the EWGSOP2 sarcopenia definition in Australia and New Zealand. This rigorous Delphi process that combined evidence, consumer expert opinion and topic expert consensus can inform similar initiatives in countries/regions lacking consensus on sarcopenia.
Collapse
Affiliation(s)
- Jesse Zanker
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St. Albans, Victoria, Australia.,Department of Medicine - Western Health, The University of Melbourne, St. Albans, Victoria, Australia
| | - Marc Sim
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.,School of Medicine, University of Western Australia, Perth, Western Australia, Australia
| | - Kate Anderson
- Institute for Health Transformation - Determinants of Health, Faculty of Health, Deakin University, Burwood, Victoria, Australia.,School of Health and Social Development, Faculty of Health, Deakin University, Burwood, Victoria, Australia
| | - Saliu Balogun
- College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory, Australia.,Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Sharon L Brennan-Olsen
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St. Albans, Victoria, Australia.,Department of Medicine - Western Health, The University of Melbourne, St. Albans, Victoria, Australia.,School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia.,Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - Elsa Dent
- Torrens University Australia, Adelaide, South Australia, Australia
| | - Gustavo Duque
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St. Albans, Victoria, Australia.,Department of Medicine - Western Health, The University of Melbourne, St. Albans, Victoria, Australia.,Research Institute of the McGill University Health Centre, Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Christian M Girgis
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.,Department of Diabetes and Endocrinology, Westmead Hospital, Westmead, New South Wales, Australia
| | - Mathis Grossmann
- Department of Medicine - Austin Health, Department of Endocrinology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Alan Hayes
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St. Albans, Victoria, Australia.,Institute for Health and Sport (IHeS), Victoria University, Footscray, Victoria, Australia
| | - Tim Henwood
- Human Movement and Nutritional Science, University of Queensland, Brisbane, Queensland, Australia
| | - Vasant Hirani
- Nutrition and Dietetics Group, School of Life and Environmental Sciences Charles Perkins Centre, University of Sydney, New South Wales, Sydney, Australia
| | - Charles Inderjeeth
- North Metropolitan Health Service & University of Western Australia, Perth, Western Australia, Australia
| | - Sandra Iuliano
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St. Albans, Victoria, Australia.,Department of Medicine - Western Health, The University of Melbourne, St. Albans, Victoria, Australia
| | - Justin Keogh
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia.,Human Potential Centre, Auckland University of Technology, Auckland, New Zealand.,Cluster for Health Improvement, Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Sunshine Coast, Queensland, Australia.,Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Joshua R Lewis
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.,School of Medicine, University of Western Australia, Perth, Western Australia, Australia.,Centre for Kidney Research, Children's Hospital at Westmead School of Public Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Gordon S Lynch
- Centre for Muscle Research, Department of Anatomy and Physiology, School of Biomedical Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Julie A Pasco
- Department of Medicine - Western Health, The University of Melbourne, St. Albans, Victoria, Australia.,IMPACT-Institute for Mental and Physical Health and Clinical Translation, Barwon Health, Deakin University, Geelong, Victoria, Australia
| | - Steven Phu
- Department of Medicine - Western Health, The University of Melbourne, St. Albans, Victoria, Australia.,Falls, Balance, and Injury Research Centre, Neuroscience Research Australia (NeuRA), Sydney, New South Wales, Australia
| | - Esmee M Reijnierse
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia.,Amsterdam UMC location Vrije Universiteit Amsterdam, Rehabilitation Medicine, Amsterdam, The Netherlands.,Amsterdam Movement Sciences, Ageing & Vitality, Amsterdam, The Netherlands
| | - Nicholas Russell
- Department of Medicine - Austin Health, Department of Endocrinology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Lara Vlietstra
- School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand
| | - Renuka Visvanathan
- Adelaide Geriatrics Training and Research with Aged Care (GTRAC) Centre, School of Medicine, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia.,Aged & Extended Care Services, Acute and Urgent Care, The Queen Elizabeth Hospital, Central Adelaide Local Health Network, Adelaide, South Australia, Australia
| | - Troy Walker
- Institute for Health Transformation, Global Obesity Centre, Deakin University, Geelong, Victoria, Australia
| | - Debra L Waters
- School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand
| | - Solomon Yu
- Adelaide Geriatrics Training and Research with Aged Care (GTRAC) Centre, School of Medicine, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia.,Aged & Extended Care Services, Acute and Urgent Care, The Queen Elizabeth Hospital, Central Adelaide Local Health Network, Adelaide, South Australia, Australia
| | - Andrea B Maier
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia.,Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Centre for Healthy Longevity, @AgeSingapore, National University Health System, Singapore.,Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Robin M Daly
- Institute for Physical Activity and Nutrition, Deakin University, Burwood, Victoria, Australia
| | - David Scott
- Institute for Physical Activity and Nutrition, Deakin University, Burwood, Victoria, Australia.,Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| |
Collapse
|
43
|
Beekman KM, Duque G, Corsi A, Tencerova M, Bisschop PH, Paccou J. Osteoporosis and Bone Marrow Adipose Tissue. Curr Osteoporos Rep 2023; 21:45-55. [PMID: 36534306 DOI: 10.1007/s11914-022-00768-1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/17/2022] [Indexed: 12/23/2022]
Abstract
PURPOSE OF REVIEW This review focuses on the recent findings regarding bone marrow adipose tissue (BMAT) concerning bone health. We summarize the variations in BMAT in relation to age, sex, and skeletal sites, and provide an update on noninvasive imaging techniques to quantify human BMAT. Next, we discuss the role of BMAT in patients with osteoporosis and interventions that affect BMAT. RECENT FINDINGS There are wide individual variations with region-specific fluctuation and age- and gender-specific differences in BMAT content and composition. The Bone Marrow Adiposity Society (BMAS) recommendations aim to standardize imaging protocols to increase comparability across studies and sites. Water-fat imaging (WFI) seems an accurate and efficient alternative for spectroscopy (1H-MRS). Most studies indicate that greater BMAT is associated with lower bone mineral density (BMD) and a higher prevalence of vertebral fractures. The proton density fat fraction (PDFF) and changes in lipid composition have been associated with an increased risk of fractures independently of BMD. Therefore, PDFF and lipid composition could potentially be future imaging biomarkers for assessing fracture risk. Evidence of the inhibitory effect of osteoporosis treatments on BMAT is still limited to a few randomized controlled trials. Moreover, results from the FRAME biopsy sub-study highlight contradictory findings on the effect of the sclerostin antibody romosozumab on BMAT. Further understanding of the role(s) of BMAT will provide insight into the pathogenesis of osteoporosis and may lead to targeted preventive and therapeutic strategies.
Collapse
Affiliation(s)
- Kerensa M Beekman
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Gustavo Duque
- Department of Medicine and Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Alessandro Corsi
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Michaela Tencerova
- Molecular Physiology of Bone, Institute of Physiology of the Czech Academy of Sciences, Prague, Czech Republic
| | - Peter H Bisschop
- Department of Endocrinology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Julien Paccou
- Department of Rheumatology, MABLaB ULR 4490, CHU Lille, University Lille, Lille, France.
| |
Collapse
|
44
|
Farsani MA, Banitalebi E, Faramarzi M, Bakhtiari N, Rahimi M, Duque G. Bone-muscle crosstalk following exercise plus Ursolic acid by myomiR-133a/Cx43-Runx2 axis in aged type 2 diabetes rat models. Chem Biol Interact 2023; 370:110315. [PMID: 36535313 DOI: 10.1016/j.cbi.2022.110315] [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: 09/07/2022] [Revised: 12/13/2022] [Accepted: 12/15/2022] [Indexed: 12/23/2022]
Abstract
Natural bioactive compound, Ursolic acid (UA), plus different types of exercise may exert the action on glycemic control, leading to clinical benefits in the prevention and treatment of aging/diabetes-associated complications. So, this study examined the effects of eight weeks combination of 250 mg of UA per day per kilogram of body weight of rat as well as resistance/endurance training on miR-133a expression across serum, bone marrow, skeletal muscle, and Connexin 43 (Cx43)-Runt-related transcription factor 2 (Runx2) signaling axis in high-fat diet and low-dose streptozotocin-induced T2D (here, HFD/STZ-induced T2D). The study was conducted on 56 male Wistar rats (427 ± 44 g, 21 months old), having HFD/STZ-induced T2D randomly assigned into 7 groups of 8 including (1) sedentary non-diabetic old rats (C); (2) sedentary type 2 diabetes animal model (D); (3) sedentary type 2 diabetes animal model + UA (DU); (4) endurance-trained type 2 diabetes animal model (DE); (5) resistance-trained type 2 diabetes animal model (DR); (6) endurance-trained type 2 diabetes animal model + UA (DEU); and (7) resistance-trained type 2 diabetes animal model + UA (DRU). Resistance training included a model of eight weeks of ladder resistance training at 60-80% maximal voluntary carrying capacity (MVCC) for five days/week. Treadmill endurance exercise protocol included eight weeks of repetitive bouts of low-/high-intensity training with 30%-40% and 60%-75% maximal running speed for five days/week, respectively. UA Supplementary groups were treated with 500 mg of UA per kg of high-fat diet per day. The results revealed significant supplement and exercise interaction effects for the BM miR-133a (p = 0.001), the bone marrow Runx2 (p = 0.002), but not the serum miR-133a (p = 0.517), the skeletal muscle miR-133a (p = 0.097) and the Cx43 (p = 0.632). In conclusion, only eight weeks of resistance-type exercise could affect miR-133a profile in muscles and osteoblast differentiation biomarker RUNX2 in aged T2D model of rats. 250 mg of UA per kilogram of body weight rat per day was administered orally, less than the sufficient dose for biological and physiological impacts on osteoblast differentiation biomarkers in aged T2D model of rats following eight weeks.
Collapse
Affiliation(s)
| | | | - Mohammad Faramarzi
- Department of Exercise Physiology, Faculty of Sport Sciences, University of Isfahan, Isfahan, Iran
| | - Nuredin Bakhtiari
- Department of Biochemistry, Faculty of Biological Sciences, North Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Mostafa Rahimi
- Department of Sport Sciences, Shahrekord University, Shahrekord, Iran
| | - Gustavo Duque
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada; Division of Geriatric Medicine, Department of Medicine, McGill University, Montreal, Quebec, Canada; Dr. Joseph Kaufmann Chair in Geriatric Medicine, Faculty of Medicine, McGill University, Montreal, QC, Canada
| |
Collapse
|
45
|
Marzetti E, Duque G. Talking to Experts: Multicomponent Strategies and Sarcopenia. J Nutr Health Aging 2023; 27:683-684. [PMID: 37702344 DOI: 10.1007/s12603-023-1955-4] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 07/03/2023] [Indexed: 09/14/2023]
Affiliation(s)
- E Marzetti
- E. Marzetti, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy,
| | | |
Collapse
|
46
|
Kositsawat J, Vogrin S, French C, Gebauer M, Candow DG, Duque G, Kirk B. Relationship Between Plasma Homocysteine and Bone Density, Lean Mass, Muscle Strength and Physical Function in 1480 Middle-Aged and Older Adults: Data from NHANES. Calcif Tissue Int 2023; 112:45-54. [PMID: 36344761 PMCID: PMC9813058 DOI: 10.1007/s00223-022-01037-0] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 10/26/2022] [Indexed: 11/09/2022]
Abstract
Hyperhomocysteinemia induces oxidative stress and chronic inflammation (both of which are catabolic to bone and muscle); thus, we examined the association between homocysteine and body composition and physical function in middle-aged and older adults. Data from the National Health and Nutrition Examination Survey was used to build regression models. Plasma homocysteine (fluorescence immunoassay) was used as the exposure and bone mineral density (BMD; dual-energy X-ray absorptiometry; DXA), lean mass (DXA), knee extensor strength (isokinetic dynamometer; newtons) and gait speed (m/s) were used as outcomes. Regression models were adjusted for confounders (age, sex, race/Hispanic origin, height, fat mass %, physical activity, smoking status, alcohol intakes, cardiovascular disease, diabetes, cancer and vitamin B12). All models accounted for complex survey design by using sampling weights provided by NHANES. 1480 adults (median age: 64 years [IQR: 56, 73]; 50.3% men) were included. In multivariable models, homocysteine was inversely associated with knee extensor strength (β = 0.98, 95% CI 0.96, 0.99, p = 0.012) and gait speed (β = 0.85, 95% CI 0.78, 0.94, p = 0.003) and borderline inversely associated with femur BMD (β = 0.84, 95% CI 0.69, 1.03, p = 0.086). In the sub-group analysis of older adults (≥ 65 years), homocysteine was inversely associated with gait speed and femur BMD (p < 0.05) and the slope for knee extensor strength and whole-body BMD were in the same direction. No significant associations were observed between homocysteine and total or appendicular lean mass in the full or sub-group analysis. We found inverse associations between plasma homocysteine and muscle strength/physical function, and borderline significant inverse associations for femur BMD.
Collapse
Affiliation(s)
| | - Sara Vogrin
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, 176 Furlong Road, St. Albans, VIC, 3021, Australia
- Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, St Albans, VIC, 3021, Australia
| | - Chloe French
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, 176 Furlong Road, St. Albans, VIC, 3021, Australia
- Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, St Albans, VIC, 3021, Australia
- School of Health Sciences, University of Manchester, Manchester, UK
| | - Maria Gebauer
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, 176 Furlong Road, St. Albans, VIC, 3021, Australia
- Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, St Albans, VIC, 3021, Australia
- University Hospital of Guadalajara, Guadalajara, Spain
| | - Darren G Candow
- Faculty of Kinesiology and Health Studies, University of Regina, Regina, Canada
| | - Gustavo Duque
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, 176 Furlong Road, St. Albans, VIC, 3021, Australia
- Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, St Albans, VIC, 3021, Australia
| | - Ben Kirk
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, 176 Furlong Road, St. Albans, VIC, 3021, Australia.
- Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, St Albans, VIC, 3021, Australia.
| |
Collapse
|
47
|
Merchant RA, Chan YH, Duque G. GDF-15 Is Associated with Poor Physical Function in Prefrail Older Adults with Diabetes. J Diabetes Res 2023; 2023:2519128. [PMID: 37152099 PMCID: PMC10162869 DOI: 10.1155/2023/2519128] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 02/07/2023] [Accepted: 04/05/2023] [Indexed: 05/09/2023] Open
Abstract
Introduction Growth differentiation factor 15 (GDF-15) has been shown to be a metabolic and appetite regulator in diabetes mellitus (DM) and obesity. We aimed to investigate (i) the association between GDF-15 and DM with and without poor physical function independent of inflammation and (ii) the prediction model for poor physical function in prefrail older adults. Methods A cross-sectional study of 108-prefrail participants ≥60 years recruited for multidomain interventions. Data was collected for demographics, cognition, function, frailty, nutrition, handgrip strength (HGS), short physical performance battery (SPPB), and gait speed. Serum concentrations of GDF-15, IL-6, and TNF-α were measured. GDF-15 was classified into tertiles (T1, T2, and T3), and its association was studied with DM and physical function (DM poor physical function, DM no poor physical function, no DM poor physical function, and no DM no poor physical function). Results Compared with T1, participants in T3 were significantly older, had a lower education level, had almost three times higher prevalence of DM, slower gait speed, longer chair-stand time, and lower SPPB scores. On multivariate analysis, the odds of having both DM and poor physical performance compared to having no DM and no poor physical performance were significantly higher in GDF-15 T3 vs. GDF-15 T1 (aOR 9.7, 95% CI 1.4-67.7; p = 0.021), and the odds of having DM no poor physical function compared to having no DM and no poor physical performance were significantly higher in GDF-15 T2 (aOR 12.7, 95% CI 1.1-143.7; p = 0.040) independent of BMI, IL-6, TNF-α, nutrition, physical function, education, age, and gender. Conclusion The association of GDF-15 with DM-associated poor physical function is independent of inflammation in prefrail older adults. Its causal-association link needs to be determined in longitudinal studies.
Collapse
Affiliation(s)
- Reshma Aziz Merchant
- Division of Geriatric Medicine, Department of Medicine, National University Hospital, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Yiong Huak Chan
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Gustavo Duque
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- Division of Geriatric Medicine, Department of Medicine, McGill University, Montreal, Quebec, Canada
| |
Collapse
|
48
|
Ruiz JG, Duque G, Castillo-Gallego C, Tello T, Theou O, Espinoza S. Editorial: A New JNHA Section on Interviews with Experts. J Nutr Health Aging 2023; 27:680. [PMID: 37702342 DOI: 10.1007/s12603-023-1957-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 07/03/2023] [Indexed: 09/14/2023]
Affiliation(s)
- J G Ruiz
- Jorge G. Ruiz, MD, Memorial Healthcare System, Hollywood, FL, USA,
| | | | | | | | | | | |
Collapse
|
49
|
Cawthon PM, Visser M, Arai H, Ávila-Funes JA, Barazzoni R, Bhasin S, Binder E, Bruyère O, Cederholm T, Chen LK, Cooper C, Duque G, Fielding RA, Guralnik J, Kiel DP, Kirk B, Landi F, Sayer AA, Von Haehling S, Woo J, Cruz-Jentoft AJ. Defining terms commonly used in sarcopenia research: a glossary proposed by the Global Leadership in Sarcopenia (GLIS) Steering Committee. Eur Geriatr Med 2022; 13:1239-1244. [PMID: 36445639 PMCID: PMC9722886 DOI: 10.1007/s41999-022-00706-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [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: 08/30/2022] [Accepted: 10/08/2022] [Indexed: 11/30/2022]
Abstract
METHODS The aim of this paper is to define terms commonly related to sarcopenia to enable standardization of these terms in research and clinical settings. The Global Leadership Initiative in Sarcopenia (GLIS) aims to bring together leading investigators in sarcopenia research to develop a single definition that can be utilized worldwide; work on a global definition of sarcopenia is ongoing. The first step of GLIS is to develop the common terminology, or a glossary, that will facilitate agreement on a global definition of sarcopenia as well as interpretation of clinical and research findings. RESULTS Several terms that are commonly used in sarcopenia research are defined, including self-reported measures of function and ability; objective physical performance tests; and measures related to muscle function and size. CONCLUSION As new methods and technologies are developed, these definitions may be expanded or refined over time. Our goal is to promote this common language to describe sarcopenia and its components in clinical and research settings in order to increase clinical awareness and research interest in this important condition. We hope that the use of common terminology in sarcopenia research will increase understanding of the concept and improve communication around this important age-related condition.
Collapse
Affiliation(s)
- Peggy M. Cawthon
- California Pacific Medical Center, Research Institute, 550 16th Street, Second Floor, San Francisco, CA 94143 USA
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA USA
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- The Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, Obu, Aichi Japan
| | - José A. Ávila-Funes
- Department of Geriatrics, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Rocco Barazzoni
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Shalender Bhasin
- Bostin Claude D. Pepper Older Americans Independence Center, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA USA
| | - Ellen Binder
- Siteman Cancer Center at Barnes-Jewish Hospital, St. Louis, MO USA
- Division of Geriatrics and Nutritional Science, Washington University School of Medicine, St. Louis, MO USA
| | - Olivier Bruyère
- Division Public Health, Epidemiology and Health Economics, World Health Organization Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, University of Liège, Liège, Belgium
| | - Tommy Cederholm
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
- Theme Inflammation and Ageing, Karolinska University Hospital, Stockholm, Sweden
| | - Liang-Kung Chen
- Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Center for Geriatrics and Gerontology, Taipei Veterans Generfranal Hospital, Taipei, Taiwan
- Taipei Municipal Gan-Dau Hospital (Managed by Taipei Veterans General Hospital), Taipei, Taiwan
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- Department of Epidemiology, University of Oxford, Oxford, OX UK
| | - Gustavo Duque
- Research Institute of the McGill University Health Centre, Montreal, QC Canada
- Division of Geriatric Medicine, Department of Medicine, McGill University, Montreal, QC Canada
| | - Roger A. Fielding
- Nutrition Exercise, Physiology, and Sarcopenia Laboratory, Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center On Aging, Tufts University, Boston, MA USA
| | - Jack Guralnik
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD USA
| | - Douglas P. Kiel
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Department of Medicine Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA USA
| | - Ben Kirk
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St. Albans, VIC Australia
- Department of Medicine-Western Health, The University of Melbourne, St. Albans, VIC Australia
| | - Francesco Landi
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, 00168 Rome, Italy
| | - Avan A. Sayer
- AGE Research Group, NIHR Newcastle Biomedical Research Centre, Newcastle Upon Tyne Hospitals NHS Foundation Trust and Faculty of Medical Sciences, Newcastle University, Newcastle, UK
| | - Stephan Von Haehling
- Department of Cardiology and Pneumology, University Medicine Göttingen (UMG), Göttingen, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany
| | - Jean Woo
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
- Faculty of Medicine, Centre for Nutritional Studies, The Chinese University of Hong Kong, Hong Kong, China
| | | |
Collapse
|
50
|
Smith C, Hiam D, Tacey A, Lin X, Woessner MN, Zarekookandeh N, Garnham A, Chubb P, Lewis JR, Sim M, Herrmann M, Duque G, Levinger I. Higher bone remodeling biomarkers are related to a higher muscle function in older adults: Effects of acute exercise. Bone 2022; 165:116545. [PMID: 36108920 DOI: 10.1016/j.bone.2022.116545] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 08/14/2022] [Accepted: 09/10/2022] [Indexed: 11/30/2022]
Abstract
Bone and muscle are closely linked mechanically and biochemically. Bone hormones secreted during bone remodeling might be linked to muscle mass and strength maintenance. Exercise elicits high mechanical strain and is essential for bone health. However, the relationship between commonly used bone turnover markers (BTMs) and muscle function in community dwelling older adults remains unclear. It is also unknown how acute exercise with differing mechanical strain may affect BTMs, and whether baseline muscle function alters BTM responses differently. We tested the hypothesis that BTMs are associated with muscle function, and that acute exercise could change the circulating levels of BTMs. Thirty-five older adults (25 females/10 males, 72.8 ± 6.0 years) participated. Baseline assessments included body composition (DXA), handgrip strength and a physical performance test (PPT) (gait speed, timed-up-and-go [TUG], stair ascent/descent). Leg muscle quality (LMQ) and stair climb power (SCP) were calculated. Participants performed (randomized) 30 min aerobic (AE) (cycling 70%HRPeak) and resistance (RE) (leg press 70%RM, jumping) exercise. Serum β-isomerized C-terminal telopeptides (β-CTX), procollagen of type I propeptide (P1NP), total osteocalcin (t)OC and ucOC were assessed at baseline and post-exercise. Data were analyzed using linear mixed models and simple regressions, adjusted for sex. At baseline, higher muscle strength (LMQ, handgrip) was related to higher P1NP, higher SCP was related to higher P1NP and β-CTX, and better physical performance (lower PPT) related to higher P1NP and β-CTX (p < 0.05). Exercise, regardless of mode, decreased β-CTX and tOC (all p < 0.05), while P1NP and ucOC remained unaltered. Higher baseline handgrip strength, SCP and LMQ was associated with lower post-exercise β-CTX responses, and poorer baseline mobility (increased TUG time) was associated with higher post-exercise β-CTX. Independently of exercise mode, acute exercise decreased β-CTX and tOC. Our data suggest that in older adults at baseline, increased BTM levels were linked to better muscle function. Altogether, our data strengthens the evidence for bone-muscle interaction, however, mechanisms behind this specific component of bone-muscle crostalk remain unclear.
Collapse
Affiliation(s)
- Cassandra Smith
- Nutrition & Health Innovation Research Institute, School of Health and Medical Sciences, Edith Cowan University, Perth, Western Australia, Australia
| | - Danielle Hiam
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Alexander Tacey
- Institute for Health and Sport (IHES), Victoria University, Melbourne, VIC, Australia; Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne and Western Health, St Albans, VIC, Australia
| | - Xuzhu Lin
- Centre for Cancer Research, Hudson Institute of Medical Research, Clayton, VIC, Australia
| | - Mary N Woessner
- Institute for Health and Sport (IHES), Victoria University, Melbourne, VIC, Australia
| | - Navabeh Zarekookandeh
- Institute for Health and Sport (IHES), Victoria University, Melbourne, VIC, Australia
| | - Andrew Garnham
- Institute for Health and Sport (IHES), Victoria University, Melbourne, VIC, Australia
| | - Paul Chubb
- PathWest Laboratory Medicine, Fiona Stanley Hospital, Perth, Australia; Medical School, University Western Australia, Perth, WA, Australia
| | - Joshua R Lewis
- Nutrition & Health Innovation Research Institute, School of Health and Medical Sciences, Edith Cowan University, Perth, Western Australia, Australia; Medical School, University Western Australia, Perth, WA, Australia; Centre for Kidney Research, Children's Hospital at Westmead, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Marc Sim
- Nutrition & Health Innovation Research Institute, School of Health and Medical Sciences, Edith Cowan University, Perth, Western Australia, Australia; Medical School, University Western Australia, Perth, WA, Australia
| | - Markus Herrmann
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, 8036 Graz, Austria
| | - Gustavo Duque
- Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne and Western Health, St Albans, VIC, Australia; Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, Melbourne, VIC, Australia
| | - Itamar Levinger
- Institute for Health and Sport (IHES), Victoria University, Melbourne, VIC, Australia; Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne and Western Health, St Albans, VIC, Australia; Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, Melbourne, VIC, Australia.
| |
Collapse
|