Metabolomic profiles to explore biomarkers of severe sarcopenia in older men: A pilot study.

BACKGROUND: The pathophysiology of sarcopenia is complex and multifactorial; however, it has not yet been fully elucidated. Identifying metabolomic profiles may help clarify the mechanisms underlying sarcopenia. OBJECTIVE: This pilot study explored potential noninvasive biomarkers of severe sarcopenia through metabolomic analysis in community-dwelling older men. METHODS: Twenty older men (mean age: 81.9 ± 2.8 years) were selected from the Korean Frailty and Aging Cohort Study. Participants with severe sarcopenia (n = 10) were compared with non-sarcopenic, age- and body mass index-matched controls (n = 10). Severe sarcopenia was defined as low muscle mass, low muscle strength, and low physical performance using the Asian Working Group for Sarcopenia 2019 criteria. Non-targeted metabolomic profiling of plasma metabolites was performed using capillary electrophoresis time-of-flight mass spectrometry and absolute quantification was performed in target metabolites. RESULTS: Among 191 plasma metabolic peaks, the concentrations of 10 metabolites significantly differed between severe sarcopenia group and non-sarcopenic controls. The plasma concentrations of L-alanine, homocitrulline, N-acetylserine, gluconic acid, N-acetylalanine, proline, and sulfotyrosine were higher, while those of 4-methyl-2-oxovaleric acid, 3-methyl-2-oxovaleric acid, and tryptophan were lower in participants with severe sarcopenia than in non-sarcopenic controls (all, p < 0.05). Among the 53 metabolites quantified as target metabolites, L-alanine (area under the receiver operating characteristic curve [AUC] = 0.760; p = 0.049), gluconic acid (AUC = 0.800; p = 0.023), proline (AUC = 0.785; p = 0.031), and tryptophan (AUC = 0.800; p = 0.023) determined the presence of severe sarcopenia. CONCLUSIONS: Plasma metabolomic analysis demonstrated that L-alanine, gluconic acid, proline, and tryptophan may be potential biomarkers of severe sarcopenia. The identified metabolites can provide new insights into the underlying pathophysiology of severe sarcopenia and serve as the basis for preventive interventions.

A Cross-Sectional Study of Perceived Dental Treatment Needs and Oral Health Status in Community-Dwelling Older Australian Men: The Concord Health and Ageing in Men Project.

BACKGROUND: Assessing perceived needs for dental treatment is important in understanding and predicting people's health behaviours. The purpose of this study is to examine older men's perceptions regarding dental treatment needs, and to investigate the disparity between perceived needs and the actual oral health of a population of community-dwelling older Australians. METHODS: Using cross-sectional data from the 4th wave of the Concord Health and Ageing in Men Project, logistic regression analysis of perceived needs for dental treatment was conducted for 596 men aged 78 and over, with functional tooth units (FTUs), number of decayed tooth surfaces, and periodontitis as independent variables. RESULTS: Thirty-six percent (n = 216) of the participants believed they required some form of dental treatment. The remaining participants did not perceive a need for treatment, yet 65.3% objectively required prosthodontic or restorative care. The regression model showed men with lower FTUs were significantly more likely to report a perceived need for dental treatment than those with 12 FTUs [0-6 FTUs: adjusted odds ratio (OR) 2.58, 95% CI 1.28-5.20; 7-11 FTUs: adjusted OR 2.43, 95% CI 1.16-5.10]. However, neither the number of decayed tooth surfaces nor the existence of periodontitis was associated with perceived dental treatment needs. CONCLUSIONS: Most older men viewed their oral health positively, and the majority of those with objectively assessed needs, did not perceive themselves as requiring dental treatment. Loss of FTUs appears to alert participants to seek treatment, but not the presence of dental caries or periodontitis.

Proinflammatory Diet Increases Circulating Inflammatory Biomarkers and Falls Risk in Community-Dwelling Older Men.

BACKGROUND: The relations between diet, chronic inflammation, and musculoskeletal health are unclear, especially among older men. OBJECTIVE: This study aimed to determine associations of the Dietary Inflammatory Index (DII) with inflammatory biomarkers, musculoskeletal health, and falls risk in community-dwelling older men. METHODS: The cross-sectional analysis included 794 community-dwelling men, mean age 81.1 ± 4.5 y, who participated in the 5-y follow-up of the Concord Health and Aging in Men Project. Of these, 616 were seen again 3 y later for the longitudinal analysis. Energy-adjusted DII (E-DII) was calculated from a validated diet history questionnaire. Bone mineral density (BMD) was measured using DXA. Twenty-four inflammatory biomarkers were analyzed. Incident falls over 3 y were determined through telephone interviews every 4 mo. Multiple regression, linear mixed effects models, negative binomial regression, and mediation analysis were utilized in this study. RESULTS: A higher E-DII score (indicating a more proinflammatory diet) was associated with higher concentrations of IL-6 (ß: 0.028 pg/mL; 95% CI: 0.003, 0.053), IL-7 (ß: 0.020 pg/mL; 95% CI: 0.002, 0.037), and TNF-α (ß: 0.027 pg/mL; 95% CI: 0.003, 0.051). A higher E-DII score was also associated with lower appendicular lean mass adjusted for BMI (ALMBMI) (ß: -0.006 kg/m2; 95% CI: -0.010, -0.001). For every unit increase in E-DII (range: -4.91 to +3.66 units), incident falls rates increased by 13% (incidence rate ratio: 1.13; 95% CI: 1.05, 1.21) over 3 y. Mediation analysis showed that the association between E-DII and 3-y incident falls was influenced by the concentrations of IL-7 by 24%. There was no association between E-DII and BMD. CONCLUSIONS: Consumption of a proinflammatory diet was associated with increased concentrations of IL-6, IL-7, and TNF-α; increased falls risk; and lower ALMBMI in community-dwelling older men. The association between incident falls and E-DII was partly mediated by concentrations of IL-7.

Three year functional changes and long-term mortality hazard in community-dwelling older men.

BACKGROUND: Low levels of physical function have been associated with higher mortality hazard in older persons. However, few studies have investigated the association between functional changes and subsequent mortality. This study aimed to examine whether 3-year functional changes independently predict subsequent all-cause mortality. METHODS: This population-based cohort study included 171 community-dwelling men aged ≥71years at wave 2 (baseline of the present analysis), living in the semi-rural community of Merelbeke (Belgium). Physical function assessments included the Short Form-36 (SF-36) Physical Function Index, Grip strength, Chair rising, and Timed Up and Go. Changes over a 3-year time were calculated using data obtained at four annual visits. RESULTS: After a 15-year follow-up, 149 men (87%) died. Median survival time was 8.2 (4.2-12.4) years. Physical function assessed at a single time point (at wave 2 or wave 5) was significantly associated with subsequent mortality hazard, independently from future or preceding 3-year changes. Greater functional declines during the 3-year follow-up were associated with higher mortality hazards. These associations were 1) more pronounced within the first seven years, 2) independent from baseline age, polypharmacy, depression, disability, and physical function, and 3) no longer significant when closure physical function was taken into account. CONCLUSION: Physical function assessed at a single time point is a robust predictor of all-cause long-term mortality in community-dwelling older men. Yet, repeated assessments of physical function can provide prognostic information beyond that available from single initial assessment. However, with repeated assessments, most prognostic information can be found in the final assessment of physical function.