[Usefulness of Simple Dietary Check Sheet as Screening Tool to Assess the Risk of Muscle Mass Reduction in Community-Dwelling Middle-Aged and Older Adults].

OBJECTIVES: The aim of this study was to investigate the usefulness of a simple dietary check sheet to assess the risk of muscle mass reduction in middle-aged and older adults. METHODS: The study participants comprised 1,272 community-dwelling individuals aged 50-89 years (mean age; 68.7 years). Bioelectrical impedance analysis was performed to estimate the appendicular skeletal muscle mass index (SMI, kg/m2). The SMIs were expressed as z-scores and adjusted for age and gender. A simple dietary check sheet was used to assess the daily intake of foods associated with maintaining muscle mass, such as meat, fish, eggs, milk, soybean products, and vegetables. RESULTS: Individuals with reduced muscle masses (SMI z-scores < -1.0) had significantly lower intakes of meat, fish, eggs, milk, and vegetables, and a lower overall dietary intake than individuals without reduced muscle masses (SMI z-scores ≥ -1.0). Food intake score was calculated to obtain quantitative estimates of the daily intake of these foods. The scores ranged from 0 to 14, with higher scores indicating higher intakes of foods that contribute to maintaining the muscle mass. Compared with the reference group with scores of ≥ 10, the groups with lower scores were at a higher risk of muscle mass reduction. The odds ratios (95% confidence interval) of the groups with scores of 9, 8, 7, 6, and ≤ 5 were 1.15 (0.42-3.13), 2.10 (0.89-4.95), 3.64 (1.61-8.23), 4.49 (1.90-10.58), and 7.53 (3.06-18.51), respectively, after adjusting for age, gender, obesity, alcohol intake, smoking, physical inactivity, hypertriglyceridemia, diabetes mellitus, and liver dysfunction. CONCLUSIONS: As the food intake scores were significantly associated with decreased muscle mass, the proposed simple dietary check sheet may help assess the risk of muscle mass reduction in middle-aged and older adults from a nutritional perspective.

Exaggerated blood pressure response to exercise is associated with subclinical vascular impairment in healthy normotensive individuals.

BACKGROUND: This study was designed to evaluate the possible association between an exaggerated blood pressure (BP) response to exercise and subclinical vascular impairment in normotensive individuals. METHODS: The study participants consisted of 92 untreated normotensive men (aged 42 ± 9 years) without a history of cardiovascular disease or stroke. A graded exercise test was conducted using a bicycle ergometer, and the mean arterial pressure (MAP) during submaximal exercise was evaluated. The brachial-ankle pulse wave velocity (baPWV) was measured as an index of arterial stiffness. The second peak of radial systolic BP (SBP2) was used as an estimate of central BP. The albumin-to-creatinine ratio (ACR) values were determined as the mean of two nonconsecutive spot urine specimens. RESULTS: Compared with individuals with a normal response (MAP z-score < +1.0, n = 60), those with an exaggerated BP response to exercise (MAP z-score ≥ +1.0, n = 32) exhibited significantly higher baPWV (1412 ± 158 vs. 1250 ± 140 cm/s), radial SBP2 (122 ± 11 vs. 106 ± 13 mmHg), and greater log-ACR (0.93 ± 0.30 vs. 0.59 ± 0.23 mg/gCre). Multiple regression analysis revealed that an exaggerated BP response to exercise was significantly associated with baPWV (ß = 0.198, P= .043), radial SBP2 (ß = 0.156, P = .049), and log-ACR (ß = 0.276, P = .006) independent of potential confounding factors. CONCLUSIONS: These results suggest that subclinical vascular impairment is associated with an exaggerated increase in BP during exercise even in the absence of clinical hypertension.

Muscle mass reduction, low muscle strength, and their combination are associated with arterial stiffness in community-dwelling elderly population: the Wakayama Study.

Age-related loss of skeletal muscle mass and function is associated with some predisposing factors that increase the risk of vascular damage. This study aimed to examine whether muscle mass reduction, low muscle strength, and their combination were related to arterial stiffness in community-dwelling elderly population. Study participants consisted of 1046 elderly individuals (aged 72 ± 5 years) without cardiovascular disease, chronic kidney disease, or liver disease. Bioelectrical impedance analysis was performed to estimate appendicular skeletal muscle mass (ASM). A value for ASM was normalized for height (ASM index, kg/m2). Handgrip strength (HGS) was measured using a Smedley grip dynamometer. Brachial-ankle pulse wave velocity (baPWV) was evaluated as an index of arterial stiffness using a simple automatic oscillometric technique. When participants were stratified based on baPWV cut-off values (< 1800 cm/s, 1800 to 1999 cm/s, ≥ 2000 cm/s), ASM index and HGS progressively decreased with an increase in baPWV levels (P for trend < 0.001). In multiple regression analysis, baPWV was significantly associated with ASM index (ß = -0.270, P < 0.001) and HGS (ß = -0.102, P < 0.001) independent of potential confounding factors. The baPWV of the subgroup with low ASM index and low HGS was significantly higher than that of those with only low ASM index or low HGS (P < 0.001). These results suggest that loss of skeletal muscle mass and function is associated with increased arterial stiffness in the elderly population, and the combination of muscle mass reduction and low muscle strength may lead to greater arterial stiffness than each of the individual conditions.

Morphologic classification of nailfold capillary microscopy in workers exposed to hand-arm vibration.

The aim of this study was to investigate the association between the morphologic classification of nailfold capillary microscopy and the clinical and demographic findings in workers exposed to hand-arm vibration. The subjects were 44 male forestry workers (average age; 51.9 ± 14.8 yr). The nailfold capillaries (NC) and the mean blood flow velocity were measured on the middle finger of the dominant side by a peripheral capillary observer. The analyses were made using 39 subjects after excluding five subjects who received medication for hypertension. The observed NC were classified into 5 types according to Kusumoto's classification: Type I, n=5; Type II, n=15; Type III, n=8; Type IV, n=5; and Type V, n=6. After excluding the subjects in the Type V, we divided the subjects into two groups: Type I/II group, n=20; and Type III/IV group, n=13. In the Type III/IV group, the operating year of handheld vibrating tools was relatively longer, the mean blood flow velocity was significantly slower, and the body mass index was relatively higher as compared to the Type I/II group. These results suggested that the nailfold capillary microscopy may reflect the effect of the vibration exposure.

Laser Doppler imaging of skin blood flow for assessing peripheral vascular impairment in hand-arm vibration syndrome.

The objective of this study was to evaluate the usefulness of laser Doppler imaging (LDPI) of the skin blood flow for assessing peripheral vascular impairment in the hand-arm vibration syndrome (HAVS). The subjects were 46 male patients with HAVS, aged 50 to 69 yr, and 31 healthy male volunteers of similar age as controls. A cold provocation test was carried out by immersing a subject's hand on his more severely affected side into cold water at a temperature of 10 degrees C for 10 min. Repeated image scanning of skin blood flow of the index, middle, and ring fingers was performed every 2 min before, during, and after the cold water immersion using a PMI-II laser Doppler perfusion imager. The mean blood perfusion values in the distal phalanx area of the fingers were calculated on each image. The patients suffering from vibration-induced white finger (VWF, n=20) demonstrated significantly lower skin blood perfusion at each interval of the test as compared with those without VWF (n=26) and the controls (p<0.01, ANOVA). The blood perfusions in the HAVS patients were associated with the severity of the symptoms as classified by the Stockholm Workshop scale for vascular staging. When a subject was considered to be positive if any of the tested fingers showing a decreased blood perfusion and/or a delayed recovery pattern, the sensitivity was 80.0%, and the specificity was 84.6% and 93.5% for patients without VWF and the controls, respectively. These results suggest that the LDPI technique could provide detailed and accurate information that may help detect the existence of impaired vascular regulation to cold exposure in the fingers of workers exposed to hand-transmitted vibration.

Preliminary study on the assessment of peripheral vascular response to cold provocation in workers exposed to hand-arm vibration using laser Doppler perfusion imager.

Measurements of changes in finger skin blood flow with laser Doppler perfusion imaging (LDPI) in response to cold provocation test (10 degrees C, 10 min) were performed in 12 men suffering from vibration induced white finger (VWF) and 13 exposed controls. The mean perfusion values in both groups reduced markedly as a result of immersion of the hand in cold water. In the controls, however, the mean value increased gradually until the end of the cold provocation, while that in the VWF subjects remained at the lowest level. After removal of the hand from the cold water, the skin blood perfusion in the controls recovered rapidly and nearly reached the baseline value. In the VWF subjects, it had a slight increase immediately following the cold immersion but no tendency to rise as the time span increased. Analysis of covariance controlling for possible confounders revealed that the VWF subjects had significantly lower perfusion values compared to the controls in the last several minutes of the cold provocation and the following recovery. These findings suggest that the LDPI technique enables visualizing and quantifying the peripheral vascular effects of cold water immersion on the finger skin blood perfusion and thus has the potential of providing more detailed and a&curate information that may help detect the peripheral circulatory impairment in the fingers of vibration-exposed workers.