Relationship between Sarcopenia and Cardiovascular Disease Risk among Taiwanese Older Adults.

OBJECTIVE: Increasing evidence supports sarcopenia as an important parameter for predicting cardiometabolic risks. The objective of this study was to investigate the relationship between muscle mass, muscle strength, and physical performance, and cardiovascular risk among older community-dwelling adults. DESIGN: The associations between dynapenia, sarcopenia, and Framingham risk score (FRS) were estimated by multivariate regression models. SETTING: Muscle mass is estimated by skeletal muscle mass index using a bioelectrical impedance analysis. Muscle strength is measured by handgrip strength using an analog isometric dynamometer. Physical performance is measured by gait speed using a 6-meter walking distance. Dynapenia was defined as low muscle strength and/or slow gait speed presents with normal muscle mass. The diagnosis of presarcopenia and sarcopenia was based on criteria proposed by the Asian Working Group for Sarcopenia in 2014. The FRS was used for evaluating 10-year coronary heart disease risk. PARTICIPANTS: Adults aged 65 years and older who attended health examinations from 2015 to 2017 were recruited. RESULTS: There were totally 709 subjects enrolled in this study. Dynapenic men (n=47) had 17.70±5.08% FRS and sarcopenic women (n=74) had 7.74±6.06% FRS. Participants with presarcopenia had the lowest FRS (men: 15.41±5.35%; women: 5.25±3.70%). Men with dynapenia had higher FRS than the presarcopenia group with odds ratio (OR) of 2.52 (95% Confidence Interval [CI]: 1.03-6.14). Women with sarcopenia had significantly higher FRS than the presarcopenia group with OR of 2.81 (95%CI: 1.09-7.27). CONCLUSION: Older dynapenic men and older sarcopenic women had higher risks of 10-year coronary heart disease. Presarcopenic older adults had the lowest coronary heart disease risk in both genders.

The relationship between polycyclic aromatic hydrocarbons exposure and serum klotho among adult population.

BACKGROUND: Klotho is an important factor involving aging process. Recently, polycyclic aromatic hydrocarbons (PAHs) exposure was reported to have adverse impact on DNA methylation associated with aging. The aim of the current study was to determine the relationship between serum klotho and PAHs exposure in an adult population. METHODS: A total of 2597 participants obtained from NHANES 2015-2016 were included in this cross-sectional study. Serum klotho levels were analyzed by enzyme-linked immunosorbent assay (ELISA). PAHs exposure was estimated by urinary sample using liquid chromatography-tandem mass spectrometry. The relationship between serum klotho and exposure to PAHS was analyzed by a multivariable linear regression model. RESULTS: 2-napthol and 3-fluorene were significantly associated with decreased klotho. After fully adjusting pertinent variables, PAH exposure was significantly associated with decreased klotho, particularly in men. CONCLUSION: In the present study we highlighted the significant association between PAHs exposure and serum klotho levels. The importance of environmental effect on aging process and age-related disorders should be paid more attention and clinical intervention is necessary.

Association between oral intake magnesium and sarcopenia: a cross-sectional study.

BACKGROUND: Sarcopenia is a common skeletal muscle disorder in the elderly population. The patients with sarcopenia increased the cost of care and the risk for hospitalization. Magnesium deficiency might increase reactive oxygen species and protein damage. The purpose of our study was to demonstrate the relation between oral intake magnesium and sarcopenia by European Working Group on Sarcopenia in Older People (EWGSOP) 2 definition. METHODS: Our study included 2532 participants with 1310 males and 1222 females. The multiple logistic regression model was designed to test the cross-sectional protective outcome of oral intake magnesium for sarcopenia. RESULTS: Oral intake magnesium had a protective outcome with sarcopenia (odd ratio (OR) = 0.997, 95% CI = 0.996, 0.998, P < 0.001). After fully adjusted, the significance persisted with OR = 0.998 (95% CI = 0.996, 0.999, P < 0.001). CONCLUSION: Results of the present study showed the dose dependent relationship between oral intake magnesium and sarcopenia. Sufficient oral intake magnesium might prevent patient from sarcopenia.

Associations between different measurements of sarcopenic obesity and health outcomes among non-frail community-dwelling older adults in Taiwan.

The most important issue for the clinical application of sarcopenic obesity (SO) is the lack of a consensus definition. The aim of the present study was to determine the best measurement for SO by estimating the association between various definitions and the risk of falls and metabolic syndrome (MS). We studied a community of 765 adults aged 65 years and older in 2015-2017. Sarcopenia obesity was measured by sarcopenia (defined by low muscle mass with either low handgrip strength or low gait speed or both) plus obesity (defined by waist circumference, body fat percentage and BMI). The MS was defined according to the National Cholesterol Education Program ATP III. Logistic regression models were constructed to examine the relationships between sarcopenia obesity and risk of fall and MS. In the analysis of the fall risk with SO defined by waist circumference, the participants with non-sarcopenia/non-obesity were treated as the reference group. The OR to fall in participants with SO was 10·16 (95 % CI 2·71, 38·13) after adjusting for confounding covariates. In the analysis of the risk of the MS between participants with individual components of sarcopenia coupled with obesity defined by waist circumference, the risk was statistically significant for low gait speed (OR: 7·19; 95 % CI 3·61, 14·30) and low grip strength (OR: 9·19; 95 % CI 5·00, 16·91). A combination of low grip strength and abdominal obesity for identifying SO may be a more precise and practical method for predicting target populations with unfavourable health risks, such as falls risk and MS.

Unraveling the link between metabolic syndrome and abdominal aortic calcification.

BACKGROUND & AIMS: Over the last few decades, the prevalence of metabolic syndrome (MetS) has gradually increased. As we know, many prior studies have connected MetS with diabetes, coronary heart disease, and cardiovascular disease. Abdominal aortic calcification (AAC) is a good marker of morbidity and mortality of vascular disease, as its degree may be associated with the severity of coronary artery calcification and disease. The aim of this article is to investigate the connection between MetS and AAC. METHODS AND RESULTS: This retrospective observational study included 2731 participants aged 58 years from the National Health and Nutrition Examination Survey (NHANES) (2013-2014). We used Dual-Energy X-ray Absorptiometry to define the degree of AAC. We defined MetS according to the National Cholesterol Education Program Adult Treatment Panel III definition. A total of 2731 participants with complete data were included for data analysis. In the fully adjusted model, an increase in the severity of AAC with the number of MetS components was still significant with ßvalues of AAC Total 24 Score 0.498 (95% confidence interval (CI): 0.018,0.978), 1.016 (95% CI: 0.514,1.519) and 1.426 (95% CI: 0.916,1.937) respectively in 2, 3 and â‰§ 4 components. Additionally, associations were observed between MetS components, including blood pressure, HDL and glucose with ßvalues of AAC Total 24 Score 0.332(95% CI: 0.069, 0.595), 0.652(95% CI: 0.380, 0.925) and 0.534 (95% CI: 0.285, 0.783) after fully adjusted, respectively. CONCLUSION: The results indicated that, in the US adult population, a greater number of components of MetS were significantly associated with AAC. Among the components of metabolic syndrome, the blood pressure, HDL and blood sugar were observed apparent association with AAC.

Cross-sectional associations among P3NP, HtrA, Hsp70, Apelin and sarcopenia in Taiwanese population.

BACKGROUND: Sarcopenia is a multifactorial pathophysiologic condition of skeletal muscle mass and muscle strength associated with aging. However, biomarkers for predicting the occurrence of sarcopenia are rarely discussed in recent studies. The aim of the study was to elucidate the relationship between sarcopenia and several pertinent biomarkers. METHODS: Using the Gene Expression Omnibus (GEO) profiles of the National Center for Biotechnology Information, the associations between mRNA expression of biomarkers and sarcopenia were explored, including high temperature requirement serine protease A1 (HtrA1), procollagen type III N-terminal peptide (P3NP), apelin, and heat shock proteins 70 (Hsp72). We enrolled 408 community-dwelling adults aged 65 years and older with sarcopenia and nonsarcopenia based on the algorithm proposed by the Asian Working Group for Sarcopenia (AWGS). Muscle strength is identified by hand grip strength using an analogue isometric dynamometer. Muscle mass is estimated by skeletal mass index (SMI) using a bioelectrical impedance analysis. Physical performance is measured by gait speed using 6 m walking distance. The associations between these biomarkers and sarcopenia were determined using receiver operating characteristic (ROC) curve analysis and multivariate regression models. RESULTS: From the GEO profiles, the sarcopenia gene set variation analysis score was correlated significantly with the mRNA expression of APLNR (p < 0.001) and HSPA2 (p < 0.001). In our study, apelin was significantly associated with decreased hand grip strength with ß values of - 0.137 (95%CI: - 0.229, - 0.046) in men. P3NP and HtrA1 were significantly associated with increased SMI with ß values of 0.081 (95%CI: 0.010, 0.153) and 0.005 (95%CI: 0.001, 0.009) in men, respectively. Apelin and HtrA1 were inversely associated with the presence of sarcopenia with an OR of 0.543 (95%CI: 0.397-0.743) and 0.003 (95%CI: 0.001-0.890) after full adjustment. The cutoff point of HtrA1 was associated with the presence of sarcopenia with an OR of 0.254 (95%CI: 0.083-0.778) in men. The cutoff point of apelin was negatively associated with the presence of sarcopenia with an OR of 0.254 (95%CI: 0.083-0.778). CONCLUSION: Our study highlights that P3NP, HtrA, and apelin are useful for diagnosis of sarcopenia in the clinical setting.

Polycyclic aromatic hydrocarbon metabolites and mortality risk in an adult population.

Occupational polycyclic aromatic hydrocarbons (PAHs) exposure has been shown to increase the risk of various cancers and may be associated with carcinogenic mortality. However, no study has explored the relationship between environmental PAH exposure and mortality in general population. The aim of our study was to explore the association between PAH exposure and all-cause, cardiovascular, and cancer mortality in a general US adult population. We analyzed data from the National Health and Nutrition Examination Survey (NHANES 2001-2006) based on the information in this dataset on 692 males and 717 females. PAH exposure was detected using biomarkers from urine samples. Follow-up data on mortality were derived from initial examination of the subjects until death or 31 December 2006 in the NHANES database. We calculated hazard ratios (HRs) of PAH metabolites among all-cause, cardiovascular, and cancer mortality using the multivariate Cox proportional hazards regression model after adjusting for covariates. Among males, 3-phenanthrene was positively associated with increased risk of all-cause mortality (HR 1.043, 95%CI 1.019-1.066). Female participants with higher 2-napthol (HR 1.043, 95%CI 1.014-1.072), 3-fluorene (HR 2.159, 95%CI 1.233-3.779), and 1-phenanthrene (HR = 1.259, 95%CI 1.070-1.481) levels had increased all-cause mortality. In addition, high 3-phenanthrene (HR 1.333, 95%CI 1.008-1.763) and 1-phenanthrene (HR 1.463, 95%CI 1.126-1.900) levels increased the risk of cardiovascular mortality. However, there were no significant findings for cancer mortality in both genders. Environmental PAH exposure among the adult population is associated with non-carcinogenic but not cancer mortality. Future studies are warranted to determine the underlying mechanisms related to these findings.

Trajectories of returning to work and its impact on survival in survivors with oral cancer: A 5-year follow-up study.

BACKGROUND: A return to work (RTW) is a challenge for survivors of oral cancer. Further light could be shed on the RTW of patients with oral cancer, which remains largely uninvestigated. The objective of this study was to investigate the trajectories of RTW and their impact on survival in workers with oral cancer. METHODS: In total, 12,222 workers who were newly diagnosed with oral cancer were identified during the period from 2004 to 2015 and were included in this cohort study. The associations between independent variables and RTW were analyzed using Cox proportional hazard models. RESULTS: Overall, 8793 workers returned to work in the first years after a diagnosis of oral cancer. Chemotherapy (hazard ratio [HR], 0.88; 95% CI, 0.78-0.99) and radiation therapy (HR, 0.83; 95% CI, 0.75-0.92) were inversely associated with RTW. Patients who had received surgical treatment (HR, 1.24; 95% CI, 1.01-1.53) were more likely to RTW. Employees with stage I (HR, 1.66; 95% CI, 1.47-1.87), stage II (HR, 1.52; 95% CI, 1.35-1.72), and stage III (HR, 1.32; 95% CI, 1.16-1.51) disease were associated with an increased likelihood of RTW in the fifth year after diagnosis. Kaplan-Meier survival analysis demonstrated better survival for the RTW group versus the non-RTW group in patients with stage III and IV oral cancer (P < .001). The fully adjusted HR indicated that the RTW group had significantly better outcomes than the non-RTW group in all-cause mortality (P < .001; HR, 0.36; 95% CI, 0.33-0.39). CONCLUSIONS: Sociodemographic and medical factors affect the RTW of cancer survivors. RTW may have a beneficial effect on survival of patients with oral cancer.

Average urinary flow rate and its association with handgrip strength.

BACKGROUND: Voiding dysfunction became a difficult problem for the elderly because of the underactive bladder (UAB). It was considered that the degeneration of detrusor muscle was the main etiology. In recent years, more articles focus on relationship between UAB and decreased muscle strength. Besides, handgrip strength (HGS) is an early indicator to detect frailty and muscle weakness in systemic reviews. METHOD: Our study involved 2258 males from NHANES datasets (2011-2012, who were divided into quartiles by urine flow rate (UFR), which was measured by uroflowmetry. Multivariate regression models were performed to analyze the associations between UFR and HGS. RESULTS: The UFR had a positive correlation to the HGS by multivariate regression models in males (ß coefficient: 1.348, 95% confidence interval (CI): 0.530, 2.166, p = 0.001). The male participants with the highest quartile of UFR have a greater HGS than those with lowest quartile of UFR (ß coefficient: 4.546, 95% CI: 2.462, 6.630, p < 0.001). Higher UFR was associated with lower odds of low HGS (OR: 0.489, 95% CI: 0.350, 0.684, p < 0.001) in the fully-adjusted model. CONCLUSIONS: Our research highlighted that the UFR had a strong associated with the HGS in the healthy group.

Examining relationship between occupational acid exposure and oral health in workplace.

BACKGROUND: Acid mist can suspend in the air and enter the body via skin contact, the respiratory tract, or even oral intake, which pose various health hazards. Previous studies have shown that occupational exposure to acid mist or acidic solutions is a major risk factor for oral diseases. However, the findings are inconsistent and do not consider individual factors and lifestyles that may cause the same oral diseases. Therefore, we conducted a comprehensive oral health survey and collected detail information to confirm the effect of acidic solution exposure on worker's oral health. METHODS: From 4 acidic solution factories, a total of 309 subjects (157 in control and 152 in exposed group) was enrolled. All participants competed oral examinations and self-report questionnaire, including the decayed, missing, and filled teeth (DMFT) index, community periodontal index (CPI), loss of attachment (LA) index, and tooth erosion. Multivariate logistic regression analysis was used to determine the association between the acidic solution exposure and oral health. RESULTS: The results showed that acid exposure was correlated with soft oral tissue injury rather than hard oral tissue in our survey. In the multivariate model (adjusted for sex, age, worked years, education level, mouthwash use, dental floss use, tooth brushing, mask use, smoking, drinking, chewing areca and dietary habits with acidic foods), significant relationships of acid exposure with LA score were observed (OR = 2.32, 95% CI 1.03-5.26). However, the presence of acid exposure was not significantly associated with tooth erosion, DMFT, and CPITN. CONCLUSION: Our study highlighted that occupational acid exposure was an independent risk factor for periodontal health, especially LA. It is important to strengthen occupational hazard control, educate workers on oral disease and related factors, and raise the awareness of oral hygiene.

Peripheral fat distribution versus waist circumference for predicting mortality in metabolic syndrome.

OBJECTIVE: To elucidate whether the peripheral fat (PF)-combined definition of metabolic syndrome (MetS) would show a better predictive ability for cause-specific mortality than the common MetS. METHODS: Data were derived from the National Health and Nutrition Examination Survey from 1999 through 2002. We investigated three types of MetS including waist circumference MetS (WCMetS), PFMetS, and PF-combined definition of MetS. The main outcome was to evaluate the predictive ability of the newly defined MetS for time to cause-specific mortality. The secondary outcomes were the relationships between the PF percentage and C-reactive protein (CRP) and homeostasis model assessment of insulin resistance (HOMA-IR) to clarify the gender discrepancy. RESULTS: For cardiovascular mortality, the adjusted hazard ratios for WCMetS, PFMetS, and PF-combined definition MetS were 1.867, 1.742, and 2.117, respectively (all P < 0.001). A positive association between PF percentage and CRP in men and a negative correlation between PF percentage and HOMA-IR in women after adjustment for all variates were found. CONCLUSIONS: The PF-combined definition of MetS had a stronger predictive ability for all-cause and cardiovascular mortality than general MetS. Notably, the PF might have differential gender-specific health effects on cardiovascular events.

The Relationship between Dietary Calcium and Age-Related Macular Degeneration.

BACKGROUND: Mineral element supplements are widely used in the older adult population. However, little is known of their impact on the progression of age-related macular degeneration (ARMD). The aim of this study was to examine the association between dietary micronutrients and ARMD in older adults. METHODS: We enrolled 5227 participants from the National Health and Nutrition Examination Survey (NHANES 2005-2008) in this cross-sectional study. ARMD was evaluated using an ophthalmic digital imaging system and digital camera. Mineral element consumption was collected using a 24-hour dietary recall. The association between mineral element use and the presence of ARMD was determined by multivariable logistic regression. RESULTS: After adjusting for relevant variables, dietary calcium was negatively associated with ARMD (OR: 680, 95%CI: 0.482-0.960). In contrast to dietary form, serum concentration of calcium was not associated with ARMD. Moreover, increased dietary calcium was associated with reduced ARMD (OR: 0.684, 95%CI: 0.468-1.000). CONCLUSION: A lower consumption of dietary calcium was significantly associated with a higher risk of ARMD. Further longitudinal studies are necessary to explore these findings.

Serum Bilirubin and Sperm Quality in Adult Population.

The neurotoxicity of bilirubin has been extensively reported in numerous studies. However, the association between bilirubin and male fertility has not yet been studied. The main goal of this study was to investigate the association between serum total bilirubin and sperm quality in an adult population. In this cross-sectional study, 9057 participants who attended the MJ health examination (2010-2016) were enrolled. Sperm specimens were collected by masturbation, and sperm quality was analyzed in accordance with the WHO criteria. Serum total bilirubin levels were measured by an automatic biochemical profile analyzer. Thereafter, the associations between serum total bilirubin and sperm quality were determined by a multivariable linear regression. Serum total bilirubin was inversely associated with sperm concentration and normal morphology with ß values of -13.82 (95% CI: -26.99, -0.64) and -18.38 (95% CI: -30.46, -6.29) after adjusting for covariables. The highest levels of serum total bilirubin were significantly associated with sperm concentration and normal morphology with ß values of -14.15 (95% CI: -28.36, 0.06) and -21.15 (95% CI: -33.99, -8.30). Our study highlighted the potential impact of serum bilirubin on sperm quality in a male population. Additional longitudinal research is necessary to explore these findings and underlying mechanisms.

Association between Dietary Calcium and Potassium and Diabetic Retinopathy: A Cross-Sectional Retrospective Study.

BACKGROUND: Micronutrients are considered to have an important role in metabolic process. The relationships between micronutrients and diabetic complication, such as retinopathy, are rarely discussed. The main purpose of the current study was to investigate the relationship between dietary micronutrients and diabetic retinopathy in an adult population. METHODS: 5321 participants from National Health and Nutritional Examination Survey (NHANES) 2005-2008 were included in this cross-sectional study. Diabetic retinopathy was diagnosed by the severity scale of the Early Treatment Diabetic Retinopathy Study (ETDRS) using nonmydriatic fundus photography. Micronutrients were assessed by 24-h dietary recall. The relationship between dietary micronutrients and the occurrence of diabetic retinopathy was analyzed by a logistic regression model. RESULTS: Dietary calcium and potassium were inversely associated with diabetic retinopathy (OR: 0.729, 95%CI: 0.562-0.945; OR: 0.875, 95%CI: 0.787-0.973). Higher quartile of dietary calcium and potassium was associated with lower occurrence of diabetic retinopathy (OR: 0.664, 95%CI: 0.472-0.933; OR: 0.700, 95%CI: 0.495-0.989). Furthermore, increased amounts of dietary calcium and potassium were significantly associated with reduced occurrence of diabetic retinopathy (OR: 0.701, 95%CI: 0.546-0.900; OR: 0.761, 95%CI: 0.596-0.972). CONCLUSIONS: Higher levels of dietary calcium and potassium are suggested to reduce the risk of diabetic retinopathy with dose-response effect. The evaluation of dietary micronutrients might be a part of treatment for patients with diabetic complications.

Clinical association between trace elements of tear and dry eye metrics.

Trace elements exposure is proposed to play a role in the pathogenesis of the systemic disease. Emerging studies have suggested that trace metal exposure may contribute to dry eye disease. Our study primarily aimed to investigate the association between trace metal exposure in tear samples and the presence of dry eye metrics in the shipyard industry. Overall, 84 eligible participants from the shipyard industry were included in this cross-sectional study. The parameters for identifying dry eye symptoms included O.S.D.I., SPEED, N.I.B.U.T., and ocular surface conditions, such as tear meniscus height, eye blinking, and meibomian gland area were performed by S.B.M. sistemi ocular surface analyzer. The concentration of tear trace elements was detected by inductively coupled plasma mass spectroscopy (ICP-MS). The association between tear trace elements and dry eye parameters was investigated using regression models. Participants in the exposure group had significantly higher levels of tear Pb than the control group. In the exposure group, tear Pb was significantly associated with increased SPEED and O.S.D.I. score with beta coefficients of 0.144 (95% CI 0.092, 0.197), 0.121 (95% CI 0.049, 0.194), respectively, and decreased lower and upper meibomian gland area with beta coefficients of - 0.158 (- 0.283, - 0.033) and - 0.228 (- 0.396, - 0.061), respectively. Tear trace elements exposure is considered to impact the appearance of dry eye metrics. Improving the occupational environment and monitoring the ocular surface health may benefit workers under exposure to trace elements.

Sleep deprivation and immunoglobulin E level.

Objectives: Sleep deprivation is a common issue for modern people and leads to many morbidities and mortality. Some papers also suspected the relationship between Immunoglobulin E (IgE) level and sleep deprivation. The purpose of this article is to make the vicious circle between serum IgE level and sleep deprivation clear. Materials and methods: In this study, we included 4,460 population aged around 48 years old respective 2,145 males and 2,315 females enrolled in the National Health and Nutrition Examination Survey (NHANES). Sleep durations were recorded, in hours, in whole numbers by the participants. The levels of total IgE were measured by anti-IgE. All procedures were analyzed using SPSS version 18 (SPSS, Inc., Chicago, IL, USA). Result: The statistical significance between higher IgE level and ≤5 h sleep duration was noted (Beta coefficients: 64.04, 95% confidence interval (CI): 2.35, 125.72, P = 0.042). In sex difference, the correlation between short sleep duration and high serum IgE levels was noted in male [Beta coefficients: 120.225 (P = 0.008)] but not in female. There were no positive findings in the ethnicity-based correlation between serum IgE levels and sleep duration. Conclusion: This study indicated that short sleep duration (≤5 h) is associated with higher serum IgE levels, especially in men. Further longitudinal investigations concerning the effect of sleep deprivation on serum IgE might provide a better explanation for the pathophysiology underlying autoimmune disease and sleep deprivation.

Unraveling the relationship between serum 25­hydroxyvitamin D levels and trabecular bone score in American adults.

INTRODUCTION: Trabecular bone score (TBS) is a novel way for clinicians to evaluate bone quality. It is directly associated with the mechanical strength of bones and helps predict fractures. Vitamin D, a secosteroid that enhances calcium absorption, is commonly used to strengthen the skeletal system. OBJECTIVES: The present analysis aimed to determine the relationship between vitamin D levels and TBS by analyzing data from the National Health and Nutrition Examination Survey. PATIENTS AND METHODS: A total of 4464 persons (2148 men and 2316 women) were included in our study. The participants were analyzed according to sex, obesity status, and T­score using regression models. RESULTS: We noted a remarkably positive relationship between serum levels of 25­hydroxyvitamin D (25[OH]D) and TBS after the results were fully adjusted (ß = 0.319; 95% CI, 0.145-0.494; P <0.001). T­score analysis showed that serum 25(OH)D levels were related to TBS in the group of participants with normal bone mineral density (T­score >-1) (ß = 0.311; 95% CI, 0.097-0.525; P = 0.005). However, in the osteopenia (T­score between -1 and -2.5) and osteoporosis (T­score <-2.5) group there was no such association (P >0.05). CONCLUSIONS: Our study shows that low serum levels of 25(OH)D may decrease the TBS, which represents the skeletal microarchitecture and is a fracture risk factor in individuals with normal T­scores.

Low urine pH is a risk factor for low muscle mass: A new way to predict sarcopenia.

AIMS: Sarcopenia, one of the primary diseases of the older adult population, is a condition characterized by loss of skeletal muscle mass, strength and functionality. Due to its considerable economic impact, preventive interventions for sarcopenia play an important role in the older adult population. Urine includes many indicators of physiology and pathophysiology. Urine analysis is used to diagnose many different diseases. The goal of this cohort study was to examine the relationship between urine pH level and skeletal muscle mass. METHODS: This community-based cross-sectional study was carried out among 9712 Taiwanese individuals (4992 men and 4720 women). We used urine pH as an independent variable and skeletal muscle mass as a dependent variable. Bioelectric impedance analysis was used to measure the percentage of skeletal muscle mass (PSMM). We collected first fasting morning urine samples after overnight fasting, and urine pH was measured with a dipstick. In the by-sex and by-obesity analyses, we stratified the sample into two subgroups and a linear regression model was used for covariate adjustment. RESULTS: In the fully adjusted model, all-subject analysis showed a statistically significant association between urine pH and the PSMM with a ß coefficient of 0.820 (95% CI 0.615-1.025; P < 0.001). Additionally, by-sex analysis showed that urine pH was related to the PSMM in both sexes, with ß coefficients of 0.261 (95% CI 0.006-0.516; P = 0.045) in men and 0.179 (95% CI 0.029-0.328; P = 0.019) in women. By-obesity status analysis showed that urine pH was related to the PSMM in the body mass index <27 group with a ß coefficient of 0.284 (95% CI 0.101-0.466; P = 0.002) after full adjustment. However, for the body mass index ≥27 group, there was no significant relationship between urine pH and the PSMM (P > 0.05). CONCLUSION: The results showed the impacts of urine pH levels on skeletal muscle mass in both sexes and non-obese populations. Due to its easily accessible and economical characteristics, urine analysis is a convenient way to approach patients with low skeletal muscle mass and predict sarcopenia. Geriatr Gerontol Int 2021; 21: 944-949.

Life expectancy estimations and determinants of return to work among cancer survivors over a 7-year period.

Due to advances in medical science and technology, the number of cancer survivors continues to increase. The workplace needs and employment difficulties cancer survivors face after treatment need to be addressed to protect these individuals' right to work and to maintain the overall labor force of the country. We conducted a retrospective cohort study with a follow-up period from 2004 to 2010. All data analyzed in the study were obtained from the Labor Insurance Database, the Taiwan Cancer Registry of the Ministry of Health and Welfare, and the National Health Insurance Research Database. The relationships between risk factors and the presence of returning to work were analyzed by a Cox proportional hazard model. The survival rates of patients with different cancer stages were evaluated using Kaplan-Meier survival analysis. Among the employees with an initial diagnosis of cancer, 70.4% remained employed through 1 year after the diagnosis, accounting for 83.4% of all cancer survivors; only 51.1% remained employed through 5 years after the diagnosis, accounting for 78.7% of all cancer survivors, a notable decrease. Age, gender, salary, treatment method, company size, and cancer stage were the factors that affected whether employees could return to work or not. The long-term survival of people diagnosed with cancer depends on their chances of returning to work. Strengthening existing return-to-work policies and assisting cancer survivors with returning to work after the treatment should be priorities for protecting these individuals' right to work and for maintaining the overall labor force.