Effect of high plant protein/peptide nutrition supplementation on knee osteoarthritis in older adults with sarcopenia: A randomized, double-blind, placebo-controlled trial.

BACKGROUND & AIMS: Skeletal muscle is an important contributor to joint health. Previous studies have shown that age-related muscle mass and strength loss are closely associated with the development of knee osteoarthritis. The objective of this study is to investigate whether a high plant protein/peptide nutrition supplementation can alleviate knee osteoarthritis by improving muscle mass and strength. METHODS: This randomized, double-blind, placebo-controlled trial that included participants aged 50-70 years diagnosed with knee osteoarthritis and sarcopenia was conducted in China from February 2022 to September 2022 (ChiCTR2200056415). Participants were randomly assigned to receive either a 12-week high plant protein/peptide nutrition supplementation or a placebo twice daily, with one serving each after breakfast and dinner, respectively. The primary outcome analyzed using intention-to-treat analysis was difference in Short Physical Performance Battery (SPPB) from baseline to week 12 between the two groups. The secondary outcomes included changes in muscle mass, strength, symptom and imaging of knee osteoarthritis, body composition, biochemical parameters, and health quality scores. RESULTS: After 12 weeks, a total of 124 participants (38.7% male) completed the trial and were included in the final analysis. Over the 12-week follow-up, the experimental group showed a significant improvement in the SPPB total score (1.03, 95% CI, 0.69 to 1.38, P < 0.0001) compared with the placebo group. Grip strength (2.83 kg, 95% CI, 2.13 to 3.53, P < 0.0001) and skeletal muscle mass index (0.66 kg/m2, 95% CI, 0.45 to 0.86, P < 0.0001) were also significantly increased in the experimental group relative to the placebo group. The mean change in Western Ontario and McMaster Universities Osteoarthritis Index total score was -3.95 points (95% CI, -5.02 to -2.89, P < 0.0001) in the experimental group and 0.23 points (95% CI, -0.17 to 0.63, P = 0.253) in the placebo group. Additionally, within the experimental group, nine participants experienced an improvement in osteophyte magnetic resonance imaging results, while no improvement was observed in the placebo group. The experimental group also exhibited significant improvements in health quality compared with the placebo group as assessed by Short Form 36, the World Health Organization Quality of Life Brief Scale, and the Chalder Fatigue Scale. No serious adverse events were reported during the trial. CONCLUSION: Oral supplementation with high levels of plant protein/peptides can alleviate symptoms of osteoarthritis in elderly individuals with minor or mild knee osteoarthritis and sarcopenia. This improvement may be attributed to the enhancements of muscle mass, strength, and physical performance.

Association of low muscle mass index and sarcopenic obesity with knee osteoarthritis: a systematic review and meta-analysis.

BACKGROUND: Sarcopenia and knee osteoarthritis are common age-related diseases that have become important public health issues worldwide. Few studies have reported the association between muscle mass loss and knee osteoarthritis. This may be due to the high level of heterogeneity between studies stemming from different definitions of muscle mass loss. METHODS: The systematic searches were carried out in PubMed and Web of Science from the inception of the databases until 13 January 2023, by two independent researchers. Pooled odds ratios (ORs) for overall and subgroup analyses were obtained using either a random effects model (I2 >50%) or fixed effects model (I2 ≤50%) in Stata. RESULTS: Of the 1,606 studies identified, we ultimately included 12 articles on the association between muscle mass and knee osteoarthritis (prospective: n = 5; cross-sectional: n = 7). Low-quality evidence indicated that low muscle mass index and sarcopenic obesity increase the odds of knee osteoarthritis (low muscle mass index OR: 1.36, 95% CI: 1.13-1.64; sarcopenic obesity OR: 1.78, 95% CI: 1.35-2.34). However, no association was observed between general sarcopenia or low muscle mass with knee osteoarthritis. CONCLUSION: This systematic review and meta-analysis revealed that low muscle mass index and sarcopenic obesity were associated with an increased risk of developing knee osteoarthritis.

Tracing solute sources and carbon dynamics under various hydrological conditions in a karst river in southwestern China.

Understanding the mechanisms that lead various hydrological conditions to influence solute and carbon dynamics in karst rivers is a crucial issue. In this study, high-frequency sampling and analyses of water chemistry and ẟ13CDIC were conducted from October 2013 to September 2014 in a typical karst river, the Beipan River in southwestern China. The major ions (such as Ca2+, Mg2+, HCO3-, K+, SO42-, Na+, and Cl-) in the river are mainly from the weathering of carbonates and silicates and present temporal hydrological variabilities. Sr and U are mainly derived from carbonate weathering and show chemostatic behaviors responding to increasing discharge, similar to carbonate-sourced ions Ca2+, Mg2+, and HCO3-. Silicate weathering is the primary source of Al and Li, which show significant dilution effects similar to those of Na+ responding to high discharge. Meanwhile, most dissolved trace elements (such as Zn, Cu, Ba, Sb, Mn, Mo, and Pb) are strongly impacted by anthropogenic overprints and also exhibit a significant seasonal variability, which may be related with mining activities in the investigated area. A simultaneous increase of ẟ13CDIC and decrease in ∆DIC contents and pCO2 values suggests that photosynthesis is the primary control on riverine DIC variability during the high-flow season. Besides, the pCO2 values display significant chemostatic behaviors owing to the influx of biological CO2, which is produced by microbiological activities and ecological processes, and enhanced by monsoonal climatic conditions. A two-dimensional endmember mixing model demonstrates that carbonate weathering (averaging 62%) along with biological carbon (averaging 38%) are main sources to the riverine DIC, with temporal variability. Consequently, these results show that carbonate weathering and involved plant photosynthesis are the dominant processes controlling the riverine DIC contents under high discharge and temperature conditions. This work provides insight into the crucial influence of hydrological variability on solute sources and carbon dynamics under monsoonal climate for the karst rivers.