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Cai L, Tan J, Chen X, Wang F, Zhang X, Chen J, Liu C, Sun Y. Ambient air pollution exposure and the risk of probable sarcopenia: A prospective cohort study. Ecotoxicol Environ Saf 2024; 275:116273. [PMID: 38564861 DOI: 10.1016/j.ecoenv.2024.116273] [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] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 03/26/2024] [Accepted: 03/28/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Sarcopenia is characterized by decreased muscle mass and strength, posing threat to quality of life. Air pollutants are increasingly recognized as risk factors for diseases, while the relationship between the two remains to be elucidated. This study investigated whether exposure to ambient air pollution contributes to the development of sarcopenia. METHODS We employed the data from the UK Biobank with 303,031 eligible participants. Concentrations of PM2·5, NO2, and NOx were estimated. Cox proportional hazard regression models were applied to investigate the associations between pollutants and sarcopenia. RESULTS 30,766 probable sarcopenia cases was identified during the follow-up. We observed that exposure to PM2.5 (HR, 1.232; 95% CI, 1.053-1.440), NO2 (HR, 1.055; 95% CI, 1.032-1.078) and NOx (HR, 1.016; 95% CI, 1.007-1.026) were all significantly associated with increased risk for probable sarcopenia for each 10 μg/m3 increase in pollutant concentration. In comparison with individuals in the lowest quartiles of exposure, those in the upper quartiles had significantly increased risk of probable sarcopenia. Sarcopenia-related factors, e.g., reduced lean muscle mass, diminished walking pace, and elevated muscle fat infiltration ratio, also exhibited positive associations with exposure to ambient air pollution. On the contrary, high level physical activity significantly mitigated the influence of air pollutants on the development of probable sarcopenia. CONCLUSIONS Air pollution exposure elevated the risk of developing sarcopenia and related manifestations in a dose-dependent manner, while physical activity maintained protective under this circumstance. Efforts should be made to control air pollution and emphasize the importance of physical activity for skeletal muscle health under this circumstance.
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Affiliation(s)
- Lubing Cai
- Department of Sports Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Jiao Tong University, Shanghai 200080, China
| | - Jiale Tan
- Department of Sports Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Jiao Tong University, Shanghai 200080, China
| | - Xinyi Chen
- Department of Sports Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Jiao Tong University, Shanghai 200080, China
| | - Fuchao Wang
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China
| | - Xingyu Zhang
- Department of Sports Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Jiao Tong University, Shanghai 200080, China
| | - Jiwu Chen
- Department of Sports Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Jiao Tong University, Shanghai 200080, China
| | - Cong Liu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China.
| | - Yaying Sun
- Department of Sports Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Jiao Tong University, Shanghai 200080, China.
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Won MH, Yun KH, Kim H, Son YJ. Prognostic role of sarcopenia on major adverse cardiac events among patients who underwent successful percutaneous coronary intervention: a retrospective cohort study. Eur J Cardiovasc Nurs 2024; 23:287-295. [PMID: 37579073 DOI: 10.1093/eurjcn/zvad080] [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: 02/22/2023] [Revised: 08/09/2023] [Accepted: 08/09/2023] [Indexed: 08/16/2023]
Abstract
AIMS We investigated the prevalence of sarcopenia and its influence on 1-year major adverse cardiac events (MACEs) in patients after successful percutaneous coronary intervention (PCI). METHODS AND RESULTS This retrospective medical record review using purposive sampling was conducted at a tertiary care university hospital in Korea. Medical records of a total of 303 patients (≥40 years) who underwent successful PCI between January 2014 and December 2020 were analysed. We retrospectively assessed sarcopenia at initial admission. Sarcopenia was assessed by a sarcopenia index based on a ratio of serum creatinine to serum cystatin C. MACE rates were evaluated within l year after PCI. A Kaplan-Meier analysis with a log-rank test was performed to compare the time with 1-year MACE event-free survival between groups with and without sarcopenia. Cox proportional hazards regression was conducted to assess sarcopenia's influence on MACE. The prevalence of sarcopenia and 1-year MACE after PCI were 24.8 and 8.6%, respectively. We found that sarcopenia at admission (hazard ratio, 3.01; 95% confidence interval, 1.22-7.38, P = 0.017) was significantly associated with 1-year MACE among patients after PCI. CONCLUSION Expanding knowledge of sarcopenia among cardiovascular nurses may aid in early recognition of patients at risk of sarcopenia. Our finding implies that the sarcopenia index based on serum creatinine and cystatin C may be available as a prognostic factor for MACE in patients undergoing PCI. Future studies should be conducted to prospectively validate the sarcopenia index with a multi-centre, large sample.
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Affiliation(s)
- Mi Hwa Won
- Department of Nursing, Wonkwang University, Iksan, South Korea
| | - Kyeong Ho Yun
- Department of Cardiovascular Medicine, Regional Cardiocerebrovascular Center, Wonkwang University Hospital, Iksan, South Korea
| | - Heeseon Kim
- Department of Nursing, Wonkwang University, Iksan, South Korea
| | - Youn-Jung Son
- Red Cross College of Nursing, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul 06974, South Korea
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Yunrong T, Jin WW, Mahendran HA, Koon YB, Jahit S, Kamaruddin MA, Anuar N, Daud NAM. Pre-operative psoas muscle index, a surrogate for sarcopenia; as a predictor of post-esophagectomy complications. Dis Esophagus 2024; 37:doad072. [PMID: 38163959 DOI: 10.1093/dote/doad072] [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: 09/18/2023] [Revised: 09/18/2023] [Accepted: 10/17/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Esophagectomy is the standard of care for curative esophageal cancer. However, it is associated with significant morbidity and mortality. Esophageal cancer is known to negatively affect the nutritional status of patients and many manifest cancer sarcopenia. At present, measures of sarcopenia involve complex and often subjective measurements. We assess whether the Psoas Muscle Index (PMI); an inexpensive, simple, validated method used to diagnose sarcopenia, can be used to predict adverse outcomes in patients after curative esophagectomy. METHODS Multi-centre, retrospective cohort between 2010-2020, involving all consecutive patients undergoing curative esophagectomy for esophageal cancer in University Malaya Medical Centre, Sungai Buloh Hospital, and Sultanah Aminah Hospital. The cut-off value differentiating low and normal PMI is defined as 443mm2/m2 in males and 326326 mm2/m2 in females. Complications were recorded using the Clavien-Dindo Scale. RESULTS There was no statistical correlation between PMI and major post-esophagectomy complications (p-value: 0.495). However, complication profile was different, and patients with low PMIs had higher 30-day mortality (21.7%) when compared with patients with normal PMI (8.1%) (p-value: 0.048). CONCLUSIONS Although PMI did not significantly predict post-esophagectomy complications, low PMI correlates with higher 30-day mortality, reflecting a lower tolerance for complications among these patients. PMI is a useful, inexpensive tool to identify sarcopenia and aids the patient selection process. This alerts healthcare professionals to institute intensive physiotherapy and nutritional optimization prior to esophagectomy.
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Affiliation(s)
- Tan Yunrong
- Surgical Department, Sultanah Aminah Hospital, Johor Bharu, Johor, Malaysia
| | - Wong Wei Jin
- Upper Gastrointestinal Surgery Unit, Surgical Department, University Malaya Medical Centre, Petaling Jaya, Malaysia
| | | | | | - Shukri Jahit
- Surgical Department, National Cancer Institute, Putrajaya, Malaysia
| | | | - Nor'Aini Anuar
- Diagnostics and Imaging Department, Sungai Buloh Hospital, Sungai Buloh, Selangor, Malaysia
| | - Noor Aida Mat Daud
- Diagnostics and Imaging Department, Sungai Buloh Hospital, Sungai Buloh, Selangor, Malaysia
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Kim A, Lee CM, Kang BK, Kim M, Choi JW. Myosteatosis and aortic calcium score on abdominal CT as prognostic markers in non-dialysis chronic kidney disease patients. Sci Rep 2024; 14:7718. [PMID: 38565556 PMCID: PMC10987640 DOI: 10.1038/s41598-024-58293-3] [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: 10/16/2023] [Accepted: 03/27/2024] [Indexed: 04/04/2024] Open
Abstract
We aimed to examine the relationship between abdominal computed tomography (CT)-based body composition data and both renal function decline and all-cause mortality in patients with non-dialysis chronic kidney disease (CKD). This retrospective study comprised non-dialysis CKD patients who underwent consecutive unenhanced abdominal CT between January 2010 and December 2011. CT-based body composition was measured using semiautomated method that included visceral fat, subcutaneous fat, skeletal muscle area and density, and abdominal aortic calcium score (AAS). Sarcopenia and myosteatosis were defined by decreased skeletal muscle index (SMI) and decreased skeletal muscle density, respectively, each with specific cutoffs. Risk factors for CKD progression and survival were identified using logistic regression and Cox proportional hazard regression models. Survival between groups based on myosteatosis and AAS was compared using the Kaplan-Meier curve. 149 patients (median age: 70 years) were included; 79 (53.0%) patients had sarcopenia and 112 (75.2%) had myosteatosis. The median AAS was 560.9 (interquartile range: 55.7-1478.3)/m2. The prognostic factors for CKD progression were myosteatosis [odds ratio (OR) = 4.31, p = 0.013] and high AAS (OR = 1.03, p = 0.001). Skeletal muscle density [hazard ratio (HR) = 0.93, p = 0.004] or myosteatosis (HR = 4.87, p = 0.032) and high AAS (HR = 1.02, p = 0.001) were independent factors for poor survival outcomes. The presence of myosteatosis and the high burden of aortic calcium were significant factors for CKD progression and survival in patients with non-dialysis CKD.
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Affiliation(s)
- Ahyun Kim
- Department of Radiology, Hanyang University Medical Center, 222-1 Wangsimni-ro, Seongdong-gu, Seoul, 04763, Republic of Korea
| | - Chul-Min Lee
- Department of Radiology, Hanyang University Medical Center, 222-1 Wangsimni-ro, Seongdong-gu, Seoul, 04763, Republic of Korea
| | - Bo-Kyeong Kang
- Department of Radiology, Hanyang University Medical Center, 222-1 Wangsimni-ro, Seongdong-gu, Seoul, 04763, Republic of Korea
| | - Mimi Kim
- Department of Radiology, Hanyang University Medical Center, 222-1 Wangsimni-ro, Seongdong-gu, Seoul, 04763, Republic of Korea.
| | - Jong Wook Choi
- Department of Internal Medicine, Hanyang University Medical Center, 222-1 Wangsimni-ro, Seongdong-gu, Seoul, Republic of Korea.
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Duarte MP, Almeida LS, Neri SG, Oliveira JS, Wilkinson TJ, Ribeiro HS, Lima RM. Prevalence of sarcopenia in patients with chronic kidney disease: a global systematic review and meta-analysis. J Cachexia Sarcopenia Muscle 2024; 15:501-512. [PMID: 38263952 PMCID: PMC10995263 DOI: 10.1002/jcsm.13425] [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: 07/10/2023] [Revised: 11/18/2023] [Accepted: 12/07/2023] [Indexed: 01/25/2024] Open
Abstract
Sarcopenia is a risk factor for adverse clinical outcomes in chronic kidney disease (CKD) patients, including mortality. Diagnosis depends on adopted consensus definition and cutoff values; thus, prevalence rates are generally heterogeneous. We conducted a systematic review and meta-analysis to investigate the global prevalence of sarcopenia and its traits across the wide spectrum of CKD. A systematic search was conducted using databases, including MEDLINE and EMBASE, for observational studies reporting the prevalence of sarcopenia. We considered sarcopenia according to the consensus definition of the European Working Group on Sarcopenia in Older People (EWGSOP), the Asian Working Group for Sarcopenia, the Foundation for the National Institutes of Health Sarcopenia Project, and the International Working Group on Sarcopenia (IWGS). Subgroup analyses by CKD stages, consensus, and gender were performed. Pooled prevalence was obtained from random-effect models. A total of 140 studies (42 041 patients) across 25 countries were included in this systematic review and meta-analyses. Global prevalence of sarcopenia was 24.5% [95% confidence interval (CI): 20.9-28.3) and did not differ among stages (P = 0.33). Prevalence varied according to the consensus definition from 11% to 30%, with no significant difference (P = 0.42). Prevalence of severe sarcopenia was 21.0% (95% CI: 11.7-32.0), with higher rates for patients on dialysis (26.2%, 95% CI: 16.6-37.1) compared to non-dialysis (3.0%, 95% CI: 0-11.1; P < 0.01). Sarcopenic obesity was observed in 10.8% (95% CI: 3.5-21.2). Regarding sarcopenia traits, low muscle strength was found in 43.4% (95%CI: 35.0-51.9), low muscle mass in 29.1% (95% CI: 23.9-34.5), and low physical performance in 38.6 (95% CI: 30.9-46.6) for overall CKD. Prevalence was only higher in patients on dialysis (50.0%, 95% CI: 41.7-57.4) compared to non-dialysis (19.6%, 95% CI: 12.8-27.3; P < 0.01) for low muscle strength. We found a high global prevalence of sarcopenia in the wide spectrum of CKD. Low muscle strength, the primary sarcopenia trait, was found in almost half of the overall population with CKD. Patients on dialysis were more prevalent to low muscle strength and severe sarcopenia. Nephrology professionals should be aware of regularly assessing sarcopenia and its traits in patients with CKD, especially those on dialysis.
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Affiliation(s)
- Marvery P. Duarte
- Faculty of Physical EducationUniversity of BrasiliaBrasíliaBrazil
- Faculty of Health SciencesUniversity of BrasiliaBrasíliaBrazil
| | - Lucas S. Almeida
- Faculty of Physical EducationUniversity of BrasiliaBrasíliaBrazil
| | - Silvia G.R. Neri
- Faculty of Physical EducationUniversity of BrasiliaBrasíliaBrazil
| | - Juliana S. Oliveira
- Institute for Musculoskeletal HealthThe University of Sydney and Sydney Local Health DistrictSydneyAustralia
- School of Public Health, Faculty of Medicine and HealthThe University of SydneySydneyAustralia
| | | | - Heitor S. Ribeiro
- Faculty of Physical EducationUniversity of BrasiliaBrasíliaBrazil
- Faculty of Health SciencesUniversity of BrasiliaBrasíliaBrazil
| | - Ricardo M. Lima
- Faculty of Physical EducationUniversity of BrasiliaBrasíliaBrazil
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Cheng E, Caan BJ, Chen WY, Prado CM, Cespedes Feliciano EM. A novel body composition risk score (B-Score) and overall survival among patients with nonmetastatic breast cancer. Clin Nutr 2024; 43:981-987. [PMID: 38471402 PMCID: PMC11009043 DOI: 10.1016/j.clnu.2024.03.001] [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: 12/05/2023] [Revised: 02/15/2024] [Accepted: 03/04/2024] [Indexed: 03/14/2024]
Abstract
BACKGROUND & AIMS Measurements (amount, distribution, and radiodensity) of muscle and adipose tissue were reported to be individually associated with overall survival in patients with breast cancer. However, they were not typically combined to develop an overall risk score, which can identify patients at high risk of death and prioritize patients in need of dietary and lifestyle interventions. Thus, we aimed to develop a novel composite body composition risk score (B-Score). METHODS We included 3105 patients with stage II or III breast cancer at Kaiser Permanente Northern California and Dana Farber Cancer Institute. From CT scans at diagnosis, we assessed areas and radiodensity of muscle and adipose tissue at the third lumber vertebrae. We considered skeletal muscle index (SMI), subcutaneous adipose tissue index (SATI) and SAT radiodensity as they were independent prognostic factors for overall survival. Each measurement was dichotomized using optimal stratification, with low SMI (<40.1 cm2/m2), high SATI (≥75.7 cm2/m2), and high SAT radiodensity (≥-97.2HU) considered risk factors. We calculated B-Score as the sum of these factors and estimated its association with overall survival using Cox proportional hazards regression with adjustment for clinicopathologic factors. RESULTS Mean (standard deviation) age was 53.9 (11.8) years, 70.3% were Non-Hispanic White, and 60.5% were stage II. Most patients (60.6%) had only one body composition risk factor (B-Score = 1). Compared to those with no risk factors (B-Score = 0), the risk of death increased with more body composition risk factors: the adjusted hazard ratios were 1.10 (95% CI: 0.85, 1.42), 1.47 (95% CI: 1.12, 1.92), and 2.11 (95% CI: 1.26, 3.53) for B-Scores of 1, 2, and 3, respectively (Ptrend < 0.001). CONCLUSIONS More unfavorable body composition characteristics were associated with increased risks of overall mortality in a dose-response manner. Considering body composition measurements together as a composite score (B-Score) may improve risk stratification and inform dietary and lifestyle interventions following breast cancer diagnosis.
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Affiliation(s)
- En Cheng
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States; Cancer Epidemiology, Prevention and Control Program, Montefiore Einstein Comprehensive Cancer Center, Bronx, NY, United States; Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States.
| | - Bette J Caan
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | - Wendy Y Chen
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, MA, United States
| | - Carla M Prado
- Human Nutrition Research Unit, Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
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Kobayashi T, Murakami T, Ono H, Takahashi T. Phase angle as an indicator of physical activity in patients with stable chronic obstructive pulmonary disease. Nutrition 2024; 120:112330. [PMID: 38262195 DOI: 10.1016/j.nut.2023.112330] [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: 09/05/2023] [Revised: 12/02/2023] [Accepted: 12/12/2023] [Indexed: 01/25/2024]
Abstract
OBJECTIVES Phase angle (PhA) reflects cell membrane integrity and vitality and is an indicator of sarcopenia. PhA is associated with physical function in patients with stable chronic obstructive pulmonary disease (COPD). To our knowledge, the association between PhA and physical activity (PA) has not been investigated. Therefore, the aim of this study was to investigate whether PhA reflects PA in patients with COPD. METHODS This single-center, cross-sectional, observational study included 103 patients with stable COPD (87 men; mean age, 74.7 ± 8.1 y; mean forced expiratory volume in 1s %predicted value, 58.9 ± 20.4%). PhA was measured by bioelectrical impedance analysis. Patients were stratified into low (n = 54) and high (n = 49) PhA groups based on median values (4.3° ± 0.6° and 5.4° ± 0.5°, respectively). PA was calculated as the average daily duration of high-intensity light PA (HLPA; 2.0-2.9 metabolic equivalents [METs] of PA) and moderate- to vigorous-intensity PA (MVPA; >3 METs). Correlation and multivariate analyses using multiple regression analysis were performed to confirm the association between PhA and PA. RESULTS The high-PhA group demonstrated greater HLPA (104.4 [16.5-332.5] versus 131.3 [61.1-328.7] min, P = 0.005) and MVPA (19.5 [4.7-96.0] versus 46.6 [8.9-139.3] min, P < 0.001) than the low-PhA group. PhA was positively correlated with HLPA (r = 0.32, P < 0.001) and MVPA (r = 0.49, P < 0.001). MVPA (β = 0.178, P = 0.029) and HLPA (β = 0.158, P = 0.026) were associated with PhA independent of age, sex, body mass index, respiratory function, muscle strength, skeletal muscle mass index, and 6-min walking distance. CONCLUSION In patients with COPD, PhA may reflect PA as well as muscle function.
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Affiliation(s)
- Takeshi Kobayashi
- Department of Rehabilitation, Tohoku Medical and Pharmaceutical University Wakabayashi Hospital, Yamatomachi, Wakabayashi-ku, Sendai, Japan.
| | - Tomoyuki Murakami
- Department of Rehabilitation, Tohoku Medical and Pharmaceutical University Wakabayashi Hospital, Yamatomachi, Wakabayashi-ku, Sendai, Japan
| | - Hiroto Ono
- Department of Rehabilitation, Tohoku Medical and Pharmaceutical University Wakabayashi Hospital, Yamatomachi, Wakabayashi-ku, Sendai, Japan
| | - Tsuneyuki Takahashi
- Department of Internal Medicine, Tohoku Medical and Pharmaceutical University Wakabayashi Hospital, Yamatomachi, Wakabayashi-ku, Sendai, Japan
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Surov A, Borggrefe J. In reply to the letter to the editor regarding: Sarcopenia is a predictor of patient death in acute ischemic stroke. J Stroke Cerebrovasc Dis 2024; 33:107565. [PMID: 38214241 DOI: 10.1016/j.jstrokecerebrovasdis.2024.107565] [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: 01/01/2024] [Accepted: 01/08/2024] [Indexed: 01/13/2024] Open
Affiliation(s)
- Alexey Surov
- Univ. Prof. Dr. med. Alexey Surov, Universitätsinstitut für Radiologie, Neuroradiologie und Nuklearmedizin, Johannes Wesling Universitätsklinikum Minden, Ruhr Universität Bochum, Hans-Nolte Str. 1, 32429 Minden, Germany.
| | - Jan Borggrefe
- Univ. Prof. Dr. med. Jan Borggrefe, Universitätsinstitut für Radiologie, Neuroradiologie und Nuklearmedizin, Johannes Wesling Universitätsklinikum Minden, Ruhr Universität Bochum, Hans-Nolte Str. 1, 32429 Minden, Germany.
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Quint EE, Liu Y, Shafaat O, Ghildayal N, Crosby H, Kamireddy A, Pol RA, Orandi BJ, Segev DL, Weiss CR, McAdams-DeMarco MA. Abdominal computed tomography measurements of body composition and waitlist mortality in kidney transplant candidates. Am J Transplant 2024; 24:591-605. [PMID: 37949413 PMCID: PMC10982050 DOI: 10.1016/j.ajt.2023.11.002] [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: 05/09/2023] [Revised: 10/10/2023] [Accepted: 11/02/2023] [Indexed: 11/12/2023]
Abstract
Body mass index is often used to determine kidney transplant (KT) candidacy. However, this measure of body composition (BC) has several limitations, including the inability to accurately capture dry weight. Objective computed tomography (CT)-based measures may improve pre-KT risk stratification and capture physiological aging more accurately. We quantified the association between CT-based BC measurements and waitlist mortality in a retrospective study of 828 KT candidates (2010-2022) with clinically obtained CT scans using adjusted competing risk regression. In total, 42.5% of candidates had myopenia, 11.4% had myopenic obesity (MO), 68.8% had myosteatosis, 24.8% had sarcopenia (probable = 11.2%, confirmed = 10.5%, and severe = 3.1%), and 8.6% had sarcopenic obesity. Myopenia, MO, and sarcopenic obesity were not associated with mortality. Patients with myosteatosis (adjusted subhazard ratio [aSHR] = 1.62, 95% confidence interval [CI]: 1.07-2.45; after confounder adjustment) or sarcopenia (probable: aSHR = 1.78, 95% CI: 1.10-2.88; confirmed: aSHR = 1.68, 95% CI: 1.01-2.82; and severe: aSHR = 2.51, 95% CI: 1.12-5.66; after full adjustment) were at increased risk of mortality. When stratified by age, MO (aSHR = 2.21, 95% CI: 1.28-3.83; P interaction = .005) and myosteatosis (aSHR = 1.95, 95% CI: 1.18-3.21; P interaction = .038) were associated with elevated risk only among candidates <65 years. MO was only associated with waitlist mortality among frail candidates (adjusted hazard ratio = 2.54, 95% CI: 1.28-5.05; P interaction = .021). Transplant centers should consider using BC metrics in addition to body mass index when a CT scan is available to improve pre-KT risk stratification at KT evaluation.
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Affiliation(s)
- Evelien E Quint
- Division of Transplant Surgery, Department of Surgery, University Medical Center Groningen, Groningen, The Netherlands
| | - Yi Liu
- Department of Surgery, New York University Grossman School of Medicine, New York, NY, USA
| | - Omid Shafaat
- Division of Vascular and Interventional Radiology, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Nidhi Ghildayal
- Department of Surgery, New York University Grossman School of Medicine, New York, NY, USA
| | - Helen Crosby
- Department of Surgery, New York University Grossman School of Medicine, New York, NY, USA
| | - Arun Kamireddy
- Division of Vascular and Interventional Radiology, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Robert A Pol
- Division of Transplant Surgery, Department of Surgery, University Medical Center Groningen, Groningen, The Netherlands
| | - Babak J Orandi
- Division of Endocrinology, Joan & Sanford Weill Medical College of Cornell University, New York, NY, USA
| | - Dorry L Segev
- Department of Surgery, New York University Grossman School of Medicine, New York, NY, USA; Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Clifford R Weiss
- Division of Vascular and Interventional Radiology, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Mara A McAdams-DeMarco
- Department of Surgery, New York University Grossman School of Medicine, New York, NY, USA; Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA.
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Kubrak C, Martin L, Grossberg AJ, Olson B, Ottery F, Findlay M, Bauer JD, Jha N, Scrimger R, Debenham B, Chua N, Walker J, Baracos V. Quantifying the severity of sarcopenia in patients with cancer of the head and neck. Clin Nutr 2024; 43:989-1000. [PMID: 38484528 DOI: 10.1016/j.clnu.2024.02.020] [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: 12/27/2023] [Revised: 02/14/2024] [Accepted: 02/18/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND & AIMS Existing skeletal muscle index (SMI) thresholds for sarcopenia are inconsistent, and do not reflect severity of depletion. In this study we aimed to define criterion values for moderate and severe skeletal muscle depletion based on the risk of mortality in a population of patients with head and neck cancer (HNC). Additionally, we aimed to identify clinical and demographic predictors of skeletal muscle depletion, evaluate the survival impact of skeletal muscle depletion in patients with minimal nutritional risk or good performance status, and finally, benchmarking SMI values of patients with HNC against healthy young adults. METHODS Population cohort of 1231 consecutive patients and external validation cohorts with HNC had lumbar SMI measured by cross-sectional imaging. Optimal stratification determined sex-specific thresholds for 2-levels of SMI depletion (Class I and II) based on overall survival (OS). Adjusted multivariable regression analyses (tumor site, stage, performance status, age, sex, dietary intake, weight loss) determined relationships between 2-levels of SMI depletion and OS. RESULTS Mean SMI (cm2/m2) was 51.7 ± 9.9 (males) and 39.8 ± 7.1 (females). The overall and sex-specific population demonstrated an increased risk of mortality associated with decreasing SMI. Sex-specific SMI (cm2/m2) depletion thresholds for 2-levels of muscle depletion determined by optimal stratification for males and females, respectively (male: 45.2-37.5, and <37.5; female: 40.9-34.2, and <34.2). In the overall population, Normal SMI, Class I and II SMI depletion occurred in 65.0%, 24.0%, and 11.0%, respectively. Median OS was: Normal SMI (114 months, 95% CI, 97.1-130.8); Class I SMI Depletion (42 months, 95% CI, 28.5-55.4), and Class II SMI Depletion (15 months, 95% CI, 9.8-20.1). Adjusted multivariable analysis compared with Normal SMI (reference), Class I SMI Depletion (HR, 1.49; 95% CI, 1.18-1.88; P < .001), Class II SMI Depletion (HR, 1.91; 95% CI, 1.42-2.58; P < .001). CONCLUSIONS Moderate and severe SMI depletion demonstrate discrimination in OS in patients with HNC. Moderate and severe SMI depletion is prevalent in patients with minimal nutrition risk and good performance status. Benchmarking SMI values against healthy young adults exemplifies the magnitude of SMI depletion in patients with HNC and may be a useful method in standardizing SMI assessment.
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Affiliation(s)
- Catherine Kubrak
- Department of Oncology, Division of Palliative Medicine, University of Alberta, Cross Cancer Institute, 11560 University Avenue, Edmonton, Alberta, T6G 1Z2, Canada.
| | - Lisa Martin
- Research and Evaluation Lead, Nutrition Services, Provincial Strategy, Standards and Practice, Alberta Health Services, Alberta, Canada.
| | - Aaron J Grossberg
- Department of Radiation Medicine, Oregon Health & Science University, Portland, OR, United States.
| | - Brennan Olson
- Mayo Clinic Department of Otolaryngology-Head and Neck Surgery, Rochester, MN, United States.
| | - Faith Ottery
- President, Ottery & Associates, LLC, Deerfield, IL, United States.
| | - Merran Findlay
- Cancer Services, Royal Prince Alfred Hospital, Camperdown, New South Wales, 2050 Australia.
| | - Judith D Bauer
- Department of Nutrition, Dietetics and Food, Monash University, Clayton, Victoria 3800 Australia.
| | - Naresh Jha
- Department of Oncology, Division of Radiation Oncology, University of Alberta, Cross Cancer Institute, 11560 University Avenue, Edmonton, Alberta, T6G 1Z2, Canada.
| | - Rufus Scrimger
- Department of Oncology, Division of Radiation Oncology, University of Alberta, Cross Cancer Institute, 11560 University Avenue, Edmonton, Alberta, T6G 1Z2, Canada.
| | - Brock Debenham
- Department of Oncology, Division of Radiation Oncology, University of Alberta, Cross Cancer Institute, 11560 University Avenue, Edmonton, Alberta, T6G 1Z2, Canada.
| | - Neil Chua
- Department Oncology, Division of Medical Oncology, University of Alberta, Cross Cancer Institute, 11560 University Avenue, Edmonton, Alberta, T6G 1Z2, Canada.
| | - John Walker
- Department Oncology, Division of Medical Oncology, University of Alberta, Cross Cancer Institute, 11560 University Avenue, Edmonton, Alberta, T6G 1Z2, Canada.
| | - Vickie Baracos
- Department of Oncology, Division of Palliative Medicine, University of Alberta, Cross Cancer Institute, 11560 University Avenue, Edmonton, Alberta, T6G 1Z2, Canada.
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11
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Chen C, Ou Y, Cai A, Huang Y, Feng Y, Nie Z. Household use of solid fuel and sarcopenia among middle-aged and older adults: The China Health and Retirement Longitudinal Study. Maturitas 2024; 182:107925. [PMID: 38325137 DOI: 10.1016/j.maturitas.2024.107925] [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: 07/26/2023] [Revised: 12/25/2023] [Accepted: 01/24/2024] [Indexed: 02/09/2024]
Abstract
OBJECTIVE Few studies have examined the effects of air pollution on the risk of sarcopenia, especially pollution in indoor settings. We explored the cross-sectional and longitudinal associations of household use of solid fuel for cooking and heating, separately and simultaneously, with risk of sarcopenia. METHODS Cross-sectional and follow-up data from the China Health and Retirement Longitudinal Study were used. Multivariable-adjusted generalized linear models and Cox proportional hazards regression models were performed to estimate the odds ratio and hazard ratio for sarcopenia, respectively. RESULTS 11,494 (median age: 57.0 years; 47.4 % males) and 7483 (median age: 57.0 years; 46.9 % males) participants were included in the cross-sectional and longitudinal study, respectively. After fully adjusting for covariates, including outdoor concentration of particulate matter (PM2.5), both the use of solid fuels for cooking and use for heating were positively associated with incident sarcopenia in the longitudinal analyses, with hazard ratios (95 % confidence interval) of 1.56 (1.28-1.89) and 1.26 (1.04-1.52), respectively. Moreover, significant multiplicative and/or additive interactions were observed between age, smoking and cooking with solid fuel and risk of sarcopenia (all P for interaction <0.05). Similar results were found in the cross-sectional analyses. CONCLUSIONS Household use of solid fuel was significantly associated with a higher risk of sarcopenia, while ageing and smoking had synergetic effects with burning solid fuels on the risk of sarcopenia. Our results highlight the importance of taking multi-pronged measures with respect to both air pollution and healthy lifestyle to prevent sarcopenia and promote healthy ageing.
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Affiliation(s)
- Chaolei Chen
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
| | - Yanqiu Ou
- Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
| | - Anping Cai
- Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
| | - Yuqing Huang
- Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
| | - Yingqing Feng
- Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China.
| | - Zhiqiang Nie
- Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China; Global Health Research Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China.
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12
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Quaresma MVLDS, Vicente BM, Balchiunas RE, Ribeiro SML. Sarcopenia risk, sarcopenia-related quality of life, and associated factors in people living with human immunodeficiency virus (HIV): A web-based survey. Nutrition 2024; 120:112352. [PMID: 38306734 DOI: 10.1016/j.nut.2024.112352] [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: 06/16/2023] [Revised: 11/17/2023] [Accepted: 01/02/2024] [Indexed: 02/04/2024]
Abstract
OBJECTIVES We aimed to screen for the risk of sarcopenia and sarcopenia-related quality of life and associated factors of people living with HIV (PLWH). RESEARCH METHODS AND PROCEDURES This nonprobabilistic web-based survey evaluated PLWH. The participants were invited directly from a university-based inpatient clinic and responded to a web questionnaire that included the SARC-F and SarQoL to screen people at risk of sarcopenia and their quality of life. People at risk of sarcopenia were defined by the proposed cutoff points for SARC-F (≥ 4 points), and SarQoL overall score was categorized according to the median. Moreover, we performed a logistic regression to investigate associations between HIV-, lifestyle-, and health-associated factors (i.e., physical activity, dietary pattern, sleep quality, gastrointestinal symptoms, HIV diagnosis, type, combinations, and duration of ART, smoking, drinking, BMI, and weight loss), and outcomes (SARC-F and SarQoL). RESULTS The sample comprised 202 PLWH, mainly middle-aged (50.6-60.5 y; n = 101). Only 5.9% (n = 12) are at risk of sarcopenia according to SARC-F, and only 17.3% (n = 35) exhibited lower sarcopenia-related quality of life according to SarQoL. In the multiple models, only the gastrointestinal symptoms increased the odds of sarcopenia risk (OR: 1.058; P = 0.01) and poor sarcopenia-associated quality of life (OR: 1.041; P = 0.013). CONCLUSIONS We verified that only 5.9% and 17.3% of PLWH are at risk of sarcopenia and presented lower sarcopenia-related quality of life, respectively. Only the gastrointestinal symptoms were associated with a risk of sarcopenia and lower sarcopenia-related quality of life, without significant differences between age groups.
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Affiliation(s)
- Marcus V L Dos Santos Quaresma
- Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil; Centro Universitário São Camilo, São Paulo, Brazil
| | | | - Roseli Espindola Balchiunas
- Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil; Centro Universitário São Camilo, São Paulo, Brazil
| | - Sandra M L Ribeiro
- Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil; Escola de Artes, Ciências e Humanidades, Universidade de São Paulo, Brazil.
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13
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Sousa IM, Silva FM, das Virgens IPA, Costa EC, Fayh APT. Response Letter to Correspondence: Methodological considerations in evaluating sarcopenia and frailty in elderly gastrointestinal cancer patients. Support Care Cancer 2024; 32:255. [PMID: 38546879 DOI: 10.1007/s00520-024-08455-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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 03/23/2024] [Indexed: 04/02/2024]
Affiliation(s)
- Iasmin Matias Sousa
- Graduate Program in Nutrition, Health Sciences Centre, Federal University of Rio Grande Do Norte, Natal, RN, Brazil
- Graduate Program in Health Sciences, Health Sciences Centre, Federal University of Rio Grande Do Norte, Natal, RN, Brazil
| | - Flávia Moraes Silva
- Nutrition Science Graduate Program of Federal, University of Health Science of Porto Alegre, Porto Alegre, Rio Grande Do Sul, Brazil
- Department of Nutrition, Nutrition Science Graduate Program, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Rio Grande Do Sul, Brazil
| | | | - Eduardo Caldas Costa
- ExCE Research Group, Department of Physical Education, Federal University of Rio Grande Do Norte, Natal, RN, Brazil
| | - Ana Paula Trussardi Fayh
- Graduate Program in Nutrition, Health Sciences Centre, Federal University of Rio Grande Do Norte, Natal, RN, Brazil.
- Graduate Program in Health Sciences, Health Sciences Centre, Federal University of Rio Grande Do Norte, Natal, RN, Brazil.
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Quiroz-Aldave JE, Gamarra-Osorio ER, Durand-Vásquez MDC, Rafael-Robles LDP, Gonzáles-Yovera JG, Quispe-Flores MA, Concepción-Urteaga LA, Román-González A, Paz-Ibarra J, Concepción-Zavaleta MJ. From liver to hormones: The endocrine consequences of cirrhosis. World J Gastroenterol 2024; 30:1073-1095. [PMID: 38577191 PMCID: PMC10989500 DOI: 10.3748/wjg.v30.i9.1073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 01/02/2024] [Accepted: 02/06/2024] [Indexed: 03/06/2024] Open
Abstract
Hepatocrinology explores the intricate relationship between liver function and the endocrine system. Chronic liver diseases such as liver cirrhosis can cause endocrine disorders due to toxin accumulation and protein synthesis disruption. Despite its importance, assessing endocrine issues in cirrhotic patients is frequently neglected. This article provides a comprehensive review of the epidemiology, pathophysiology, diagnosis, and treatment of endocrine disturbances in liver cirrhosis. The review was conducted using the PubMed/Medline, EMBASE, and Scielo databases, encompassing 172 articles. Liver cirrhosis is associated with endocrine disturbances, including diabetes, hypoglycemia, sarcopenia, thyroid dysfunction, hypogonadotropic hypogonadism, bone disease, adrenal insufficiency, growth hormone dysfunction, and secondary hyperaldosteronism. The optimal tools for diagnosing diabetes and detecting hypoglycemia are the oral glucose tolerance test and continuous glucose monitoring system, respectively. Sarcopenia can be assessed through imaging and functional tests, while other endocrine disorders are evaluated using hormonal assays and imaging studies. Treatment options include metformin, glucagon-like peptide-1 analogs, sodium-glucose co-transporter-2 inhibitors, and insulin, which are effective and safe for diabetes control. Established standards are followed for managing hypoglycemia, and hormone replacement therapy is often necessary for other endocrine dysfunctions. Liver transplantation can address some of these problems.
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Affiliation(s)
| | | | | | | | | | | | | | - Alejandro Román-González
- Department of Endocrinology, Hospital Universitario de San Vicente Fundación, Medellin 050010, Colombia
- Internal Medicine, Universidad de Antioquia, Medellín 050010, Colombia
| | - José Paz-Ibarra
- School of Medicine, Universidad Nacional Mayor de San Marcos, Lima 15081, Peru
- Department of Endocrinology, Hospital Nacional Edgardo Rebagliati Martins, Lima 15072, Peru
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15
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Tu X, Lin T, Ju Y, Shu X, Jiang T, Ge N, Yue J. Sarcopenia in systemic sclerosis: prevalence and impact-a systematic review and meta-analysis. BMJ Open 2024; 14:e078034. [PMID: 38448063 PMCID: PMC10916105 DOI: 10.1136/bmjopen-2023-078034] [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: 07/22/2023] [Accepted: 02/16/2024] [Indexed: 03/08/2024] Open
Abstract
OBJECTIVE This review aims to provide an estimate of sarcopenia prevalence and its impact on clinical characteristics in patients with systemic sclerosis (SSc). DESIGN Systematic review and meta-analysis. DATA SOURCES Embase, Medline, Web of Science and the Cochrane Central Register of Controlled Trials were systemically searched from inception to 24 May 2023. ELIGIBILITY CRITERIA FOR SELECTING STUDIES We included observational studies that reported the prevalence of sarcopenia in patients with SSc. DATA EXTRACTION AND SYNTHESIS Two reviewers independently performed study selection and data extraction using standardised methods. Risk of bias was assessed using the Agency for Healthcare Research and Quality Scale and the Newcastle-Ottawa Scale. Meta-analysis was conducted using random effects models. RESULTS A total of 4583 articles were screened and 9 studies with data from 815 patients were included in the analysis (8 cross-sectional studies and 1 retrospective cohort study). The overall prevalence of sarcopenia in patients with SSc was 22% (95% CI 17% to 28%). Patients with SSc with sarcopenia had a poorer quality of life (mean difference -12.02; 95% CI -19.11 to -4.93) and higher C reactive protein (CRP) levels (standardised mean difference 0.67; 95% CI 0.35 to 1.00). CONCLUSIONS Sarcopenia is common in patients with SSc. Patients with SSc with sarcopenia had a worse quality of life and higher CRP levels, based on our findings. Given the detrimental impact of sarcopenia on quality of life, future efforts aimed at early identification of sarcopenia in the clinical assessment of patients with SSc may have significance. PROSPERO REGISTRATION NUMBER CRD42022368326.
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Affiliation(s)
- Xiangping Tu
- Department of Geriatrics, Sichuan University West China Hospital, Chengdu, Sichuan, China
- National Clinical Research Center for Geriatrics, Sichuan University West China Hospital, Chengdu, Sichuan, China
| | - Taiping Lin
- Department of Geriatrics, Sichuan University West China Hospital, Chengdu, Sichuan, China
- National Clinical Research Center for Geriatrics, Sichuan University West China Hospital, Chengdu, Sichuan, China
| | - Yuan Ju
- Sichuan University Library, Sichuan University, Chengdu, Sichuan, China
| | - Xiaoyu Shu
- Department of Geriatrics, Sichuan University West China Hospital, Chengdu, Sichuan, China
- National Clinical Research Center for Geriatrics, Sichuan University West China Hospital, Chengdu, Sichuan, China
| | - Tingting Jiang
- Department of Geriatrics, Sichuan University West China Hospital, Chengdu, Sichuan, China
- National Clinical Research Center for Geriatrics, Sichuan University West China Hospital, Chengdu, Sichuan, China
| | - Ning Ge
- Department of Geriatrics, Sichuan University West China Hospital, Chengdu, Sichuan, China
- National Clinical Research Center for Geriatrics, Sichuan University West China Hospital, Chengdu, Sichuan, China
| | - Jirong Yue
- Department of Geriatrics, Sichuan University West China Hospital, Chengdu, Sichuan, China
- National Clinical Research Center for Geriatrics, Sichuan University West China Hospital, Chengdu, Sichuan, China
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16
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Zhang Y, Zhu Y. Sarcopenia and Its Influencing Factors in Patients With Colorectal Cancer. Gastroenterol Nurs 2024; 47:138-147. [PMID: 38567857 DOI: 10.1097/sga.0000000000000779] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 07/21/2023] [Indexed: 04/05/2024] Open
Abstract
Sarcopenia can lead to more postoperative complications and poorer prognosis in patients with colorectal cancer; however there is limited research exploring the incidence and influencing factors of different stages of sarcopenia in patients with colorectal cancer. We investigated 312 patients with colorectal cancer. Sarcopenia was determined by measuring muscle mass, grip strength, and gait speed. According to the European Working Group on Sarcopenia in Older People (EWGSOP) 2010, patients were classified into four groups: nonsarcopenia, presarcopenia, sarcopenia, and severe sarcopenia. The incidence of sarcopenia and severe sarcopenia was 10.3% and 8.7%, respectively. Multivariate logistic regression analysis showed that age, TNM stage smoking history, total protein, upper arm circumference, waist circumference, and Patient-Generated Subjective Global Assessment (PG-SGA) score were independently associated with sarcopenia at different stages. This study suggests that routine data should be used to provide targeted care during hospitalization for patients with colorectal cancer in order to reduce the incidence of sarcopenia and improve prognosis.
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Affiliation(s)
- Ying Zhang
- Ying Zhang, MSN, is from the School of Nursing, Qingdao University, Qingdao, Shandong, China
- Yongjian Zhu, MSN, is from the School of Nursing, Qingdao University, Qingdao, Shandong, China; and Nursing Department, Yuhuangding Hospital, Yuhuangding, Yantai, Shandong, China
| | - Yongjian Zhu
- Ying Zhang, MSN, is from the School of Nursing, Qingdao University, Qingdao, Shandong, China
- Yongjian Zhu, MSN, is from the School of Nursing, Qingdao University, Qingdao, Shandong, China; and Nursing Department, Yuhuangding Hospital, Yuhuangding, Yantai, Shandong, China
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LoMauro A, Gervasoni F, Ricci V, Salce G, Andreoli A, Pantoni L, Özçakar L. Sarcopenia and Multisensory Integration Deficit in Post-COVID Syndrome Patients: The Clinical, Ultrasound and Robotic Evaluation Protocol in a Cross-sectional Study. Am J Phys Med Rehabil 2024; 103:181-187. [PMID: 37208815 DOI: 10.1097/phm.0000000000002291] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
INTRODUCTION Post-COVID syndrome affects relatively young outpatients with fatigue as the mostly reported symptom. We wondered whether sarcopenia could play a role. METHODS Seventy-four outpatients (median age: 53.8 yrs, 45 females), reporting fatigue and persistent mild neurological/motor deficits, completed the Clinical, Ultrasound and Robotic Evaluation protocol 4.8 mos after the infection. RESULTS The incidence of sarcopenia was 41%. Sarcopenic patients were older (62.7 vs. 46.4 yrs, P < 0.001), they experienced longer infection (33 vs. 24 days, P = 0.006) and higher incidence of hospitalization (86.6 vs. 29.5%, P < 0.001), they did not report more fatigue (44.5 vs. 48, P = 0.424), but they walked slower (1.27 vs. 1.5 m/sec, P = 0.027).After multivariable adjustment using multiple logistic regression, sarcopenia was dependent on age (odds ratio = 1.09) and on the duration of the disease (odds ratio = 1.04).When expressed as z score, in 79% of patients, the sway path during elastic balance shifted significantly toward negative values with closed eye, indicating multisensory integration deficit. CONCLUSIONS Post-COVID syndrome in relatively young outpatients complaining mild motor deficit is associated with high incidence of sarcopenia. In addition, they have multisensory integration deficit that further contributes to symptoms. The Clinical, Ultrasound and Robotic Evaluation protocol is able to objectivize symptoms that common diagnostic tool cannot reveal. TO CLAIM CME CREDITS Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME. TO CLAIM CME CREDITS Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME. CME OBJECTIVES Upon completion of this article, the reader should be able to: (1) Determine the best diagnostic algorithm for the diagnosis of sarcopenia; (2) Identify and treat two additional factors that help to explain and understand the symptoms reported by relatively young post-COVID syndrome patients; and (3) Extend their diagnostic capability through the use of technology. LEVEL Advanced. ACCREDITATION The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s) ™. Physicians should only claim credit commensurate with the extent of their participation in the activity. LEVEL Advanced. ACCREDITATION The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s) ™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
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Affiliation(s)
- Antonella LoMauro
- From the Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milan, Italy (ALM); Physical and Rehabilitation Medicine Unit, "Luigi Sacco" University Hospital, Asst Fatebenefratelli Sacco, Milan, Italy (FG, VR, GS, AA); Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy (LP); and Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey (LÖ)
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Nakamura Y, Saldajeno DP, Kawaguchi K, Kawaoka S. Progressive, multi-organ, and multi-layered nature of cancer cachexia. Cancer Sci 2024; 115:715-722. [PMID: 38254286 PMCID: PMC10921013 DOI: 10.1111/cas.16078] [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: 10/27/2023] [Revised: 12/27/2023] [Accepted: 01/05/2024] [Indexed: 01/24/2024] Open
Abstract
Cancer cachexia is a complex, multifaceted condition that negatively impacts the health, treatment efficacy, and economic status of cancer patients. The management of cancer cachexia is an essential clinical need. Cancer cachexia is currently defined mainly according to the severity of weight loss and sarcopenia (i.e., macrosymptoms). However, such macrosymptoms may be insufficient to give clinicians clues on how to manage this condition as these symptoms appear at the late stage of cancer. We need to understand earlier events during the progression of cancer cachexia so as not to miss a clinical opportunity to control this complex syndrome. Recent research indicates that cancer-induced changes in the host are much wider than previously recognized, including disruption of liver function and the immune system. Furthermore, such changes are observed before the occurrence of visible distant metastases (i.e., in early, localized cancers). In light of these findings, we propose to expand the definition of cancer cachexia to include all cancer-induced changes to host physiology, including changes caused by early, localized cancers. This new definition of cancer cachexia can provide a new perspective on this topic, which can stimulate the research and development of novel cancer cachexia therapies.
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Affiliation(s)
- Yuki Nakamura
- Inter‐Organ Communication Research TeamInstitute for Life and Medical SciencesKyotoJapan
- Department of Breast SurgeryKyoto University Graduate School of MedicineKyotoJapan
| | - Don Pietro Saldajeno
- Inter‐Organ Communication Research TeamInstitute for Life and Medical SciencesKyotoJapan
- Mathematical Informatics Laboratory, Division of Information ScienceNara Institute of Science and TechnologyIkomaNaraJapan
| | - Kosuke Kawaguchi
- Department of Breast SurgeryKyoto University Graduate School of MedicineKyotoJapan
| | - Shinpei Kawaoka
- Inter‐Organ Communication Research TeamInstitute for Life and Medical SciencesKyotoJapan
- Department of Integrative Bioanalytics, Institute of Development, Aging and Cancer (IDAC)Tohoku UniversitySendaiJapan
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Abstract
Inflammatory bowel diseases (IBDs) are characterized by a multifactorial clinical picture, in which age-related physical, functional and psychological symptoms may coexist. The accurate evaluation and identification of such symptomatology acquires considerable importance in the context of older adults, since those core factors typical of IBD may also expose older patients to an increased risk for age-related negative outcomes, such as frailty and disability. The purpose of the present review was to provide an updated overview on the evaluation and management of IBD in the elderly population, with regard to fatigue, sarcopenia, and frailty. The assessment of fatigue might contribute to the identification of early symptoms of IBD, such as pain and mood disorders, which should be treated timely to offer elderly patient a better quality of life. Similarly, an accurate evaluation of sarcopenia might represent a useful Prognostic Index to identify those patients at risk of developing physical frailty. Frailty in IBD should be evaluated not only in relation to the occurrence of negative outcomes, but also should be considered itself as an outcome itself in IBD. A recommendation for future research on this topic might be the implementation of randomized trials, which include older adults and evaluate fatigue, sarcopenia, and frailty. Similarly, the development of tailored intervention programs, based on both physical and psychological outcomes, with the purpose of improving patients' adaptation to the disease, and monitoring the evolution of symptoms and the response to therapies over time, should be encouraged.
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Affiliation(s)
- Federica Bellone
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Alberto Sardella
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Marco Muscianisi
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Giorgio Basile
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy -
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Takaoka S, Hamada T, Takahara N, Saito K, Endo G, Hakuta R, Ishida K, Ishigaki K, Kanai S, Kurihara K, Oyama H, Saito T, Sato T, Suzuki T, Suzuki Y, Tange S, Tokito Y, Tateishi R, Nakai Y, Fujishiro M. Skeletal muscle status and survival among patients with advanced biliary tract cancer. Int J Clin Oncol 2024; 29:297-308. [PMID: 38319509 PMCID: PMC10884055 DOI: 10.1007/s10147-023-02466-z] [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: 06/27/2023] [Accepted: 12/19/2023] [Indexed: 02/07/2024]
Abstract
BACKGROUND Studies have demonstrated a prognostic role of sarcopenia (i.e., loss of skeletal muscle volume and functionality) in patients with various cancer types. In patients with biliary tract cancer, the quantity and quality of skeletal muscles and their serial changes have not been fully investigated in relation to survival outcomes. METHODS We identified 386 patients with unresectable or recurrent biliary tract cancer and calculated skeletal muscle index (SMI) and skeletal muscle density (SMD) to estimate muscular quantity and quality, respectively, based on computed tomography images. Using the Cox regression model with adjustment for potential confounders, we calculated hazard ratios (HRs) and 95% confidence intervals (CIs) for progression-free survival (PFS) and overall survival (OS) according to skeletal muscle status and its serial change. RESULTS Compared to patients without sarcopenia, patients with sarcopenia were associated with shorter PFS (multivariable HR, 1.60; 95% CI, 1.15-2.22; P = 0.005), but not with OS (P = 0.027) at the adjusted α level of 0.013. SMD at baseline was associated with OS (multivariable HR comparing the extreme quartiles, 1.52; 95% CI, 1.07-2.14; Ptrend = 0.012), but not with PFS (Ptrend = 0.13). A reduction in SMI rather than that in SMD was associated with OS. Progressive disease was a risk factor for reductions in SMI and SMD. CONCLUSIONS Skeletal muscle quantity and quality and their serial changes were associated with survival outcomes in patients with advanced biliary tract cancer. Our data highlight the importance of designing nutritional and physical interventions for improvements in skeletal muscle status.
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Affiliation(s)
- Shinya Takaoka
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tsuyoshi Hamada
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Department of Hepato-Biliary-Pancreatic Medicine, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Naminatsu Takahara
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kei Saito
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Go Endo
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Ryunosuke Hakuta
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kota Ishida
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kazunaga Ishigaki
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Sachiko Kanai
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Department of Endoscopy and Endoscopic Surgery, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo City, Tokyo, 113-8655, Japan
| | - Kohei Kurihara
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hiroki Oyama
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tomotaka Saito
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tatsuya Sato
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tatsunori Suzuki
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yukari Suzuki
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shuichi Tange
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yurie Tokito
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Ryosuke Tateishi
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yousuke Nakai
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
- Department of Endoscopy and Endoscopic Surgery, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo City, Tokyo, 113-8655, Japan.
| | - Mitsuhiro Fujishiro
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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21
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Matsumoto R, Kikuta K, Takikawa T, Sano T, Hamada S, Sasaki A, Sakano M, Hayashi H, Manaka T, Ikeda M, Miura S, Kume K, Masamune A. Skeletal muscle mass and function are affected by pancreatic atrophy, pancreatic exocrine insufficiency and poor nutritional status in patients with chronic pancreatitis. Pancreatology 2024; 24:197-205. [PMID: 38216352 DOI: 10.1016/j.pan.2024.01.002] [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: 11/11/2023] [Revised: 01/03/2024] [Accepted: 01/05/2024] [Indexed: 01/14/2024]
Abstract
BACKGROUND/OBJECTIVE Previous studies have demonstrated that sarcopenia is frequently observed in patients with chronic pancreatitis (CP). However, most studies have defined sarcopenia solely based on skeletal muscle (SM) loss, and muscle weakness such as grip strength (GS) reduction has not been considered. We aimed to clarify whether SM loss and reduced GS have different associations with clinical characteristics and pancreatic imaging findings in patients with CP. METHODS One hundred two patients with CP were enrolled. We defined SM loss by the SM index at the third lumbar vertebra on CT (<42 cm2/m2 for males and <38 cm2/m2 for females), and reduced GS by < 28 kg for males and <18 kg for females. RESULTS Fifty-seven (55.9 %) patients had SM loss, 21 (20.6 %) had reduced GS, and 17 (16.7 %) had both. Patients with SM loss had lower body mass index, weaker GS, higher Controlling Nutritional Status score, lower serum lipase level, and lower urinary para-aminobenzoic acid excretion rate, suggesting worse nutritional status and pancreatic exocrine insufficiency. On CT, main pancreatic duct dilatation and parenchymal atrophy were more frequent in patients with SM loss than in those without it. Patients with reduced GS were older and had worse nutritional status than those without it. CONCLUSIONS SM loss was associated with pancreatic exocrine insufficiency, low nutritional status, and pancreatic imaging findings such as parenchymal atrophy and main pancreatic duct dilatation, whereas older age and low nutritional status led to additional reduced GS.
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Affiliation(s)
- Ryotaro Matsumoto
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Miyagi, Sendai, 980-8574, Japan
| | - Kazuhiro Kikuta
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Miyagi, Sendai, 980-8574, Japan
| | - Tetsuya Takikawa
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Miyagi, Sendai, 980-8574, Japan
| | - Takanori Sano
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Miyagi, Sendai, 980-8574, Japan
| | - Shin Hamada
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Miyagi, Sendai, 980-8574, Japan
| | - Akira Sasaki
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Miyagi, Sendai, 980-8574, Japan
| | - Misako Sakano
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Miyagi, Sendai, 980-8574, Japan
| | - Hidehiro Hayashi
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Miyagi, Sendai, 980-8574, Japan
| | - Tomoo Manaka
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Miyagi, Sendai, 980-8574, Japan
| | - Mio Ikeda
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Miyagi, Sendai, 980-8574, Japan
| | - Shin Miura
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Miyagi, Sendai, 980-8574, Japan
| | - Kiyoshi Kume
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Miyagi, Sendai, 980-8574, Japan
| | - Atsushi Masamune
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Miyagi, Sendai, 980-8574, Japan.
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22
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Affourtit C, Carré JE. Mitochondrial involvement in sarcopenia. Acta Physiol (Oxf) 2024; 240:e14107. [PMID: 38304924 DOI: 10.1111/apha.14107] [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: 11/30/2023] [Revised: 01/11/2024] [Accepted: 01/22/2024] [Indexed: 02/03/2024]
Abstract
Sarcopenia lowers the quality-of-life for millions of people across the world, as accelerated loss of skeletal muscle mass and function contributes to both age- and disease-related frailty. Physical activity remains the only proven therapy for sarcopenia to date, but alternatives are much sought after to manage this progressive muscle disorder in individuals who are unable to exercise. Mitochondria have been widely implicated in the etiology of sarcopenia and are increasingly suggested as attractive therapeutic targets to help restore the perturbed balance between protein synthesis and breakdown that underpins skeletal muscle atrophy. Reviewing current literature, we note that mitochondrial bioenergetic changes in sarcopenia are generally interpreted as intrinsic dysfunction that renders muscle cells incapable of making sufficient ATP to fuel protein synthesis. Based on the reported mitochondrial effects of therapeutic interventions, however, we argue that the observed bioenergetic changes may instead reflect an adaptation to pathologically decreased energy expenditure in sarcopenic muscle. Discrimination between these mechanistic possibilities will be crucial for improving the management of sarcopenia.
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Affiliation(s)
| | - Jane E Carré
- School of Biomedical Sciences, University of Plymouth, Plymouth, UK
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23
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Sun K, Zhu H, Huang B, Li J, Liu G, Jiao G, Chen G. MRI-based central sarcopenia negatively impacts the therapeutic effectiveness of single-segment lumbar fusion surgery in the elderly. Sci Rep 2024; 14:5043. [PMID: 38424180 PMCID: PMC10904385 DOI: 10.1038/s41598-024-55390-1] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Accepted: 02/22/2024] [Indexed: 03/02/2024] Open
Abstract
Central sarcopenia is associated with the prognosis of various orthopedic surgeries in the elderly. This study aims to investigate its impact on the outcomes of single-segment lumbar fusion surgery in elderly patients. Retrospective analysis was conducted on 314 patients aged 60 to 80 who underwent single-segment posterior lumbar fusion surgery due to degenerative lumbar diseases. Patients were categorized into high psoas and L4 vertebral index (PLVI) and low PLVI groups according to the MRI-measured PLVI for central sarcopenia. Basic patient data, surgery-related parameters, functional assessments at preoperative and postoperative 3, 6, and 12 months, and X-ray-based fusion status were compared. The basic data of the two groups showed no significant differences. Parameters including the operative segment, preoperative hemoglobin levels, surgical duration, and intraoperative blood loss exhibited no significant variances. However, notable differences were observed in postoperative initial hemoglobin levels, transfusion requirements, and length of hospital stay between the two groups. During the postoperative follow-ups at 3, 6, and 12 months, the VAS scores for lower back pain and ODI scores in the lower PLVI group were significantly higher compared to the high PLVI group. Additionally, the EuroQoL 5D scores were notably lower in the low PLVI group. There were no significant differences between the groups in terms of leg pain VAS scores at each time point and the fusion status at 12 months postoperatively. MRI-based central sarcopenia has a negative impact on the therapeutic effectiveness following single-segment lumbar fusion surgery in elderly patients.
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Affiliation(s)
- Kai Sun
- Department of Orthopedic Surgery, Jiujiang University Affiliated Hospital, Jiujiang, 332006, China
- Department of Orthopedic Surgery, The Fifth Affiliated Hospital of Jinan University (Heyuan Shenhe People's Hospital), Heyuan, 517400, China
| | - Haoran Zhu
- Department of Orthopedic Surgery, The Fifth Affiliated Hospital of Jinan University (Heyuan Shenhe People's Hospital), Heyuan, 517400, China
| | - Bo Huang
- Department of Orthopedic Surgery, Jiujiang University Affiliated Hospital, Jiujiang, 332006, China
| | - Jun Li
- Department of Orthopedic Surgery, Jiujiang University Affiliated Hospital, Jiujiang, 332006, China
| | - Genjiu Liu
- Dongguan Key Laboratory of Central Nervous System Injury and Repair / Department of Orthopedic Surgery, The Sixth Affiliated Hospital of Jinan University (Dongguan Eastern Central Hospital), Dongguan, 523573, China.
| | - Genlong Jiao
- Dongguan Key Laboratory of Central Nervous System Injury and Repair / Department of Orthopedic Surgery, The Sixth Affiliated Hospital of Jinan University (Dongguan Eastern Central Hospital), Dongguan, 523573, China.
| | - Guoliang Chen
- Department of Orthopedic Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, 510630, China.
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24
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Deng GM, Song HB, Du ZZ, Xue YW, Song HJ, Li YZ. Evaluating the influence of sarcopenia and myosteatosis on clinical outcomes in gastric cancer patients undergoing immune checkpoint inhibitor. World J Gastroenterol 2024; 30:863-880. [PMID: 38516238 PMCID: PMC10950641 DOI: 10.3748/wjg.v30.i8.863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/16/2024] [Accepted: 02/01/2024] [Indexed: 02/26/2024] Open
Abstract
BACKGROUND The development and progression of gastric cancer (GC) are closely linked to the nutritional status of patients. Although immunotherapy has been demonstrated to be clinically effective, the relationships of sarcopenia and myosteatosis with the use of immune checkpoint inhibitors (ICIs) in patients with gastric cancer remain to be characterized. AIM To assess the effects of sarcopenia and myosteatosis on the clinical outcomes of patients with GC undergoing treatment with an ICI. METHODS We performed a retrospective study of patients who were undergoing immunotherapy for GC. For the evaluation of sarcopenia, the optimal cut-off value for the skeletal muscle index was established using receiver operating characteristic analysis of data obtained from pre-treatment computed tomography images at the L3 vertebral level. Myosteatosis was defined using the mean skeletal muscle density (SMD), with a threshold value of < 41 Hounsfield units (HU) for patients with a body mass index (BMI) < 25 kg/m² and < 33 HU for those with a BMI ≥ 25 kg/m². The log-rank test was used to compare progression-free survival (PFS) and overall survival (OS), and a Cox proportional hazard model was used to identify prognostic factors. Nomograms were developed to predict the PFS and OS of patients on the basis of the results of multivariate analyses. RESULTS We studied 115 patients who were undergoing ICI therapy for GC, of whom 27.4% had sarcopenia and 29.8% had myosteatosis. Patients with sarcopenia or myosteatosis had significantly shorter PFS and OS than those without these conditions. Furthermore, both sarcopenia and myosteatosis were found to be independent predictors of PFS and OS in patients with GC administering an ICI. The prediction models created for PFS and OS were associated with C-indexes of 0.758 and 0.781, respectively. CONCLUSION The presence of sarcopenia or myosteatosis is a reliable predictor of the clinical outcomes of patients with GC who are undergoing treatment with an ICI.
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Affiliation(s)
- Gui-Ming Deng
- Department of Gastrointestinal Surgery, Harbin Medical University Cancer Hospital, Harbin 150081, Heilongjiang Province, China
| | - Hai-Bin Song
- Department of Gastrointestinal Surgery, Harbin Medical University Cancer Hospital, Harbin 150081, Heilongjiang Province, China
| | - Zhong-Ze Du
- Department of Gastrointestinal Surgery, Harbin Medical University Cancer Hospital, Harbin 150081, Heilongjiang Province, China
| | - Ying-Wei Xue
- Department of Gastrointestinal Surgery, Harbin Medical University Cancer Hospital, Harbin 150081, Heilongjiang Province, China
| | - Hong-Jiang Song
- Department of Gastrointestinal Surgery, Harbin Medical University Cancer Hospital, Harbin 150081, Heilongjiang Province, China
| | - Yuan-Zhou Li
- Department of Radiology, Harbin Medical University Cancer Hospital, Harbin 150081, Heilongjiang Province, China
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25
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Jiang MJ, Wu MC, Duan ZH, Wu J, Xu XT, Li J, Meng QH. Prevalence and clinical impact of sarcopenia in liver transplant recipients: A meta-analysis. World J Gastroenterol 2024; 30:956-968. [PMID: 38516245 PMCID: PMC10950632 DOI: 10.3748/wjg.v30.i8.956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 01/03/2024] [Accepted: 02/01/2024] [Indexed: 02/26/2024] Open
Abstract
BACKGROUND The prevalence of sarcopenia in patients undergoing liver transplantation (LT) remains to be determined partly because of different diagnostic criteria. Sarcopenia has recently been recognized as a new prognostic factor for predicting outcomes in LT candidates. AIM To estimate the prevalence of sarcopenia and evaluate its clinical effect on LT candidates. METHODS This systematic search was conducted in PubMed, Web of Science, Embase, and Cochrane Library for original English-language articles that investigated the prevalence and influence of sarcopenia in patients undergoing LT from database inception to November 30, 2022. Cohort studies of the definition of sarcopenia that estimate sarcopenia prevalence and evaluate its effect on clinical outcomes and the risk of mortality were included. RESULTS Twenty-five studies involving 7760 patients undergoing LT were included. The pooled prevalence of sarcopenia in patients undergoing LT was 40.7% [95% confidence intervals (95%CI): 32.1-49.6]. The 1-, 3-, and 5-year cumulative probabilities of post-LT survival in patients with preoperative sarcopenia were all lower than those without sarcopenia (P < 0.05). Sarcopenia was associated with an increased risk of post-LT mortality in patients undergoing LT (adjusted hazard ratio: 1.58; 95%CI: 1.21-2.07). Patients with preoperative sarcopenia had a longer intensive care unit stay, a high risk ratio of sepsis, and serious post-LT complications than those without sarcopenia. CONCLUSION Sarcopenia is prevalent in a substantial proportion of patients undergoing LT and is strongly and independently associated with higher a risk of mortality risk.
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Affiliation(s)
- Min-Jie Jiang
- Department of Hepatology, Beijing You-An Hospital, Capital Medical University, Beijing 100069, China
| | - Mu-Chen Wu
- Department of Hepatology, Beijing You-An Hospital, Capital Medical University, Beijing 100069, China
| | - Zhong-Hui Duan
- Department of Emergency, Beijing You-An Hospital, Capital Medical University, Beijing 100069, China
| | - Jing Wu
- Department of Hepatology, Beijing You-An Hospital, Capital Medical University, Beijing 100069, China
| | - Xiao-Tong Xu
- Department of Hepatology, Beijing You-An Hospital, Capital Medical University, Beijing 100069, China
| | - Juan Li
- Department of Hepatology, Beijing You-An Hospital, Capital Medical University, Beijing 100069, China
| | - Qing-Hua Meng
- Department of Hepatology, Beijing You-An Hospital, Capital Medical University, Beijing 100069, China
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26
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Zhou J, Chen XF, Gao YH, Yan F, Xi HQ. [Prevalence and risk factors of sarcopenia after radical gastrectomy for gastric cancer]. Zhonghua Wei Chang Wai Ke Za Zhi 2024; 27:189-195. [PMID: 38413088 DOI: 10.3760/cma.j.cn441530-20230324-00093] [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] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
Objective: To investigate the prevalence and risk factors of sarcopenia in patients following radical gastrectomy with the aim of guiding clinical decisions. Methods: This was a retrospective observational study of data of patients who had undergone radical gastrectomy between June 2021 and June 2022 at the Department of General Surgery, First Medical Center of Chinese PLA General Hospital. Participants were reviewed 9-12 months after surgery. Inclusion criteria were as follows: (1) radical gastrectomy with a postoperative pathological diagnosis of primary gastric cancer; (2) no invasion of neighboring organs, peritoneal dissemination, or distant metastasis confirmed intra- or postoperatively; (3) availability of complete clinical data, including abdominal enhanced computed tomography and pertinent blood laboratory tests 9-12 after surgery. Exclusion criteria were as follows: (1) age <18 years; (2) presence of gastric stump cancer or previous gastrectomy; (3) history of or current other primary tumors within the past 5 years; (4) preoperative diagnosis of sarcopenia (skeletal muscle index [SMI) ≤52.4 cm²/m² for men, SMI ≤38.5 cm²/m² for women). The primary focus of the study was to investigate development of postoperative sarcopenia in the study cohort. Univariate and multivariate logistic regression were used to identify the factors associated with development of sarcopenia after radical gastrectomy. Results: The study cohort comprised 373 patients of average age of 57.1±12.3 years, comprising 292 (78.3%) men and 81 (21.7%) women. Postoperative sarcopenia was detected in 81 (21.7%) patients in the entire cohort. The SMI for the entire group was (41.79±7.70) cm2/m2: (46.40±5.03) cm2/m2 for men and (33.52±3.63) cm2/m2 for women. According to multivariate logistic regression analysis, age ≥60 years (OR=2.170, 95%CI: 1.175-4.007, P=0.013), high literacy (OR=2.512, 95%CI: 1.238-5.093, P=0.011), poor exercise habits (OR=3.263, 95%CI: 1.648-6.458, P=0.001), development of hypoproteinemia (OR=2.312, 95%CI: 1.088-4.913, P=0.029), development of hypertension (OR=2.169, 95%CI: 1.180-3.984, P=0.013), and total gastrectomy (OR=2.444, 95%CI:1.214-4.013,P=0.012) were independent risk factors for postoperative sarcopenia in post-gastrectomy patients who had had gastric cancer (P<0.05). Conclusion: Development of sarcopenia following radical gastrectomy demands attention. Older age, higher education, poor exercise habits, hypoproteinemia, hypertension, and total gastrectomy are risk factors for its development post-radical gastrectomy.
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Affiliation(s)
- J Zhou
- Division of Gastric Surgery, Senior Department of General Surgery, the First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - X F Chen
- Division of Gastric Surgery, Senior Department of General Surgery, the First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - Y H Gao
- Division of Gastric Surgery, Senior Department of General Surgery, the First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - F Yan
- Department of Diagnostic Radiology,the First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - H Q Xi
- Division of Abdominal Trauma Surgery, Senior Department of General Surgery, the First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
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27
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Moretti D, Fiorillo P, Mogliani M, Buncuga M, Fain H. [Evaluation of sarcopenia and bioimpedance parameters related to muscle strength in the pre-operative consultation for spinal surgery]. NUTR HOSP 2024; 41:145-151. [PMID: 38047409 DOI: 10.20960/nh.04660] [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] [Indexed: 12/05/2023] Open
Abstract
Introduction Introduction: sarcopenia is characterized by loss of muscle mass and function. Spinal disorders are a risk factor for muscle deterioration. In turn, sarcopenia is associated with adverse outcomes in the postoperative period of spinal surgery. Objectives: to evaluate sarcopenia and the relationship of muscle strength with bioimpedance parameters in the preoperative consultation. Material and methods: cross-sectional observational study. Muscle strength (dynamometry) and body composition (bioimpedance spectroscopy) were measured as part of the functional assessment of nutritional status. Sarcopenia was defined according to the European Working Group on Sarcopenia in Older People 2019 (EGWSOP2) and dynapenia/myopenia in the case of low strength or isolated muscularity. The relationship between the dynamometry values and the bioimpedance variables was summarized with the Spearman's coefficient. Results: twenty-two patients were included. The median (IQR) age was 60 years (43-65) and 72 % were women. The most frequent diagnosis and surgical procedure was spondylolisthesis (45 %) and posterior fixation (50 %). The mean body mass index (BMI) was 28.3 (± 4.59) kg/m2. The presence of sarcopenia, dynapenia and myopenia was 18.2 %, 13.6 % and 22.7 %, respectively. Dynamometry was correlated with lean tissue index: 0.61 (p 0.002); body cell mass: 0.68 (p 0.000); appendicular skeletal muscle: 0.49 (p 0.021); phase angle: 0.46 (p 0.031); and resistance index 200/5 kHz: -0.47 (p 0.028). Conclusion: muscle strength is correlated with bioimpedance parameters. Sarcopenia, dynapenia and myopenia are frequent and objectifiable in the preoperative spinal surgery consultation.
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Affiliation(s)
- Dino Moretti
- Centro de Nutrición y Metabolismo (CeNuMe). Unidad de Cuidados Intensivos. Hospital Escuela "Eva Perón"
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28
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Nie H, Liu Y, Zeng X, Chen M. Neutrophil-to-lymphocyte ratio is associated with sarcopenia risk in overweight maintenance hemodialysis patients. Sci Rep 2024; 14:3669. [PMID: 38351264 PMCID: PMC10864262 DOI: 10.1038/s41598-024-54056-2] [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: 11/02/2023] [Accepted: 02/08/2024] [Indexed: 02/16/2024] Open
Abstract
Neutrophil-to-lymphocyte ratio (NLR), a novel inflammatory marker, is strongly associated with the risk of sarcopenia. Notably, being overweight has been found to accelerate the loss of skeletal muscle mass and function in chronic kidney disease (CKD) patients. However, the effect of overweight status on the relationship between NLR and sarcopenia risk has been poorly studied. We conducted a cross-sectional study at a hemodialysis center in Chengdu, China, from September to December 2022. The prevalence of sarcopenia was determined according to the Asian Working Group for Sarcopenia (AWGS). Participants were stratified based on body mass index (BMI) categories for the Asian population (non-overweight < 23 kg/m2 and overweight ≥ 23 kg/m2). 272 participants aged 18-85 years were included, with 144 being male. The overall prevalence of sarcopenia was 32.72% (89/272). After adjusting for covariates, NLR was significantly associated with sarcopenia risk in overweight participants (OR 1.60, 95% CI 1.15-2.24, p = 0.006), whereas it was not significant in the non-overweight group (OR 0.88, 95% CI 0.70-1.10, p = 0.254). Moreover, subgroup analysis showed a significant interactive association between NLR and overweight status with respect to sarcopenia. These findings emphasize the potential significance of regular screening of NLR for the early detection of sarcopenia in overweight patients undergoing maintenance hemodialysis.
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Affiliation(s)
- Huibin Nie
- Department of Nephrology, Chengdu First People's Hospital, Integrated TCM and Western Medicine Hospital Affiliated to Chengdu University of TCM, No. 18 Wanxiang North Street, Chengdu, 610095, Sichuan, China
| | - Yan Liu
- Department of Clinical Nutrition, Chengdu First People's Hospital, Integrated TCM and Western Medicine Hospital Affiliated to Chengdu University of TCM, No. 18 Wanxiang North Street, Chengdu, 610095, Sichuan, China
| | - Xiaoyan Zeng
- Department of Nephrology, Chengdu First People's Hospital, Integrated TCM and Western Medicine Hospital Affiliated to Chengdu University of TCM, No. 18 Wanxiang North Street, Chengdu, 610095, Sichuan, China
| | - Min Chen
- Department of Nephrology, Chengdu First People's Hospital, Integrated TCM and Western Medicine Hospital Affiliated to Chengdu University of TCM, No. 18 Wanxiang North Street, Chengdu, 610095, Sichuan, China.
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Suto A, Fujii K, Nakatani T, Ogawa K, Ichihara T, Li S, Sato K, Miura K, Funayama T, Yamazaki M. Correlation between preoperative CT scan of the paraspinal, psoas, and gluteus muscles and postoperative ambulatory status in patients with femoral neck fractures. BMC Musculoskelet Disord 2024; 25:132. [PMID: 38347481 PMCID: PMC10860248 DOI: 10.1186/s12891-024-07251-1] [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: 08/25/2023] [Accepted: 02/02/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND This study aimed to investigate the relationship between femoral neck fractures and sarcopenia. METHODS This was a retrospective analysis of 92 patients with femoral neck fractures, from September 2017 to March 2020, who were classified into high ambulatory status (HG) and low ambulatory status (LG) groups. Ambulatory status was assessed before surgery, one week after surgery, at discharge, and during the final follow-up. To evaluate sarcopenia, muscle mass and fatty degeneration of the muscles were measured using preoperative CT. An axial slice of the superior end of the L5 vertebra was used to evaluate the paraspinal and psoas muscles, a slice of the superior end of the femoral head for the gluteus maximus muscle, and a slice of the inferior end of the sacroiliac joint for the gluteus medius muscle. The degeneration of the muscles was evaluated according to the Goutallier classification. RESULTS The cross-sectional area of the gluteus medius and paraspinal muscles was significantly correlated with ambulatory status before the injury, at discharge, and during the final follow-up. CONCLUSIONS Measurement of the gluteus medius and paraspinal muscles has the potential to evaluate sarcopenia and predict ambulatory status after femoral neck fractures.
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Affiliation(s)
- Akihito Suto
- Department of Orthopaedic Surgery, Showa General Hospital, 8-1-1 Hanakoganei, Kodaira, Tokyo, Japan
| | - Kengo Fujii
- Department of Orthopaedic Surgery, Showa General Hospital, 8-1-1 Hanakoganei, Kodaira, Tokyo, Japan
| | - Takushi Nakatani
- Department of Orthopaedic Surgery, Showa General Hospital, 8-1-1 Hanakoganei, Kodaira, Tokyo, Japan
| | - Kaishi Ogawa
- Department of Orthopaedic Surgery, Showa General Hospital, 8-1-1 Hanakoganei, Kodaira, Tokyo, Japan
| | - Takumi Ichihara
- Department of Orthopaedic Surgery, Showa General Hospital, 8-1-1 Hanakoganei, Kodaira, Tokyo, Japan
| | - Sayori Li
- Department of Orthopaedic Surgery, Showa General Hospital, 8-1-1 Hanakoganei, Kodaira, Tokyo, Japan
| | - Kosuke Sato
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 3058575, Japan
| | - Kousei Miura
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 3058575, Japan
| | - Toru Funayama
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 3058575, Japan.
| | - Masashi Yamazaki
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 3058575, Japan
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Wan H, Hu YH, Li WP, Wang Q, Su H, Chenshu JY, Lu X, Gao W. Quality of life, household income, and dietary habits are associated with the risk of sarcopenia among the Chinese elderly. Aging Clin Exp Res 2024; 36:29. [PMID: 38334908 PMCID: PMC10857955 DOI: 10.1007/s40520-023-02656-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 11/07/2023] [Indexed: 02/10/2024]
Abstract
BACKGROUND Health-related quality of life (HRQoL), which can be influenced by various aspects, especially socioeconomic status and lifestyle, has been identified as an important predictor of the prognosis of older adults. Dietary habit, a major part of lifestyle, can affect the nutritional status, which is closely correlated with the development of geriatric syndromes in the elderly. AIMS The aim of the study was to examine the association of HRQoL, socioeconomic status, and lifestyle with the risk and severity of sarcopenia, a geriatric syndrome characterized by progressive loss of skeletal muscle mass, strength and function. METHODS A cross-sectional retrospective study with 2877 participants aged ≥65 years was performed. HRQoL was assessed using EuroQoL Five Dimensions questionnaire. Socioeconomic status was assessed by the educational attainment, occupation, and household income. Lifestyle was assessed using 12 items closely related to Chinese living habits. The information of daily dietary habits including tea, alcohol, type of diet, and volume of drinking water were collected. The associations of HRQoL, socioeconomic status, and lifestyle with the risk of sarcopenia were examined by multivariate regression logistical analysis. The potential causal role of age, body mass index, and waist circumference in the effect of HRQoL on sarcopenia risk was analyzed by causal mediation analysis. RESULTS High HRQoL [adjusted odds ratio (OR) =0.85, 95% confidence interval (CI) =0.69-0.95, P=0.034] and household income levels (adjusted OR =0.74, 95% CI =0.57-0.95, P=0.019) were inversely associated with the risk of sarcopenia. Meanwhile, more consumption of spicy food (adjusted OR =1.34, 95% CI =1.09-1.81, P =0.037) and occasionally drinking (adjusted OR =1.46, 95% CI =1.07-2.00, P =0.016, as compared to those never drinking) were associated with higher risk of sarcopenia, while skipping breakfast occasionally (adjusted OR =0.37, 95% CI =0.21-0.64, P <0.001, as compared to those eating breakfast every day) and less consumption of salt (adjusted OR =0.71, 95% CI =0.52-0.96, P =0.026, as compared to those consuming high amount of salt) were associated with lower risk of sarcopenia. Further causal mediation analysis aimed to explore how much age, body mass index, and waist circumference might explain the effect of HRQoL on the risk of sarcopenia showed that the estimated proportion that mediated the effect of HRQoL on the risk of sarcopenia by age was 28.0%. CONCLUSIONS In summary, our findings demonstrate that low levels of HRQoL and household income, more intake of salt and spicy food, and occasional intake of alcohol are correlated with higher risk of sarcopenia, while skipping breakfast occasionally is associated with lower risk of sarcopenia in a Chinese population of older adults.
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Affiliation(s)
- Hua Wan
- Department of Health Management, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China
| | - Yan-Hui Hu
- Department of Public Health, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China
| | - Wei-Peng Li
- Department of Geriatrics, Sir Run Run Hospital, Nanjing Medical University, No.109 Longmian Avenue, Nanjing, 211166, China
| | - Quan Wang
- Department of Geriatrics, Sir Run Run Hospital, Nanjing Medical University, No.109 Longmian Avenue, Nanjing, 211166, China
| | - Hong Su
- Department of Health Management, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China
| | - Jun-Yan Chenshu
- Department of Health Management, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China
| | - Xiang Lu
- Department of Geriatrics, Sir Run Run Hospital, Nanjing Medical University, No.109 Longmian Avenue, Nanjing, 211166, China.
| | - Wei Gao
- Department of Geriatrics, School of Medicine, Zhongda Hospital, Southeast University, No.87 Dingjiaqiao, Nanjing, 210009, Jiangsu, China.
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Pelc Z, Sędłak K, Mlak R, Chawrylak K, Mielniczek K, Leśniewska M, Skórzewska M, Kwietniewska M, Paśnik I, Gęca K, van der Sluis P, Banasiewicz T, Pędziwiatr M, Polkowski WP, Pawlik TM, Małecka-Massalska T, Rawicz-Pruszyński K. MalnutritiOn assessment with biOelectrical impedaNce analysis in gastRic cancer patIentS undergoing multimodaltrEatment (MOONRISE)-Study protocol for a single-arm multicenter cross-sectional longitudinal study. PLoS One 2024; 19:e0297583. [PMID: 38319910 PMCID: PMC10846730 DOI: 10.1371/journal.pone.0297583] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 01/03/2024] [Indexed: 02/08/2024] Open
Abstract
European data suggests that over 30% of gastric cancer (GC) patients are diagnosed with sarcopenia before surgery, while unintentional weight loss occurs in approximately 30% of patients following gastrectomy. Preoperative sarcopenia significantly increases the risk of major postoperative complications, and preoperative body weight loss remains a superior predictor of outcome and an independent prognostic factor for overall survival (OS) in patients with GC. A standardized approach of nutritional risk screening of GC patients is yet to be established. Therefore, the MOONRISE study aims to prospectively analyze the changes in nutritional status and body composition at each stage of multimodal treatment among GC patients from five Western expert centers. Specifically, we seek to assess the association between nutritional status and body composition on tumor response following neoadjuvant chemotherapy (NAC). Secondary outcomes of the study are treatment toxicity, postoperative complications, quality of life (QoL), and OS. Patients with locally advanced gastric adenocarcinoma scheduled for multimodal treatment will be included in the study. Four consecutive nutritional status assessments will be performed throughout the treatment. The following study was registered in ClinicalTrials.gov (Identifier: NCT05723718) and will be conducted in accordance with the STROBE statement. The anticipated duration of the study is 12-24 months, depending on the recruitment status. Results of this study will reveal whether nutritional status and body composition assessment based on BIA will become a validated and objective tool to support clinical decisions in GC patients undergoing multimodal treatment.
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Affiliation(s)
- Zuzanna Pelc
- Department of Surgical Oncology, Medical University of Lublin, Lublin, Poland
| | - Katarzyna Sędłak
- Department of Surgical Oncology, Medical University of Lublin, Lublin, Poland
| | - Radosław Mlak
- Department of Human Physiology, Medical University of Lublin, Lublin, Poland
| | - Katarzyna Chawrylak
- Department of Surgical Oncology, Medical University of Lublin, Lublin, Poland
| | | | | | | | | | - Iwona Paśnik
- Department of Clinical Pathomorphology, Medical University of Lublin, Lublin, Poland
| | - Katarzyna Gęca
- Department of Surgical Oncology, Medical University of Lublin, Lublin, Poland
| | - Pieter van der Sluis
- Upper Gastrointestinal Department of Surgery, Erasmus MC, Rotterdam, The Netherlands
| | - Tomasz Banasiewicz
- Department of General, Endocrynological Surgery and Gastrointestinal Oncology, Institute of Surgery, Poznan University of Medical Sciences, Poznań, Polska
| | - Michał Pędziwiatr
- 2nd Department of Surgery, Jagiellonian University Medical College, Kraków, Polska
| | | | - Timothy M. Pawlik
- Department of Surgery, The Ohio State University Wexner Medical Center and James Cancer Center, Columbus, Ohio, United States of America
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Kanemura T, Takeoka T, Sugase T, Urakawa S, Masuike Y, Shinno N, Hara H, Kitakaze M, Kubo M, Mukai Y, Sueda T, Hasegawa S, Akita H, Nishimura J, Wada H, Yasui M, Omori T, Miyata H. Significance of Comprehensive Analysis of Preoperative Sarcopenia Based on Muscle Mass, Muscle Strength, and Physical Function for the Prognosis of Patients with Esophageal Cancer. Ann Surg Oncol 2024; 31:818-826. [PMID: 37989955 DOI: 10.1245/s10434-023-14306-5] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 08/06/2023] [Indexed: 11/23/2023]
Abstract
BACKGROUND The assessment of muscle mass loss, muscle strength, and physical function has been recommended in diagnosing sarcopenia. However, only muscle mass has been assessed in previous studies. Therefore, this study investigated the effect of comprehensively diagnosed preoperative sarcopenia on the prognosis of patients with esophageal cancer. METHODS The study analyzed 115 patients with esophageal cancer (age ≥ 65 years) who underwent curative esophagectomy. Preoperative sarcopenia was analyzed using the skeletal mass index (SMI), handgrip strength, and gait speed based on the Asian Working Group for Sarcopenia 2019 criteria. Clinicopathologic factors, incidence of postoperative complications, and overall survival (OS) were compared between the sarcopenia and non-sarcopenia groups. The significance of the three individual parameters also was evaluated. RESULTS The evaluation identified 47 (40.9%) patients with low SMI, 31 (27.0%) patients with low handgrip strength, and 6 (5.2%) patients with slow gait speed. Sarcopenia was diagnosed in 23 patients (20%) and associated with older age and advanced pT stage. The incidence of postoperative complications did not differ significantly between the two groups. Among the three parameters, only slow gait speed was associated with Clavien-Dindo grade 2 or greater complications. The sarcopenia group showed significantly worse OS than the non-sarcopenia group. Those with low handgrip strength tended to have worse OS, and those with slow gait speed had significantly worse OS than their counterparts. CONCLUSIONS Preoperative sarcopenia diagnosed using skeletal muscle mass, muscle strength, and physical function may have an impact on the survival of patients with esophageal cancer.
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Affiliation(s)
- Takashi Kanemura
- Department of Gastroenterological Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - Tomohira Takeoka
- Department of Gastroenterological Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - Takahito Sugase
- Department of Gastroenterological Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - Shinya Urakawa
- Department of Gastroenterological Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - Yasunori Masuike
- Department of Gastroenterological Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - Naoki Shinno
- Department of Gastroenterological Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - Hisashi Hara
- Department of Gastroenterological Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - Masatoshi Kitakaze
- Department of Gastroenterological Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - Masahiko Kubo
- Department of Gastroenterological Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - Yousuke Mukai
- Department of Gastroenterological Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - Toshinori Sueda
- Department of Gastroenterological Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - Shinichiro Hasegawa
- Department of Gastroenterological Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - Hirofumi Akita
- Department of Gastroenterological Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - Junichi Nishimura
- Department of Gastroenterological Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - Hiroshi Wada
- Department of Gastroenterological Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - Masayoshi Yasui
- Department of Gastroenterological Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - Takeshi Omori
- Department of Gastroenterological Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - Hiroshi Miyata
- Department of Gastroenterological Surgery, Osaka International Cancer Institute, Osaka, Japan.
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Barbosa ACC, Brison RS, Gomes CC, Wilkinson TJ, Duarte MP, Gruezo ND, Ribeiro HS. Should we consider sarcopenia in pediatric patients with chronic kidney disease? A preliminary cross-sectional analysis. Pediatr Nephrol 2024; 39:539-545. [PMID: 37566115 DOI: 10.1007/s00467-023-06111-9] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 07/20/2023] [Accepted: 07/21/2023] [Indexed: 08/12/2023]
Abstract
BACKGROUND Pediatric patients with chronic kidney disease (CKD) frequently present an inadequate nutritional profile and musculoskeletal impairments. We investigated sarcopenia and its related traits in children and adolescents with CKD. METHODS A cross-sectional study that enrolled pediatric patients with CKD (≥ 4 and < 18 years old). Physical function was assessed by handgrip strength and the 60-s sit-to-stand (STS-60) tests. Body composition measurement was performed by bioelectrical impedance analysis and anthropometry through mid-upper arm circumference (MUAC). Normative reference values from healthy pediatrics were used for identifying poor physical function and low MUAC. Probable sarcopenia was considered as low handgrip strength, whereas sarcopenia was defined by adding low MUAC. RESULTS Twenty-two pediatric patients with CKD (11 ± 4 years and 59% boys) were evaluated; eight on peritoneal dialysis (36%), six on hemodialysis (27%), and eight non-dialysis (36%). Regarding sarcopenia traits, we observed low physical function by handgrip strength and STS-60 in 59% and 100% of the patients, respectively, while low MUAC in 77%. Probable sarcopenia was found in 9% and sarcopenia in 50%, but prevalence did not differ among stages. Handgrip strength was strongly associated with MUAC (r = 0.90; p < 0.001); on the other hand, the STS-60 was not significantly associated with any of the body composition variables. CONCLUSION Among pediatric patients with CKD, the prevalence of sarcopenia and its related traits was high. Nephrology professionals should consider the assessment of sarcopenia in this population, while more evidence is needed to determine its prognostic value. A higher resolution version of the Graphical abstract is available as Supplementary information.
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Affiliation(s)
| | - Raquel S Brison
- Hospital da Criança de Brasília José Alencar, Brasília, Federal District, Brazil
- Faculty of Health Sciences, University of Brasília, Brasília, Federal District, 70910-900, Brazil
| | - Carolina C Gomes
- Hospital da Criança de Brasília José Alencar, Brasília, Federal District, Brazil
| | - Thomas J Wilkinson
- NIHR Applied Research Collaboration East Midlands (ARC-EM), Leicester Diabetes Centre, University of Leicester, Leicester, UK
| | - Marvery P Duarte
- Faculty of Health Sciences, University of Brasília, Brasília, Federal District, 70910-900, Brazil
| | - Nádia Dias Gruezo
- Hospital da Criança de Brasília José Alencar, Brasília, Federal District, Brazil
| | - Heitor S Ribeiro
- Faculty of Health Sciences, University of Brasília, Brasília, Federal District, 70910-900, Brazil.
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Beer SS, Wong Vega M. Malnutrition, sarcopenia, and frailty assessment in pediatric transplantation. Nutr Clin Pract 2024; 39:27-44. [PMID: 38088812 DOI: 10.1002/ncp.11105] [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: 10/02/2023] [Revised: 11/08/2023] [Accepted: 11/13/2023] [Indexed: 01/13/2024] Open
Abstract
Nutrition assessment can be challenging in children with end-stage organ disease and in those requiring an organ transplant. The effect of poor nutrition status can exert long-lasting effects on children with end-stage organ disease requiring transplantation. Malnutrition, sarcopenia, and frailty are conditions that require provision of optimal nutrition to prevent or support the treatment of these conditions. Unfortunately, the literature on the assessment of malnutrition, sarcopenia, and frailty in pediatric end-stage organ disease is scarce, thus leading to confusion on how to effectively identify them. Recently, the addition of a variety of validated nutrition and functional assessment techniques has assisted with appropriate assessment of these conditions. The objective of this narrative review is to provide an overview of the current literature for pediatric assessment of malnutrition, sarcopenia, and frailty in the setting of solid organ transplantation and provide practicing nutrition clinicians a solid foundation for learning how to effectively assess these conditions with the current literature available.
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Affiliation(s)
- Stacey Silver Beer
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| | - Molly Wong Vega
- Renal Section, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
- Department of Health and Human Performance, University of Houston, Houston, Texas, USA
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Kusakabe T, Arai H, Yamamoto Y, Nakao K, Akamatsu Y, Ishihara Y, Tagami T, Yasoda A, Satoh-Asahara N. Cross-sectional association of skeletal muscle mass and strength with dietary habits and physical activity among first-year university students in Japan: Results from the KEIJI-U study. Nutrition 2024; 118:112265. [PMID: 37995554 DOI: 10.1016/j.nut.2023.112265] [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: 06/09/2023] [Accepted: 10/09/2023] [Indexed: 11/25/2023]
Abstract
OBJECTIVE Recently, the high prevalence of young Japanese individuals who are underweight has received attention because of the potential risk for sarcopenia. The aim of this study was to examine the prevalence and characteristics of sarcopenia in Japanese youth. METHODS In this cross-sectional study, we measured skeletal muscle mass using a multifrequency bioelectrical impedance analysis device and handgrip strength (HGS) and administered questionnaires on dietary habits and physical activity in 1264 first-year university students ages 18 to 20 y (838 men and 426 women). Sarcopenia was confirmed based on the presence of both low skeletal muscle mass and weak muscle strength. RESULTS In all, 145 men (17%) and 69 women (16%) were diagnosed as underweight. Sarcopenia was diagnosed in 8 men (1%) and 5 women (1%). There was a significantly higher prevalence of low skeletal muscle mass index (SMI) and/or weak HGS in underweight individuals than in those in other body mass index (BMI) ranges. The multivariate analyses indicated that SMI and HGS were significantly associated with BMI in both sexes. Furthermore, after adjusting for BMI, both SMI and HGS were significantly associated with physical activity in men, and SMI was significantly associated with energy intake in women. CONCLUSIONS First-year university students showed a high incidence of being underweight with low SMI and/or weak HGS, but the prevalence of sarcopenia was low in both sexes. There may be sex differences in factors related to muscle mass and strength, but further research is needed to clarify this.
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Affiliation(s)
- Toru Kusakabe
- Department of Endocrinology, Metabolism, and Hypertension Research, Clinical Research Institute, NHO Kyoto Medical Center, Kyoto, Japan.
| | - Hiroshi Arai
- Health Administration Center, Kyoto Institute of Technology, Kyoto, Japan
| | - Yuji Yamamoto
- Health and Medical Services Center, Shiga University, Shiga, Japan
| | - Kazuwa Nakao
- Medical Innovation Center, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yasunori Akamatsu
- Department of Endocrinology, Metabolism, and Hypertension Research, Clinical Research Institute, NHO Kyoto Medical Center, Kyoto, Japan
| | - Yuki Ishihara
- Department of Endocrinology, Metabolism, and Hypertension Research, Clinical Research Institute, NHO Kyoto Medical Center, Kyoto, Japan; Department of Endocrinology and Metabolism, NHO Kyoto Medical Center, Kyoto, Japan
| | - Tetsuya Tagami
- Department of Endocrinology, Metabolism, and Hypertension Research, Clinical Research Institute, NHO Kyoto Medical Center, Kyoto, Japan; Department of Endocrinology and Metabolism, NHO Kyoto Medical Center, Kyoto, Japan
| | - Akihiro Yasoda
- Clinical Research Institute, NHO Kyoto Medical Center, Kyoto, Japan
| | - Noriko Satoh-Asahara
- Department of Endocrinology, Metabolism, and Hypertension Research, Clinical Research Institute, NHO Kyoto Medical Center, Kyoto, Japan
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Ruiz-Margáin A, Macías-Rodríguez RU, Flores-García NC, Román Calleja BM, Fierro-Angulo OM, González-Regueiro JA. Assessing nutrition status, sarcopenia, and frailty in adult transplant recipients. Nutr Clin Pract 2024; 39:14-26. [PMID: 38097210 DOI: 10.1002/ncp.11107] [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: 09/01/2023] [Revised: 11/15/2023] [Accepted: 11/15/2023] [Indexed: 01/13/2024] Open
Abstract
The assessment of nutrition status, sarcopenia, and frailty holds significant relevance in the context of adult transplantation, as these factors are associated with an unfavorable prognosis; thus, transplant candidates must undergo a full nutrition assessment. Screening tools may be used to prioritize patients, this can be done using the Nutrition Risk Screening 2002 or Royal Free Hospital-Nutritional Prioritizing Tool. Subsequently, a thorough nutrition-focused physical examination should be conducted to evaluate clinical signs of nutrition deficiencies, fat and muscle loss, and fluid overload; dietary history and current intake must also be assessed. Apart from physical examination, specific testing for sarcopenia and frailty are recommended. For sarcopenia assessment, specifically for muscle quantification, the gold standard is the cross-sectional measurement of the muscle at L3 obtained from a computed tomography scan or magnetic resonance imaging; dual-energy x-ray absorptiometry is also a good tool especially when appendicular skeletal muscle index is calculated. Other more readily available options include phase angle from bioelectrical impedance or bioimpedance spectroscopy. In the sarcopenia assessment, muscle function evaluation is required, handgrip strength stands as the primary test for this purpose; this test is also part of the subjective global assessment and is included in some frailty scores. Finally, for frailty assessment, the Short Physical Performance Battery is useful for evaluating physical frailty, and for a multidimensional evaluation, the Fried frailty phenotype can be used. Specifically for liver transplant candidates, the use of Liver Frailty Index is recommended.
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Affiliation(s)
- Astrid Ruiz-Margáin
- Division of Hepatology, Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Ricardo U Macías-Rodríguez
- Division of Hepatology, Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Nayelli C Flores-García
- Division of Hepatology, Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Berenice M Román Calleja
- Division of Hepatology, Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Oscar M Fierro-Angulo
- Division of Hepatology, Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - José A González-Regueiro
- Division of Hepatology, Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
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Özcan B, Güner M, Ceylan S, Öztürk Y, Girgin S, Okyar Baş A, Koca M, Balcı C, Doğu BB, Cankurtaran M, Yıldırım T, Halil MG. Calf circumference predicts sarcopenia in maintenance hemodialysis. Nutr Clin Pract 2024; 39:193-201. [PMID: 37933421 DOI: 10.1002/ncp.11089] [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: 06/21/2023] [Revised: 09/28/2023] [Accepted: 10/07/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND Early recognition of sarcopenia in hemodialysis (HD) patients will be of great importance in preventing adverse outcomes and improving the quality of life in these patients. The main goal of this study was to evaluate the diagnostic accuracy of calf circumference (CC) measurement in detecting sarcopenia among CKD patients undergoing maintenance HD. METHODS This cross-sectional study included 52 patients (53 ± 17 years) who were currently in a maintenance HD. Muscle strength was evaluated using handgrip strength, and smooth muscle mass index (SMI) was assessed through bioelectrical impedance analysis, and CC was measured at the widest part of the calf with the foot pressed against a hard surface. RESULTS Out of the total patient population, sarcopenia was identified in 32.7% (n = 17). The two groups were comparable in terms of age, weight, and height, but the median body mass index of sarcopenic group was statistically lower than nonsarcopenic group (21.6 kg/m2 [18.9-24.6] vs 24.7 kg/m2 [21.4-27.3]. The sarcopenic group had a substantially smaller CC than the nonsarcopenic group (30.0 cm [26.5-32.0] vs 31.5 cm [30.3-34.8], P = 0.013; respectively). In the regression analysis, CC was found to be independently associated with post-HD SMI (P < 0.001; odds ratio, 1.938; and 95% CI, 1.020-2.856). CC was positively but weakly correlated with handgrip strength, however strong and significant correlation was found between CC and SMI (r = 0.277, P = 0.047 and r = 0.733, P < 0.001; respectively). A CC of 31 cm or less predicted confirmed sarcopenia in HD patients (area under the curve = 0.709, P = 0.006, specificity = 0.556, sensitivity = 0.765). CONCLUSIONS Low muscle mass and potentially low muscle strength in HD patients can be accurately identified through the use of CC measurements. Specifically, a CC measurement below 31 cm has found to be a useful indicator to identify individuals on maintenance HD.
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Affiliation(s)
- Berşan Özcan
- Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Merve Güner
- Department of Internal Medicine, Division of Geriatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Serdar Ceylan
- Department of Internal Medicine, Division of Geriatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Yelda Öztürk
- Department of Internal Medicine, Division of Geriatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Sinem Girgin
- Department of Internal Medicine, Division of Nephrology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Arzu Okyar Baş
- Department of Internal Medicine, Division of Geriatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Meltem Koca
- Department of Internal Medicine, Division of Geriatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Cafer Balcı
- Department of Internal Medicine, Division of Geriatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Burcu Balam Doğu
- Department of Internal Medicine, Division of Geriatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Mustafa Cankurtaran
- Department of Internal Medicine, Division of Geriatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Tolga Yıldırım
- Department of Internal Medicine, Division of Nephrology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Meltem Gülhan Halil
- Department of Internal Medicine, Division of Geriatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Hoang DK, Doan MC, Le NM, Nguyen HG, Ho-Pham LT, Nguyen TV. Prevalence of and risk factors for sarcopenia in community-dwelling people: The Vietnam Osteoporosis Study. J Cachexia Sarcopenia Muscle 2024; 15:380-386. [PMID: 38146138 PMCID: PMC10834338 DOI: 10.1002/jcsm.13383] [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: 12/22/2022] [Revised: 05/09/2023] [Accepted: 10/22/2023] [Indexed: 12/27/2023] Open
Abstract
BACKGROUND Sarcopenia is a geriatric disease characterized by the progressive and generalized loss of skeletal lean mass and strength with age. The prevalence of sarcopenia in the Vietnamese population is unknown. This study sought to estimate the prevalence of and risk factors for sarcopenia among community-dwelling individuals in Vietnam. METHODS This cross-sectional study is part of the ongoing Vietnam Osteoporosis Study project. The study involved 1308 women and 591 men aged 50 years and older as at 2015 (study entry). Whole-body dual-energy X-ray absorptiometry was used to measure the appendicular skeletal lean mass. Anthropometric and clinical data were collected using a structured questionnaire. Sarcopenia was defined according to the criteria proposed by the Asian Working Group for Sarcopenia in 2019. Logistic regression analysis was used to determine the association between potential risk factors and sarcopenia. RESULTS The prevalence of sarcopenia in women and men was 14% (n = 183) and 16% (n = 83), respectively. Age (odds ratio [OR] per 10 years = 1.37; 95% confidence interval [CI] 1.26-1.48) and being underweight (OR = 1.61; 95% CI 1.00-2.58) were independently associated with increased risk of sarcopenia. The combination of low physical activity, being underweight and advancing age accounted for ~27% of sarcopenic patients. However, most of the attributable fraction was due to ageing. CONCLUSIONS Sarcopenia is common in community-dwelling Vietnamese adults, particularly those with advancing age, who are underweight and with low physical activity.
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Affiliation(s)
- Duy K Hoang
- University of Technology Sydney, Sydney, New South Wales, Australia
- Saigon Precision Medicine Research Center, Ho Chi Minh City, Vietnam
| | - Minh C Doan
- Biomedical Research Center, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
- Saigon Precision Medicine Research Center, Ho Chi Minh City, Vietnam
| | - Nhan M Le
- Biomedical Research Center, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
- Saigon Precision Medicine Research Center, Ho Chi Minh City, Vietnam
| | - Huy G Nguyen
- University of Technology Sydney, Sydney, New South Wales, Australia
- Saigon Precision Medicine Research Center, Ho Chi Minh City, Vietnam
| | - Lan T Ho-Pham
- Biomedical Research Center, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
- Saigon Precision Medicine Research Center, Ho Chi Minh City, Vietnam
- Bone and Muscle Research Group, Ton Duc Thang University, Ho Chi Minh City, Vietnam
| | - Tuan V Nguyen
- University of Technology Sydney, Sydney, New South Wales, Australia
- School of Population Health, UNSW Sydney, Sydney, New South Wales, Australia
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Liu C, Cheng L, Ye W, Lin L. Risk factors for sarcopenia in patients with head and neck cancer. Head Neck 2024; 46:346-352. [PMID: 38031723 DOI: 10.1002/hed.27585] [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: 04/17/2023] [Revised: 09/25/2023] [Accepted: 11/16/2023] [Indexed: 12/01/2023] Open
Abstract
OBJECTIVE Sarcopenia is a common condition among patients with cancer. To better understand the prevalence of sarcopenia in patients with head and neck cancer (HNC), we analysed the risk factors of sarcopenia and developed a theoretical foundation for further development of sarcopenia prevention and treatment strategies. METHODS Six hundred and seventeen patients with HNC were recruited for this cross-sectional observational study, and the data were analyzed using logistic regression analyses. The bioelectrical impedance analysis (BIA) was used to measure skeletal muscle mass, and sarcopenia was diagnosed according to the 2019 diagnostic criteria of the Asian Sarcopenia Working Group (AWGS). RESULTS Among the 617 patients enrolled in the study, 115 (18.6%) had sarcopenia. The prevalence of sarcopenia was 29.1% in males and 8% in females. In the multivariate analysis, older age (OR = 12.266, 95% CI: 3.864-38.934, p < 0.01), body fat (OR = 1.775, 95% CI: 1.511-2.084, p < 0.01), and sex (OR = 138.659, 95% CI: 42.382-453.642, p < 0.01) were independent risk factors for sarcopenia. Body mass index (BMI) (OR = 0.137, 95% CI: 0.09-0.21, p < 0.01), and total body water/fat free mass (TBW/FFM) (OR = 0.122, 95% CI: 0.031-0.474, p < 0.01) were protective factors for sarcopenia; we observed that sarcopenia decreased with increasing BMI and TBW/FFM. CONCLUSIONS Male sex, advanced age, and excess body fat were identified as risk factors for sarcopenia in patients with HNC, whereas a higher BMI and TBW/FFM acted as protective factors against sarcopenia in these patients.
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Affiliation(s)
- Chen Liu
- Department of Oncology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Clinical Nutrition, The Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Ling Cheng
- Department of Oncology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Internal Medicine of Oncology, Affiliated Cancer Hospital and Institute of Guangzhou Medical University, Guangzhou, China
| | - Wenfeng Ye
- Department of Clinical Nutrition, The Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Lizhu Lin
- Department of Oncology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
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Qaisar R, Karim A, Muhammad T, Ahmad F. Butyrate supplementation reduces sarcopenia by repairing neuromuscular junction in patients with chronic obstructive pulmonary disease. Respir Med 2024; 222:107510. [PMID: 38135194 DOI: 10.1016/j.rmed.2023.107510] [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: 11/16/2023] [Revised: 12/14/2023] [Accepted: 12/20/2023] [Indexed: 12/24/2023]
Abstract
INTRODUCTION Chronic obstructive pulmonary disease (COPD) is associated with an intestinal leak and neuromuscular junction (NMJ) degradation, which contributes to physical compromise and accelerated age-related muscle loss, called sarcopenia. However, the relevant interventions partly remain ineffective. We investigated the effects of exogenous butyrate on sarcopenia and physical capacity with relevance to intestinal permeability and NMJ integrity in COPD patients. METHODS COPD patients were randomized into placebo (n = 67) and butyrate (n = 64) groups in a double-blind manner. The patients in the butyrate group received one 300 mg capsule a day for 12 weeks. We measured circulating markers of intestinal leak (zonulin), systemic bacterial load (LBP), and NMJ loss (CAF22), along with handgrip strength (HGS), and short physical performance battery (SPPB) at baseline and 12 weeks. RESULTS Butyrate supplementation improved HGS and gait speed in COPD patients. Among SPPB indices, butyrate improved the ability to maintain postural balance and walking and prevented a decline in the ability to rise from a chair. Butyrate also reduced the plasma levels of zonulin, LBP, and CAF22 levels in COPD patients (all p < 0.05). Regression analysis revealed significant associations of plasma zonulin and CAF22 with HGS, gait speed, and cumulative SPPB scores in butyrate group. These changes were associated with reduced markers of inflammation and muscle damage. CONCLUSION Butyrate may provide a therapeutic approach to sarcopenia and physical dependency in COPD by repairing intestinal leak and NMJ loss.
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Affiliation(s)
- Rizwan Qaisar
- Basic Medical Sciences, College of Medicine, University of Sharjah, Sharjah, 27272, United Arab Emirates; Space Medicine Research Group, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, 27272, United Arab Emirates; Cardiovascular Research Group, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, 27272, United Arab Emirates.
| | - Asima Karim
- Basic Medical Sciences, College of Medicine, University of Sharjah, Sharjah, 27272, United Arab Emirates
| | - Tahir Muhammad
- Department of Biochemistry, Gomal Medical College, Gomal University, Dera Ismail Khan, 30130, Pakistan
| | - Firdos Ahmad
- Basic Medical Sciences, College of Medicine, University of Sharjah, Sharjah, 27272, United Arab Emirates; Space Medicine Research Group, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, 27272, United Arab Emirates; Cardiovascular Research Group, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, 27272, United Arab Emirates
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Feng Y, Feng W, Xu M, Wu C, Yang H, Wang Y, Gan H. Sarcopenia and treatment failure in inflammatory bowel disease: a systematic review and meta-analysis. Rev Esp Enferm Dig 2024; 116:68-76. [PMID: 37706492 DOI: 10.17235/reed.2023.9808/2023] [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] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
BACKGROUND The association between sarcopenia and treatment outcomes in inflammatory bowel disease (IBD) is currently a subject of controversy. METHODS A systematic search was performed of PubMed, Embase, Web of Science, and the Cochrane Library for studies published until April 2023. The quality assessment of each included study was performed using the Newcastle-Ottawa Scale. RESULTS Seventeen studies were included with 2,895 IBD patients. Sarcopenia exhibited an increased risk of treatment failure (OR=2.00, 95% CI: 1.43-2.79) and notably increased the need for surgery (OR=1.54,95%CI:1.06-2.23) as opposed to a pharmacologic treatment plan change (OR=1.19, 95% CI:0.71-2.01) among IBD patients. However, no significant association was found between sarcopenia and treatment failure in corticosteroid (OR=1.21, 95% CI: 0.55-2.64) or biologic agent (OR=1.65, 95% CI: 0.93-2.92) cohorts. Sarcopenia was also linked to elevated treatment failure risks in patients with Crohn's disease (OR=1.82, 95% CI: 1.15-2.90) and those diagnosed with ulcerative colitis (OR=2.55, 95% CI: 1.05-6.21), spanning both Asian (OR=1.88, 95% CI: 1.29-2.74) and non-Asian regions (OR=2.17, 95% CI: 1.48-3.18). CONCLUSIONS Sarcopenia was considered a novel marker for use in clinical practice to predict treatment failure, specifically, the need for surgery in IBD patients. This distinct cohort necessitates clinical attention and tailored care strategies.
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Affiliation(s)
- Yue Feng
- Center of Gerontology and Geriatrics, West China Hospital. Sichuan University, China
| | - Weihua Feng
- Laboratory Medicine, West China Hospital. Sichuan University, China
| | - Mei Xu
- Gastroenterology and Hepatology, West China Hospital. Sichuan University, China
| | - Chaoping Wu
- Gastroenterology and Hepatology, West China Hospital. Sichuan University, China
| | - Huanhuan Yang
- Gastroenterology and Hepatology, West China Hospital. Sichuan University, China
| | - Yu Wang
- Gastroenterology and Hepatology, West China Hospital. Sichuan University, China
| | - Huatian Gan
- Center of Gerontology and Geriatrics, West China Hospital. Sichuan University, China
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Shi W, Li Y, Zhao JV. Long-term exposure to ambient air pollution with sarcopenia among middle-aged and older adults in China. J Nutr Health Aging 2024; 28:100029. [PMID: 38388113 DOI: 10.1016/j.jnha.2023.100029] [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: 09/26/2023] [Accepted: 11/19/2023] [Indexed: 02/24/2024]
Abstract
BACKGROUND Few studies have examined the role of outdoor air pollution exposure in sarcopenia in Asia. We aimed to investigate the association of outdoor air pollutants exposure with sarcopenia among Chinese adults. METHODS This nationally population-representative study used data from the China Health and Retirement Longitudinal Study (CHARLS) in 2015, 11,700 participants at least 45 years old from 125 Chinese cities were included. Sarcopenia status was identified according to the Asian Working Group for Sarcopenia 2019 (AWGS 2019) criteria. Ambient annual average air pollutants including fine particulate matter (PM2.5), inhalable particles (PM10), coarse particulate matter (PMcoarse), nitrogen dioxide (NO2), sulfur dioxide (SO2), and carbon monoxide (CO) were estimated by satellite models and ground-based measurements. Multinomial logistic regression models were performed to examine the associations of air pollutants exposure with different status of sarcopenia (including possible sarcopenia and sarcopenia). Stratified analyses were utilized to assess the effect modifiers. RESULTS Among the 11,700 participants (52.6% women), the average age was 61.0 years. Each 10 μg/m3 increment of annual PMcoarse was associated with a higher risk of possible sarcopenia (odds ratio (OR) = 1.08, 95% confidence interval (CI) 1.04-1.11). Stratified analyses showed a positive risk of possible sarcopenia in women after exposure to PM10, PMcoarse, and NO2. Ambient NO2 exposure was positively associated with sarcopenia (OR = 1.13, 95% CI 1.04-1.22) in those aged 65 years and older. However, we have not observed differences by sex, age, residence, smoking, and drinking. Robustness results were found for PMcoarse in the sensitivity analyses. CONCLUSION This nationwide study suggested that long-term exposure to outdoor air pollution, especially for PMcoarse, was associated with the risk of sarcopenia among Chinese adults. Our findings provide epidemiological implications for protecting healthy ageing by improving air quality.
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Affiliation(s)
- Wenming Shi
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 999077, Hong Kong SAR, China
| | - Yongzhen Li
- Clinical Nutrition Department, Starkids Children's Hospital, Shanghai, New Hong Qiao Campus for Children's Hospital of Fudan University, Shanghai, 201106, China
| | - Jie V Zhao
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 999077, Hong Kong SAR, China.
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Aykanat Yurtsever B, Yurtsever C, Atasoy V. Incidence and risk factors of sarcopenia in hospitalized survivors of COVID-19; a retrospective cohort study. J Infect Dev Ctries 2024; 18:14-20. [PMID: 38377083 DOI: 10.3855/jidc.18287] [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: 03/29/2023] [Accepted: 06/22/2023] [Indexed: 02/22/2024] Open
Abstract
INTRODUCTION Among the persistent conditions affecting patients in the post-acute COVID-19 period, sarcopenia is increasingly emphasized. In this study, we aimed to determine the incidence of sarcopenia and to reveal the risk factors predicting it in hospitalized survivors of COVID-19. METHODOLOGY This is a retrospective cohort study conducted between December 2021 and May 2022 in the post-COVID follow-up center of a tertiary hospital in Turkey. One hundred and sixty-eight patients who were hospitalized because of COVID-19 and discharged were included in the study. The SARC-F scale was applied to determine the risk of sarcopenia in the participants. Twelve patients with a SARC-F score ≥ 4 before COVID-19 were excluded from the study. The medical records of the remaining 156 participants were reviewed, and their demographic characteristics, COVID-19 disease data, hemogram, and CRP parameters were also noted. RESULTS Sarcopenia risk was detected in 17 (10.9%) patients whose median age was higher than the others. Increased risk for sarcopenia was higher in women, lack of education, use of assisted respirators at home, having a psychiatric illness, losing > 10% weight during the hospitalization, and being treated in the intensive care unit. Multiple regression analysis showed that female gender (OR: 8.04 [1.51-42.76]), having a psychiatric illness (OR: 13.23 [2.12-82.51]), and losing > 10% weight during hospitalization (OR: 18.46 [2.57-132.72]) predicted the sarcopenia risk. CONCLUSIONS Sarcopenia should be closely monitored in patients with cases of severe inflammatory effect, inadequate food intake, and diminished physical activity such as hospitalized survivors of COVID-19.
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Affiliation(s)
- Burcu Aykanat Yurtsever
- Kanuni Training and Research Hospital, Family Medicine Clinic, Post-COVID-19 Follow-up Center, Trabzon, Turkey
| | - Ceyhun Yurtsever
- Kanuni Training and Research Hospital, Family Medicine Clinic, Post-COVID-19 Follow-up Center, Trabzon, Turkey
| | - Volkan Atasoy
- Kanuni Training and Research Hospital, Family Medicine Clinic, Post-COVID-19 Follow-up Center, Trabzon, Turkey
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Andrade FP, Borges S, da Silva Filho CA, Martins TF, Benvenutti H, de Freitas JDMC, Thomé FS, Karohl C, Souza GC, Cipriano GFB, Rovedder PME. Respiratory sarcopenia screening in dialysis patients: cross-sectional and multicentre study protocol. BMC Nephrol 2024; 25:41. [PMID: 38287281 PMCID: PMC10826040 DOI: 10.1186/s12882-023-03390-0] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 11/06/2023] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND Respiratory sarcopenia is characterized by the weakness of respiratory muscles associated with sarcopenia due to aging or systemic diseases such as chronic kidney disease (CKD). Patients with CKD undergoing dialysis are particularly susceptible to respiratory muscle weakness caused by factors such as fluid overload and electrolyte imbalance. This weakness not only affects ventilation but also impairs oxygen uptake and delivery to muscle tissue, potentially leading to severe sarcopenia. Thus, the objective of this study is to conduct a respiratory sarcopenia screening in patients with CKD undergoing haemodialysis (HD) and peritoneal dialysis (PD). METHODS This is an observational, cross-sectional and multicentre study conducted between March 2023 and March 2025. The study was approved by the Research Ethics Committee at two centres. Sarcopenia diagnosis is determined based on low handgrip strength and amount of appendicular skeletal muscle mass, assessed through bioelectrical impedance analysis. Respiratory sarcopenia is diagnosed in patients with sarcopenia who have low inspiratory muscle strength, evaluated through a manovacuometry test. The severity of sarcopenia and respiratory sarcopenia is defined, respectively, by low physical performance (measured using the Short Physical Performance Battery and Timed-Up and Go test) and pulmonary performance (measured through spirometry). Thus, this study will include 81 patients undergoing dialysis (41 on HD and 40 on PD) from three participating centres. DISCUSSION The literature has been focused on respiratory function in CKD; however, the relationship with sarcopenia remains understudied. We believe that, similar to appendicular skeleton muscles, the axial skeleton muscles are also likely to weaken with the presence of chronic disease, such as CKD.
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Affiliation(s)
- Francini Porcher Andrade
- Ciências Pneumológicas Post-Graduation Programme, Federal University of Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2400 2º andar, Porto Alegre, RS, 90035-003, Rio Grande do Sul, Brazil.
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Rio Grande do Sul, Brazil.
- Research Center in Sports Sciences, Health Sciences and Human Development, University of Maia (CIDESD-UMAIA), Maia, Portugal.
| | - Sheila Borges
- Science and Technology in Health Programme, University of Brasília (UnB), Brasília, Distrito Federal, Brazil
| | - César Alencar da Silva Filho
- Ciências Pneumológicas Post-Graduation Programme, Federal University of Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2400 2º andar, Porto Alegre, RS, 90035-003, Rio Grande do Sul, Brazil
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Taís Ferreira Martins
- Sciences of Rehabilitation Post-Graduation Programme, University of Brasília (UnB), Brasilia, Distrito Federal, Brazil
| | - Heloíse Benvenutti
- Ciências Pneumológicas Post-Graduation Programme, Federal University of Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2400 2º andar, Porto Alegre, RS, 90035-003, Rio Grande do Sul, Brazil
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Júlia de Melo Cardoso de Freitas
- Medical Sciences Focused on Endocrinology Post-Graduation Programme, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Fernando Saldanha Thomé
- Faculty of Medicine, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
- Instituto de Doenças Renais (IDR), Porto Alegre, Rio Grande do Sul, Brazil
| | - Cristina Karohl
- Faculty of Medicine, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Gabriela Correa Souza
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Rio Grande do Sul, Brazil
- Graduate Program in Food, Nutrition and Health, Medical School, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Graziella França Bernardelli Cipriano
- Science and Technology in Health Programme, University of Brasília (UnB), Brasília, Distrito Federal, Brazil
- Sciences of Rehabilitation Post-Graduation Programme, University of Brasília (UnB), Brasilia, Distrito Federal, Brazil
| | - Paula Maria Eidt Rovedder
- Ciências Pneumológicas Post-Graduation Programme, Federal University of Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2400 2º andar, Porto Alegre, RS, 90035-003, Rio Grande do Sul, Brazil
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Rio Grande do Sul, Brazil
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Fernández-Jiménez R, García-Rey S, Roque-Cuéllar MC, Fernández-Soto ML, García-Olivares M, Novo-Rodríguez M, González-Pacheco M, Prior-Sánchez I, Carmona-Llanos A, Muñoz-Jiménez C, Zarco-Rodríguez FP, Miguel-Luengo L, Boughanem H, García-Luna PP, García-Almeida JM. Ultrasound Muscle Evaluation for Predicting the Prognosis of Patients with Head and Neck Cancer: A Large-Scale and Multicenter Prospective Study. Nutrients 2024; 16:387. [PMID: 38337671 PMCID: PMC10857428 DOI: 10.3390/nu16030387] [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: 01/02/2024] [Revised: 01/22/2024] [Accepted: 01/24/2024] [Indexed: 02/12/2024] Open
Abstract
Head and neck cancer (HNC) is a prevalent and aggressive form of cancer with high mortality rates and significant implications for nutritional status. Accurate assessment of malnutrition in patients with HNC is crucial for optimizing treatment outcomes and improving survival rates. This study aimed to evaluate the use of ultrasound techniques for predicting nutritional status, malnutrition, and cancer outcomes in patients with HNC. A total of 494 patients with HNC were included in this cross-sectional observational study. Various tools and body composition measurements, including muscle mass and adipose tissue ultrasound evaluations, were implemented. Using regression models, we mainly found that high levels of RF-CSA (rectus femoris cross-sectional area) were associated with a decreased risk of malnutrition (as defined with GLIM criteria (OR = 0.81, 95% CI: 0.68-0.98); as defined with PG-SGA (OR = 0.78, 95% CI: 0.62-0.98)) and sarcopenia (OR = 0.64, 95% CI: 0.49-0.82) after being adjusted for age, sex, and BMI. To predict the importance of muscle mass ultrasound variables on the risk of mortality, a nomogram, a random forest, and decision tree models were conducted. RF-CSA was the most important variable under the random forest model. The obtained C-index for the nomogram was 0.704, and the Brier score was 16.8. With an RF-CSA < 2.7 (AUC of 0.653 (0.59-0.77)) as a split, the decision tree model classified up to 68% of patients as possessing a high probability of survival. According to the cut-off value of 2.7 cm2, patients with a low RF-CSA value lower than 2.7 cm2 had worse survival rates (p < 0.001). The findings of this study highlight the importance of implementing ultrasound tools, for accurate diagnoses and monitoring of malnutrition in patients with HNC. Adipose tissue ultrasound measurements were only weakly associated with malnutrition and not with sarcopenia, indicating that muscle mass is a more important indicator of overall health and nutritional status. These results have the potential to improve survival rates and quality of life by enabling early intervention and personalized nutritional management.
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Affiliation(s)
- Rocío Fernández-Jiménez
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Málaga Biomedical Research Institute and BIONAND Platform (IBIMA), 29010 Malaga, Spain; (R.F.-J.); (J.M.G.-A.)
- Department of Endocrinology and Nutrition, QuironSalud Malaga Hospital, 29004 Malaga, Spain
- Department of Medicine and Dermatology, Faculty of Medicine, University of Malaga, 29010 Malaga, Spain
| | - Silvia García-Rey
- Department of Endocrinology and Nutrition, Virgen del Rocío University Hospital, Instituto de Biomedicina de Sevilla (IBIS), 41013 Seville, Spain; (S.G.-R.); (M.C.R.-C.); (P.P.G.-L.)
| | - María Carmen Roque-Cuéllar
- Department of Endocrinology and Nutrition, Virgen del Rocío University Hospital, Instituto de Biomedicina de Sevilla (IBIS), 41013 Seville, Spain; (S.G.-R.); (M.C.R.-C.); (P.P.G.-L.)
| | - María Luisa Fernández-Soto
- Endocrinology and Nutrition Clinical Management Unit, University Hospital San Cecilio, 18012 Granada, Spain;
- Biosanitary Institute of Granada, Medicine Department, Faculty of Medicine of Granada, University of Granada, 18010 Granada, Spain
| | - María García-Olivares
- Department of Medicine and Dermatology, Faculty of Medicine, University of Malaga, 29010 Malaga, Spain
- Department of Endocrinology and Nutrition, Instituto de Investigación Biomédica de Málaga (IBIMA), Regional University Hospital, 29007 Malaga, Spain
| | - María Novo-Rodríguez
- Department of Endocrinology and Nutrition, FIBAO (Fundación para la Investigación Biosanitaria de Andalucia Oriental), Virgen de las Nieves University Hospital, 18014 Granada, Spain;
| | - María González-Pacheco
- Department of Endocrinology and Nutrition, Instituto de Investigación e Innovación Biomédica de Cádiz (INIBICA), Puerta del Mar University Hospital, 11009 Cadiz, Spain;
| | | | - Alba Carmona-Llanos
- Department of Endocrinology and Nutrition, Instituto de Investigación e Innovación Biomédica de Cádiz (INIBICA), Jerez de la Frontera University Hospital, 11407 Cadiz, Spain;
| | - Concepción Muñoz-Jiménez
- Department of Endocrinology and Nutrition, Maimonides Institute for Biomedical Research in Córdoba (IMIBIC), Reina Sofía University Hospital, 14011 Cordoba, Spain;
| | | | - Luis Miguel-Luengo
- Department of Endocrinology and Nutrition, Badajoz University Hospital, 06080 Badajoz, Spain;
- Departamento de Ciencias Biomédicas, Facultad de Medicina, Universidad de Extremadura, 06006 Badajoz, Spain
| | - Hatim Boughanem
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Málaga Biomedical Research Institute and BIONAND Platform (IBIMA), 29010 Malaga, Spain; (R.F.-J.); (J.M.G.-A.)
- Spanish Biomedical Research Center in Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Unidad de Gestión Clinica Medicina Interna, Lipids and Atherosclerosis Unit, Maimonides Institute for Biomedical Research in Córdoba (IMIBIC), Reina Sofia University Hospital, University of Córdoba, 14004 Cordoba, Spain
| | - Pedro Pablo García-Luna
- Department of Endocrinology and Nutrition, Virgen del Rocío University Hospital, Instituto de Biomedicina de Sevilla (IBIS), 41013 Seville, Spain; (S.G.-R.); (M.C.R.-C.); (P.P.G.-L.)
| | - José Manuel García-Almeida
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Málaga Biomedical Research Institute and BIONAND Platform (IBIMA), 29010 Malaga, Spain; (R.F.-J.); (J.M.G.-A.)
- Department of Endocrinology and Nutrition, QuironSalud Malaga Hospital, 29004 Malaga, Spain
- Department of Medicine and Dermatology, Faculty of Medicine, University of Malaga, 29010 Malaga, Spain
- Spanish Biomedical Research Center in Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
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46
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Wang D, Zhang G, Yu Y, Zhang Z. Imaging of Sarcopenia in Type 2 Diabetes Mellitus. Clin Interv Aging 2024; 19:141-151. [PMID: 38292460 PMCID: PMC10826713 DOI: 10.2147/cia.s443572] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 01/17/2024] [Indexed: 02/01/2024] Open
Abstract
Sarcopenia is an age-related condition characterized by the loss of skeletal muscle mass, muscular strength, and muscle function. In older adults, type 2 diabetes mellitus (T2DM) constitutes a significant health burden. Skeletal muscle damage and deterioration have emerged as novel chronic complications in patients with diabetes, often linked to their increased longevity. Diabetic sarcopenia has been associated with increased rates of hospitalization, cardiovascular events, and mortality. Nevertheless, effectively managing metabolic disorders in patients with T2DM through appropriate therapeutic interventions could potentially mitigate the risk of sarcopenia. Utilizing imaging technologies holds substantial clinical significance in the early detection of skeletal muscle mass alterations associated with sarcopenia. Such detection is pivotal for arresting disease progression and preserving patients' quality of life. These imaging modalities offer reproducible and consistent patterns over time, as they all provide varying degrees of quantitative data. This review primarily delves into the application of dual-energy X-ray absorptiometry, computed tomography, magnetic resonance imaging, and ultrasound for both qualitative and quantitative assessments of muscle mass in patients with T2DM. It also juxtaposes the merits and limitations of these four techniques. By understanding the nuances of each method, clinicians can discern how best to apply them in diverse clinical scenarios.
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Affiliation(s)
- Dingyue Wang
- Department of Ultrasound, the First Affiliated Hospital China Medical University, Shenyang City, Liaoning Province, 110001, People’s Republic of China
| | - Gaosen Zhang
- Department of Ultrasound, the First Affiliated Hospital China Medical University, Shenyang City, Liaoning Province, 110001, People’s Republic of China
| | - Yana Yu
- Department of Ultrasound, the First Affiliated Hospital China Medical University, Shenyang City, Liaoning Province, 110001, People’s Republic of China
| | - Zhen Zhang
- Department of Ultrasound, the First Affiliated Hospital China Medical University, Shenyang City, Liaoning Province, 110001, People’s Republic of China
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47
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Uyar GC, Öksüzoğlu ÖBÇ, Sütcüoğlu O. Correspondence: Methodological considerations in evaluating sarcopenia and frailty in elderly gastrointestinal cancer patients. Support Care Cancer 2024; 32:130. [PMID: 38270696 DOI: 10.1007/s00520-024-08336-2] [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: 12/25/2023] [Accepted: 01/18/2024] [Indexed: 01/26/2024]
Affiliation(s)
- Galip Can Uyar
- Department of Medical Oncology, Ankara Etlik City Hospital, Ankara, Turkey
| | | | - Osman Sütcüoğlu
- Department of Medical Oncology, Ankara Etlik City Hospital, Ankara, Turkey.
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48
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Li S, Xie K, Xiao X, Xu P, Tang M, Li D. Correlation between sarcopenia and esophageal cancer: a narrative review. World J Surg Oncol 2024; 22:27. [PMID: 38267975 PMCID: PMC10809562 DOI: 10.1186/s12957-024-03304-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 01/13/2024] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND In recent years, the research on the relationship between sarcopenia before and after the treatment of esophageal cancer, as well as its impact on prognosis of esophageal cancer, has increased rapidly, which has aroused people's attention to the disease of patients with esophageal cancer complicated with sarcopenia. This review examines the prevalence of sarcopenia in patients with esophageal cancer, as well as the relationship between sarcopenia (before and after surgery or chemotherapy) and prognosis in patients with esophageal cancer. Moreover, we summarized the potential pathogenesis of sarcopenia and pharmacologic and non-pharmacologic therapies. METHODS A narrative review was performed in PubMed and Web of Science using the keywords ("esophageal cancer" or "esophageal neoplasm" or "neoplasm, esophageal" or "esophagus neoplasm" or "esophagus neoplasms" or "neoplasm, esophagus" or "neoplasms, esophagus" or "neoplasms, esophageal" or "cancer of esophagus" or "cancer of the esophagus" or "esophagus cancer" or "cancer, esophagus" or "cancers, esophagus" or "esophagus cancers" or "esophageal cancer" or "cancer, esophageal" or "cancers, esophageal" or "esophageal cancers") and ("sarcopenia" or "muscular atrophy" or "aging" or "senescence" or "biological aging" or "aging, biological" or "atrophies, muscular" or "atrophy, muscular" or "muscular atrophies" or "atrophy, muscle" or "atrophies, muscle" or "muscle atrophies"). Studies reporting relationship between sarcopenia and esophageal cancer were analyzed. RESULTS The results of the review suggest that the average prevalence of sarcopenia in esophageal cancer was 46.3% ± 19.6% ranging from 14.4 to 81% and sarcopenia can be an important predictor of poor prognosis in patients with esophageal cancer. Patients with esophageal cancer can suffer from sarcopenia due to their nutritional deficiencies, reduced physical activity, chemotherapy, and the effects of certain inflammatory factors and pathways. When classic diagnostic values for sarcopenia such as skeletal muscle index (SMI) are not available clinically, it is also feasible to predict esophageal cancer prognosis using simpler metrics, such as calf circumference (CC), five-count sit-up test (5-CST), and six-minute walk distance (6MWD). CONCLUSIONS Identifying the potential mechanism of sarcopenia in patients with esophageal cancer and implementing appropriate interventions may hold the key to improving the prognosis of these patients.
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Affiliation(s)
- Shenglan Li
- Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, 410008, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
- The Hunan Institute of Pharmacy Practice and Clinical Research, Changsha, 410008, China
- Institute of Hospital Pharmacy, Central South University, Changsha, 410008, China
| | - Kaiqiang Xie
- Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, 410008, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
- The Hunan Institute of Pharmacy Practice and Clinical Research, Changsha, 410008, China
- Institute of Hospital Pharmacy, Central South University, Changsha, 410008, China
| | - Xiaoxiong Xiao
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Department of Thoracic Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Xiangya Lung Cancer Center, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Pingsheng Xu
- Phase I Clinical Trial Center, Xiangya Hospital, Central South University, Changsha, 410008, China
| | - Mimi Tang
- Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, 410008, China.
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China.
- The Hunan Institute of Pharmacy Practice and Clinical Research, Changsha, 410008, China.
- Institute of Hospital Pharmacy, Central South University, Changsha, 410008, China.
| | - Dai Li
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China.
- Phase I Clinical Trial Center, Xiangya Hospital, Central South University, Changsha, 410008, China.
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49
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Antuña E, Potes Y, Baena-Huerta FJ, Cachán-Vega C, Menéndez-Coto N, Álvarez Darriba E, Fernández-Fernández M, Burgos Bencosme N, Bermúdez M, López Álvarez EM, Gutiérrez-Rodríguez J, Boga JA, Caballero B, Vega-Naredo I, Coto-Montes A, Garcia-Gonzalez C. NLRP3 Contributes to Sarcopenia Associated to Dependency Recapitulating Inflammatory-Associated Muscle Degeneration. Int J Mol Sci 2024; 25:1439. [PMID: 38338718 PMCID: PMC10855188 DOI: 10.3390/ijms25031439] [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: 12/21/2023] [Revised: 01/17/2024] [Accepted: 01/21/2024] [Indexed: 02/12/2024] Open
Abstract
Sarcopenia, a complex and debilitating condition characterized by progressive deterioration of skeletal muscle, is the primary cause of age-associated disability and significantly impacts healthspan in elderly patients. Despite its prevalence among the aging population, the underlying molecular mechanisms are still under investigation. The NLRP3 inflammasome is crucial in the innate immune response and has a significant impact on diseases related to inflammation and aging. Here, we investigated the expression of the NLRP3 inflammasome pathway and pro-inflammatory cytokines in skeletal muscle and peripheral blood of dependent and independent patients who underwent hip surgery. Patients were categorized into independent and dependent individuals based on their Barthel Index. The expression of NLRP3 inflammasome components was significantly upregulated in sarcopenic muscle from dependent patients, accompanied by higher levels of Caspase-1, IL-1β and IL-6. Among older dependent individuals with sarcopenia, there was a significant increase in the MYH3/MYH2 ratio, indicating a transcriptional shift in expression from mature to developmental myosin isoforms. Creatine kinase levels and senescence markers were also higher in dependent patients, altogether resembling dystrophic diseases and indicating muscle degeneration. In summary, we present evidence for the involvement of the NLRP3/ASC/NEK7/Caspase-1 inflammasome pathway with activation of pro-inflammatory SASP in the outcome of sarcopenia in the elderly.
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Affiliation(s)
- Eduardo Antuña
- Research Group OSKAR, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain
- Department of Morphology and Cell Biology, University of Oviedo, 33006 Oviedo, Spain
- Instituto de Neurociencias del Principado de Asturias (INEUROPA), 33006 Oviedo, Spain
| | - Yaiza Potes
- Research Group OSKAR, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain
- Department of Morphology and Cell Biology, University of Oviedo, 33006 Oviedo, Spain
- Instituto de Neurociencias del Principado de Asturias (INEUROPA), 33006 Oviedo, Spain
| | | | - Cristina Cachán-Vega
- Research Group OSKAR, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain
- Department of Morphology and Cell Biology, University of Oviedo, 33006 Oviedo, Spain
- Instituto de Neurociencias del Principado de Asturias (INEUROPA), 33006 Oviedo, Spain
| | - Nerea Menéndez-Coto
- Department of Morphology and Cell Biology, University of Oviedo, 33006 Oviedo, Spain
| | | | | | | | - Manuel Bermúdez
- Research Group OSKAR, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain
- Geriatric Service, Monte Naranco Hospital, 33012 Oviedo, Spain
| | - Eva María López Álvarez
- Research Group OSKAR, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain
- Geriatric Service, Monte Naranco Hospital, 33012 Oviedo, Spain
| | - José Gutiérrez-Rodríguez
- Research Group OSKAR, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain
- Geriatric Service, Monte Naranco Hospital, 33012 Oviedo, Spain
| | - José Antonio Boga
- Grupo de Investigación Microbiología Traslacional, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain
- Servicio de Microbiología, Hospital Universitario Central de Asturias (HUCA), 33011 Oviedo, Spain
| | - Beatriz Caballero
- Research Group OSKAR, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain
- Department of Morphology and Cell Biology, University of Oviedo, 33006 Oviedo, Spain
- Instituto de Neurociencias del Principado de Asturias (INEUROPA), 33006 Oviedo, Spain
| | - Ignacio Vega-Naredo
- Research Group OSKAR, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain
- Department of Morphology and Cell Biology, University of Oviedo, 33006 Oviedo, Spain
- Instituto de Neurociencias del Principado de Asturias (INEUROPA), 33006 Oviedo, Spain
| | - Ana Coto-Montes
- Research Group OSKAR, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain
- Department of Morphology and Cell Biology, University of Oviedo, 33006 Oviedo, Spain
- Instituto de Neurociencias del Principado de Asturias (INEUROPA), 33006 Oviedo, Spain
| | - Claudia Garcia-Gonzalez
- Research Group OSKAR, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain
- Department of Morphology and Cell Biology, University of Oviedo, 33006 Oviedo, Spain
- Instituto de Neurociencias del Principado de Asturias (INEUROPA), 33006 Oviedo, Spain
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50
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Nishikawa H, Kim SK, Asai A. Body Composition in Chronic Liver Disease. Int J Mol Sci 2024; 25:964. [PMID: 38256036 PMCID: PMC10815828 DOI: 10.3390/ijms25020964] [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: 11/14/2023] [Revised: 01/08/2024] [Accepted: 01/11/2024] [Indexed: 01/24/2024] Open
Abstract
Body composition has recently been attracting people's attention, not only from a cosmetic standpoint but also from the perspective of health and longevity. The body is classified into three components: fat, bone, and lean soft tissue, and it is common to see an increase in body fat and a decrease in total body muscle mass with aging. Aging-related loss of muscle mass and muscle function is referred to as primary sarcopenia, while sarcopenia caused by disease-specific conditions is referred to as secondary sarcopenia. On the other hand, the liver-muscle axis has been attracting attention in recent years, and it has become clear that the liver and the skeletal muscles interact with each other. In particular, patients with cirrhosis are prone to secondary sarcopenia due to protein-energy malnutrition, which is a characteristic pathophysiology of the disease, suggesting the importance of the organ-organ network. In this review, we would like to outline the latest findings in this field, with a focus on body composition in liver diseases such as liver cirrhosis, fatty liver disease, alcoholic liver disease, and hepatocellular carcinoma.
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Affiliation(s)
- Hiroki Nishikawa
- Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Osaka, Japan
| | - Soo Ki Kim
- Department of Gastroenterology, Kobe Asahi Hospital, Kobe 653-8501, Hyogo, Japan
| | - Akira Asai
- Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Osaka, Japan
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