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Tanaka M, Kanayama M, Hashimoto T, Oha F, Shimamura Y, Tsujimoto T, Hasegawa Y, Endo T, Nojiri H, Ishijima M. Characteristics of older patients with postmenopausal osteoporosis who developed loss of muscle mass during the COVID-19 pandemic - a case-control study. BMC Musculoskelet Disord 2023; 24:626. [PMID: 37533001 PMCID: PMC10394852 DOI: 10.1186/s12891-023-06755-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 07/25/2023] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND Under the restriction of social activities during the coronavirus disease 2019 (COVID-19) pandemic, there was concern about the loss of muscle mass due to a decrease in physical activity for the elderly. The purpose of this study was to investigate the characteristics of older patients with postmenopausal osteoporosis who developed loss of muscle mass during the COVID-19 pandemic in Japan. METHODS A total of 54 patients with postmenopausal osteoporosis were evaluated in this study. Whole-body dual-energy X-ray absorptiometry was performed pre- and post-COVID-19 pandemic to measure trunk and lower limb muscle mass. At the time of the post-COVID-19 pandemic, we conducted a survey to compare lifestyle before pandemic (the frequency of going out, the frequency of meeting acquaintances or families living apart, regular exercise habits, walking time, family structure), and comorbidities between the muscle mass loss (ML) group and the muscle mass maintenance (MM) group. The ML group consisted of patients with at least a 5% decrease in lower limb muscle mass or trunk muscle mass. RESULTS A significant difference was found only for the family structure (P = 0.0279); in the ML group, those living alone were the largest group, while in the MM group they were the smallest group. CONCLUSIONS The ML group was significantly more likely to live alone than the MM group. The current study showed that loss of muscle mass was more common in patients living alone.
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Affiliation(s)
- Masaru Tanaka
- Spine Center, Hakodate Central General Hospital, Hon-Cho 33-2, Hakodate, Hokkaido, 040-8585, Japan.
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, 1-5-29-4F Yushima, Bunkyo-Ku, Tokyo, 113-0034, Japan.
| | - Masahiro Kanayama
- Spine Center, Hakodate Central General Hospital, Hon-Cho 33-2, Hakodate, Hokkaido, 040-8585, Japan
| | - Tomoyuki Hashimoto
- Spine Center, Hakodate Central General Hospital, Hon-Cho 33-2, Hakodate, Hokkaido, 040-8585, Japan
| | - Fumihiro Oha
- Spine Center, Hakodate Central General Hospital, Hon-Cho 33-2, Hakodate, Hokkaido, 040-8585, Japan
| | - Yukitoshi Shimamura
- Spine Center, Hakodate Central General Hospital, Hon-Cho 33-2, Hakodate, Hokkaido, 040-8585, Japan
| | - Takeru Tsujimoto
- Spine Center, Hakodate Central General Hospital, Hon-Cho 33-2, Hakodate, Hokkaido, 040-8585, Japan
| | - Yuichi Hasegawa
- Spine Center, Hakodate Central General Hospital, Hon-Cho 33-2, Hakodate, Hokkaido, 040-8585, Japan
| | - Tsutomu Endo
- Spine Center, Hakodate Central General Hospital, Hon-Cho 33-2, Hakodate, Hokkaido, 040-8585, Japan
| | - Hidetoshi Nojiri
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, 1-5-29-4F Yushima, Bunkyo-Ku, Tokyo, 113-0034, Japan
| | - Muneaki Ishijima
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, 1-5-29-4F Yushima, Bunkyo-Ku, Tokyo, 113-0034, Japan
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Oliveira MS, Santo RCE, Silva JMS, Alabarse PVG, Brenol CV, Young SP, Xavier RM. Urinary metabolomic biomarker candidates for skeletal muscle wasting in patients with rheumatoid arthritis. J Cachexia Sarcopenia Muscle 2023. [PMID: 37243418 PMCID: PMC10401545 DOI: 10.1002/jcsm.13240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 12/01/2022] [Accepted: 04/02/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Rheumatoid arthritis (RA) is an autoimmune disease that affects the joints, leading to chronic synovial inflammation and local tissue destruction. Extra-articular manifestations may also occur, such as changes in body composition. Skeletal muscle wasting is often observed in patients with RA, but methods for assessing loss of muscle mass are expensive and not widely available. Metabolomic analysis has shown great potential for identifying changes in the metabolite profile of patients with autoimmune diseases. In this setting, urine metabolomic profiling in patients with RA may be a useful tool to identify skeletal muscle wasting. METHODS Patients aged 40-70 years with RA have been recruited according to the 2010 ACR/EULAR classification criteria. Further, the Disease Activity Score in 28 joints using the C-reactive protein level (DAS28-CRP) determined the disease activity. The muscle mass was measured by Dual X-ray absorptiometry (DXA) to generate the appendicular lean mass index (ALMI) by summing the lean mass measurements for both arms and legs and dividing them by height squared (kg/height2 ). Finally, urine metabolomic analysis by 1 H nuclear magnetic resonance (1 H-NMR) spectroscopy was performed and the metabolomics data set analysed using the BAYESIL and MetaboAnalyst software packages. Principal component analysis (PCA) and partial least squares-discriminant analysis (PLS-DA) were applied to the 1 H-NMR data, followed by Spearman's correlation analysis. The combined receiver operating characteristic curve (ROC) was calculated, as well as the logistic regression analyses to establish a diagnostic model. The significance level at P < 0.05 was set for all analyses. RESULTS The total set of subjects investigated included 90 patients with RA. Most patients were women (86.7%), with a mean age of 56.5 ± 7.3 years old and a median DAS28-CRP of 3.0 (IQR 1.0-3.0). Fifteen metabolites were identified in the urine samples with high variable importance in projection (VIP scores) by MetaboAnalyst. Of these, dimethylglycine (r = 0.205; P = 0.053), oxoisovalerate (r = -0.203; P = 0.055), and isobutyric acid (r = -0.249; P = 0.018) were significantly correlated with ALMI. Based on the low muscle mass (ALMI ≤6.0 kg/m2 for women and ≤8.1 kg/m2 for men) a diagnostic model have been established with dimethylglycine (area under the curve [AUC] = 0.65), oxoisovalerate (AUC = 0.49), and isobutyric acid (AUC = 0.83) with significant sensitivity and specificity. CONCLUSIONS Isobutyric acid, oxoisovalerate, and dimethylglycine from urine samples were associated with low skeletal muscle mass in patients with RA. These findings suggest that this group of metabolites may be further tested as biomarkers for identification of skeletal muscle wasting.
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Affiliation(s)
- Marianne S Oliveira
- Autoimmune Disease Laboratory, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Medical School, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Rafaela C E Santo
- Autoimmune Disease Laboratory, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Medical School, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Jordana M S Silva
- Autoimmune Disease Laboratory, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Medical School, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Claiton V Brenol
- Autoimmune Disease Laboratory, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Medical School, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Steve P Young
- Rheumatology Research Group, University of Birmingham, Birmingham, UK
| | - Ricardo M Xavier
- Autoimmune Disease Laboratory, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Medical School, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Zhang J, Huang Y, Chen Y, Shen X, Pan H, Yu W. Impact of Muscle Mass on Survival in Patients with Sepsis: A Systematic Review and Meta-Analysis. Ann Nutr Metab 2021; 77:330-336. [PMID: 34657039 DOI: 10.1159/000519642] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 09/14/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The aim of this study is to investigate the association between loss of muscle mass and prognosis of sepsis. METHODS Six databases, including PubMed, Embase, Cochrane Library, Web of Science, Scopus, and Ovid, were searched by the deadline of August 18, 2020. A meta-analysis was conducted on the collected data by means of a random-effects model. The quality of each included article was assessed according to the Newcastle-Ottawa Scale. RESULTS Out of 1,819 references, 6 articles and 1 conference abstract were included. Sepsis patients with a loss of muscle mass or sarcopenia had higher mortality (risk ratio [RR]: 1.94, 95% confidence intervals [CI]: 1.59-2.37; I-squared = 18.7%, p < 0.001). The RR of mortality within 30 days (RR: 2.31, 95% CI: 1.78-2.99, p < 0.001) was higher than that of mortality over 30 days. Loss of psoas muscle mass, as evaluated by CT, showed the highest RR of sepsis mortality. In addition, based on data on overall survival retrieved from 4 trials, the pooled hazard ratio (HR) for patients with a loss of muscle mass or sarcopenia was 3.04. Subgroup analysis showed that survival time was the main source of heterogeneity for the overall HR. Furthermore, the scanning areas of muscle mass in survival patients were 0.33 cm2/m2 higher than those measured in deceased patients. CONCLUSION A loss of muscle mass, as evaluated by CT scan, was associated with a poor outcome in sepsis.
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Affiliation(s)
- Jiajie Zhang
- Department of Infectious Diseases, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China
| | - Yicheng Huang
- Department of Infectious Diseases, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China
| | - Yingsha Chen
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaomin Shen
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Hongying Pan
- Department of Infectious Diseases, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China
| | - Wei Yu
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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