Sex differences in the prevalence and adverse outcomes of sarcopenia and sarcopenic obesity in community dwelling elderly in East China using the AWGS criteria.

BACKGROUND: Sarcopenia and sarcopenic obesity (SO) have a greater impact on the elderly. This study aimed to explore whether there were sex differences in the prevalence and adverse outcomes of sarcopenia and SO in community-dwelling elderly individuals in East China. METHODS: This was a cross-sectional study that enrolled 213 males and 418 females aged > 65 years. Demographic characteristics, body composition, hand grip, gait speed, and indices of glucose and lipid metabolism were collected. Sarcopenia and SO were diagnosed using the Asian Working Group for Sarcopenia criteria. RESULTS: (1) The prevalence of sarcopenia was 19.2% in males and 8.6% in females. The prevalence of SO was 7.0% in males and 2.4% in females. (2) In males, the odds ratios (ORs) of osteoporosis and dyslipidemia in the SO group were 4.21-fold and 4.15-fold higher than those in the normal group, respectively. In females, the ORs of osteoporosis and hyperglycemia in the SO group were 1.12-fold and 4.21-fold higher than those in the normal group. CONCLUSIONS: Males were more likely to be sarcopenic and to have SO than females using the AWGS criteria. Females with SO were more likely to have higher blood glucose, whereas males with SO were more likely to have osteoporosis and dyslipidemia.

A cross-sectional study of loss of muscle mass corresponding to sarcopenia in healthy Chinese men and women: reference values, prevalence, and association with bone mass.

A cross-sectional survey was conducted in Shanghai, eastern China, to evaluate the prevalence of loss of muscle mass corresponding to sarcopenia in Chinese men and women and compare the results with the prevalence in other populations. We also analyzed the differences between men and women, and assessed the effect of lean mass and fat mass of different regions on bone mass. A total of 1766 men and 1778 women aged 18-96 years participated in this study. Bone mineral density of spine and femur, and lean mass and fat mass of several body regions were measured by dual-energy X-ray absorptiometry. Class 1 and class 2 sarcopenia were defined as the appendicular lean mass (ALM) index (ALM/height(2)) 1 and 2 standard deviations below the sex-specific means for young adults. Mean values for ALM index were 7.93 for men and 6.04 kg/m(2) for women, aged 18-40 years. The reference values for classes 1 and 2 sarcopenia were 7.01 and 6.08 kg/m(2) in men and 5.42 and 4.79 kg/m(2) in women. The prevalence of sarcopenia was 4.8% in women and 13.2% in men aged 70 years and older, which is lower than that in Caucasian populations, but the same as that in Japanese and Koreans in Asia. Men demonstrated greater declines in muscle mass with aging than women, partly due to the protective effect of fat mass on lean mass in women. Leg lean mass was the strongest factor on femur bone mass; however, trunk lean mass was the strongest factor on spine bone mass. Maintaining a healthy weight is important for the elderly in order to avoid osteoporosis and sarcopenia.

A Modified Hyaluronic Acid-Based Dissolving Microneedle Loaded With Daphnetin Improved the Treatment of Psoriasis.

Psoriasis is a common chronic immune-inflammatory disease. Challenges exist in the present treatment of psoriasis, such as difficulties in transdermal drug administration and severe side effects. We hope to achieve a better therapeutic outcome for psoriasis treatment. By using modified soluble microneedles (MNs) loaded with daphnetin, the psoriasis symptoms of mice, the abnormal proliferation of keratinocytes, and the secretion of inflammatory factors were significantly reduced. In vitro, daphnetin is proven to inhibit the NF-κB signaling pathway and to inhibit the proliferation of HaCaT cells and the release of inflammatory factors, especially CCL20. This research showed that the modified microneedle loaded with daphnetin optimized transdermal drug delivery and relieved the symptoms of psoriasis more effectively. The novel route of Daph administration provides a future research direction for the treatment of psoriasis.

[Investigation on bone health conditions in 1637 aged women].

OBJECTIVE: To investigate bone health conditions in 1637 aged women. METHODS: From May 2004 to October 2008, Bone mineral density (BMD) of 1637 women at age of more than 60 years old were measured by Hologic DephiA dual energy X-ray absorptiometry (DXEA) in Huadong hospital affiliated to Fudan University. All data were compared and analyzed among each group which will be divided by every ten years. Those women were divided into groups on 10 years range. BMD of lumbar vertebral and hip bone, fracture incidence and bone turnover marker were compared and analyzed. RESULTS: (1) BMD: at age of ≥90, 80-89, 70-79, 60-69, BMD of the lumbar vertebral 2-4 (L2-4) values were (0.96±0.18), (0.90±0.20), (0.81±0.16), (0.83±0.14) g/cm2, respectively. There were significantly increased BMD of lumbar of women at the age of 80-89 and ≥90 year-old compared with those of 60-69 year-old (P<0.05). At age of ≥90, 80-89, 70-79, 60-69 BMD of femur neck, Total, Torch, Ward's trianger were (0.60±0.11), (0.65±0.11), (0.47±0.09), (0.37±0.09) g/cm2; at age of 80-89 BMD of FN, Total, Torch, Ward's trianger were (0.57±0.10), (0.68±0.13), (0.48±0.11), (0.35±0.10) g/cm2; at age of 70-79 BMD of FN, Total, Torch, Ward's trianger were (0.57±0.10), (0.69±0.12), (0.49±0.10), (0.36±0.11) g/cm2; at age of 60-69 BMD of FN, Total, Torch, Ward's trianger were (0.63±0.10), (0.76±0.12), (0.54±0.10), (0.45±0.15) g/cm2; There were significantly decreased in BMD of hip at the age of 70-79, 80-89, ≥90 year-old compared with those of 60-69 year-old (P<0.05). (2) Fracture incidence:one time fracture incidence at age of 60-69, 70-79, 80-89, ≥90 were 34.8% (242/695), 45.0% (296/658), 51.3% (137/267), 5/17. There were increasing trend of fracture in aged women. (3) Bone turnover marker of bone Gla protein (BGP) N-mid (N-midBGP) in serum and C-terminal telopeptide of type I collagen/Cr (CTX/Cr) in urine values were (17±5) µg/L, (106±56) µg/mmol at age of more than 90 years, (17±7) µg/L, (128±99) µg/mmol at age of 80-89 years, (21±14) µg/L, (182±173) µg/mmol at age of 70-79 years, (25±13) µg/L, (190±168) µg/mmol at age of 60-69 years. There were significant decreased trends of N-midBGP at age of 70-79, 80-89 compared with that of 60-year (P<0.05). There were significant decreased trends of CTX/Cr 80-89 compared with that of 60-year (P<0.05). CONCLUSIONS: There were significant decreased bone metabolism in aged women. The risk of hip fracture is significantly increased in aged women. Diagnosis of osteoporosis based on BMD of hip in aged women is more reliable.

Age and sex effects on the relationship between body composition and hip geometric structure in males and females from East China.

The study finds bone mineral density is the principal determinant of hip geometry and lean mass is a better determinant than fat mass in Chinese. Moreover, the impact of fat on skeleton differs with age, with a negative effect in young people but a more positive effect in elderly. PURPOSE: The aim of this study was to examine whether the correlation between body composition including bone mineral density (BMD), lean mass (LM) and fat mass (FM), and hip geometric structure change with aging in males and females from East China. METHODS: It was a cross-section study. A total of 1168 healthy male and 1066 healthy females in Shanghai were divided into six groups based on their age and sex. All participants were evaluated by assessing the BMD of lumber spine and proximal hip, total LM, total FM, and geometric parameters of the hip such as the cross-sectional area (CSA), average cortical thickness (ACT), and the buckling ratio (BR) at the narrow neck (NN), the intertrochanter (IT), and the shaft (FS). RESULTS: Among the three body composition, the correlation between hip BMD and hip geometric structure was strongest. LM showed significantly positive correlations with CSA. FM showed negative or little positive correlation with hip geometry in the young group. However, the degree of the contribution of FM to hip geometric structure became substantially positive with aging. Limb LM produced the largest positive contribution to CSA and ACT at all three regions in young males. However, in older males the trunk LM produced the largest positive contribution to CSA and ACT. CONCLUSIONS: Among all body composition parameters, hip BMD showed the largest correlation with hip geometric structure, with LM showing the second largest. The impact of FM and LM on hip geometry changed with aging and with different distributions of lean mass and fat mass.

Circulating TGF-ß1 levels are negatively correlated with sclerostin levels in early postmenopausal women.

BACKGROUND: TGF-ß1 regulates bone metabolism and mediates bone turnover during postmenopause. Sclerostin negatively regulates Wnt signaling pathway and also has an important role in postmenopausal bone loss. Little is known about the relationship between serum TGF-ß1 and sclerostin during menopause. METHODS: We compared serum levels of TGF-ß1 and sclerostin in pre- and postmenopausal women and assessed the potential correlations of these levels with each other and with serum levels of bone turnover markers and bone mineral density. RESULTS: A total of 176 women (58 premenopausal, 62 early postmenopausal, and 56 late postmenopausal) were included in this study. Serum TGF-ß1 level was significantly higher in early postmenopausal women compared with premenopausal (32.0±7.19 vs. 26.55±6.67 ng/ml, p=0.01) and late postmenopausal (32.0±7.19 vs. 28.65±7.70 pg/ml, p=0.031) women, and no significant differences in serum sclerostin levels were observed among the 3 groups. There was a significant negative correlation between TGF-ß1 and sclerostin in early postmenopausal women, but not in other groups of women. Based on multiple regression analysis, only TGF-ß1 (ß=-0.362; p=0.007) was an independent predictor of sclerostin during early postmenopause. CONCLUSIONS: Our findings suggest that serum TGF-ß1 level increases during postmenopause and declines in old age. Sclerostin production is inhibited by TGF-ß1 during early postmenopause.

Prevalence of Sarcopenia and Its Relationship with Sites of Fragility Fractures in Elderly Chinese Men and Women.

OBJECTIVE: Sarcopenia might be associated with bone fragility in elderly individuals. This study aimed to investigate the prevalence of sarcopenia and its association with fragility fracture sites in elderly Chinese patients. METHODS: Patients (322 men and 435 women) aged 65-94 years and with a history of fragility fractures in the ankle, wrist, vertebrae or hip, and healthy men (n = 1263) and women (n = 1057) aged 65-92 years without a history of fractures were enrolled. Whole-body dual energy X-ray absorptiometry was used to analyze skeletal muscle mass index (SMI), fat mass and bone mineral density. Sarcopenia was defined as SMI less than two standard deviations below the mean of a young reference group. RESULTS: Sarcopenia occurrence varied with fracture location. Sarcopenia was more common in females with vertebral and hip fractures and in men with hip and ankle fractures than in the non-fracture group). Sarcopenia was significantly more prevalent in men with wrist, hip and ankle fractures than in women. SMI was correlated with BMD in different fracture groups. Logistic regression analyses revealed that lower SMI was associated with an increased risk of hip fracture both in men and women and ankle fracture in men. DISCUSSION: Sarcopenia may be an independent risk factor for hip and ankle fractures in men, and for hip fractures in women.