Prevalence of Ideal Cardiovascular Health Metrics among Young Asian Adults over 5 Years of Follow-Up.

BACKGROUND: Ideal cardiovascular health (CVH) metrics play an important role in preventing cardiovascular disease (CVD). However, there is a lack of cohort studies on CVH metrics among young Asian adults. The aims of this study were to describe early changes in CVH among young Asian adults and to investigate the association between CVH metrics and sociodemographic variables. METHODS: A total of 10,000 young adults (aged 21-30 years) were recruited between 2000 and 2016. There were two CVH measurements taken from these participants over the study period. One measurement was taken at the beginning, and the other was taken five years later. Subgroup analysis of the changes in CVH metrics was divided by education level and marital status. RESULTS: The mean age of the participants was 26.8 years. The initial prevalence of ideal CVH metrics was 52.3% and 86.8% and decreased to 43.8% and 81.2% after five years for males and females, respectively. In the subgroup analysis, males with less than a university education had a smaller ideal CVH metric decrease (6.2%) than males with more than a university education (8.9%), while females with more than a university education had a smaller ideal CVH metric decrease (5.4%) than females with less than a university education (7.3%). Married males had a smaller ideal CVH metric decrease (6.1%) than single males (9.1%), while single females had a smaller ideal CVH metric decrease (5.3%) than married females (6.2%). CONCLUSIONS: The prevalence of ideal CVH metrics among young adults gradually decreased as age increased. Higher educational attainment and unmarried status were associated with a greater prevalence of ideal CVH metrics regardless of sex, but early CVH changes differed by sex, education level, and marital status. The prevalence of CVH changes found early among young adults can be used to monitor CVH changes quickly. Effective health promotion programs are needed to maintain CVH metrics among young adults.

Relationship between Ideal Cardiovascular Health and Incident Proteinuria: A 5 Year Retrospective Cohort Study.

The objective of this study was to examine whether a higher number of ideal cardiovascular health (CVH) metrics are beneficial for lowering the risk of proteinuria. This is a retrospective cohort study with an average follow-up of 5 years. Participants between 21 and 75 years old and without a history of cardiovascular disease and proteinuria were enrolled. CVH metrics, including smoking, diet, physical activity, blood pressure, body mass index (BMI), cholesterol, and fasting glucose, were assessed by questionnaires, physical examination, and blood analysis. Proteinuria was assessed by dipstick measurement. During the follow-up period, 169,366 participants were enrolled, and 1481 subjects developed proteinuria. A higher number of ideal CVH metrics was related to a lower risk of proteinuria after adjustment. Among the components of CVH metrics, ideal blood pressure (HR = 0.33, 95% CI = 0.25-0.43), fasting glucose (HR = 0.17, 95% CI = 0.12-0.22), and BMI (HR = 0.20, 95% CI = 0.15-0.27) had beneficial effects on proteinuria. Despite no significant benefit of diet score, the corresponding lower sodium intake showed a lower risk of proteinuria (HR = 0.58, 95% CI = 0.43-0.79). Incident proteinuria was inversely related to the number of ideal CVH metrics. CVH metrics may be a predictor of proteinuria, and achieving a higher number of ideal scores should be recommended as a proteinuria prevention strategy.

Exploring Muscle Health Deterioration and Its Determinants Among Community-Dwelling Older Adults.

Background: Age-related muscle mass and function decline are critical issues that have gained attention in clinical practice and research. Nevertheless, little is known regarding the time course of muscle health progression, and its determinants during this transition should be estimated. Methods: We enrolled community-dwelling adults aged ≥65 years during their regular health checkup. The participants' body composition and muscle function were measured annually from 2015 to 2021. Presarcopenia was characterized by the loss of muscle mass only; dynapenia was defined as low muscle function without changes in muscle mass; and sarcopenia was indicated as a decline in both muscle mass and muscle function. We observed the natural course of muscle health progression during aging. The relationship between muscle health decline and different determinants among old adults was examined. Results: Among 568 participants, there was 18.49%, 3.52%, and 1.06% of healthy individuals transited to dynapenia, presarcopenia, and sarcopenia, respectively. Significant positive correlations between age, fat-to-muscle ratio (FMR) and the dynapenia transition were existed [hazard ratio (HR) = 1.08 and HR = 1.73, all p < 0.05]. Serum albumin level had negative correlation with the dynapenia transition risk (HR = 0.30, p = 0.004). Participants with these three risk factors had the highest HR of dynapenia transition compared to those without (HR = 8.67, p = 0.001). A dose-response effect existed between risk factors numbers and the risk of dynapenia transition (p for trend < 0.001). This positive association and dose-response relationship remains after multiple covariates adjustment (HR = 7.74, p = 0.002, p for trend < 0.001). Participants with two or more than two risk factors had a higher risk of dynapenia transition than those with low risk factors (p = 0.0027), and the HR was 1.96 after multiple covariate adjustment (p = 0.029). Conclusion: Healthy community-dwelling old adults tended to transit to dynapenia during muscle health deterioration. Individuals with older age, higher FMR, lower albumin level had a higher risk of dynapenia transition; and a positive dose-response effect existed among this population as well.

Association Between Ideal Cardiovascular Health and Vegetarian Dietary Patterns Among Community-Dwelling Individuals.

Background: Vegetarians have been shown to have better metabolic profiles than non-vegetarians, and vegetarianism has potential beneficial effects on cardiovascular disease. However, there is a lack of studies on vegetarians that examine both metabolic profiles and lifestyle habits, such as physical activity, smoking habits, and dietary patterns, which are equally important in the context of cardiovascular disease. We explored whether a vegetarian diet is associated with both metabolic traits and lifestyle habits by assessing cardiovascular health (CVH) metrics. Methods: This was a cross-sectional study conducted in a Taiwanese population. Data collected between 2000 and 2016 were extracted from the MJ Health database. Participants aged 40 years and older without cardiovascular disease were included. CVH metrics included smoking habits, blood pressure, total cholesterol, serum glucose, body mass index, physical activity, and healthy diet score. Vegetarian participants were full-time vegetarians who did not consume meat or fish. All the data were assessed from self-report questionnaires, physical examinations, and blood analyses following standard protocol. Multiple logistic regression analysis was used to evaluate the association between vegetarianism and CVH metrics. Results: Of 46,287 eligible participants, 1,896 (4.1%) were vegetarian. Overall, vegetarians had better CVH metrics (OR = 2.09, 95% CI = 1.84-2.37) but lower healthy diet scores (OR = 0.41, 95% CI = 0.33-0.51) after adjustment. No difference in physical activity (OR = 0.86, 95% CI = 0.73-1.02) was identified between vegetarians and non-vegetarians. Additionally, vegetarians had higher whole grain intake (OR = 2.76, 95% CI = 2.28-3.35) and lower sugar-sweetened beverage consumption (OR = 1.36, 95% CI = 1.18-1.58). Conclusions: Our results suggested that vegetarians had better overall ideal CVH metrics but lower ideal healthy diet scores than non-vegetarians, which was likely due to the lack of fish consumption in this population group. When assessing CVH metrics and healthy diet scores for vegetarians, metrics and scores chosen should be suitable for use with vegetarian populations.

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.

Health risks of dual use of electronic and combustible cigarettes: exposure to acrylamide and glycidamide.

INTRODUCTION: A combustible cigarette is a significant source of acrylamide, which is associated with numerous adverse effects. Electronic cigarette (e­cigarette) is an emerging smoking device with uncertain health effects. OBJECTIVES The aim of the study was to explore the exposure risks of acrylamide (AA) by measuring biomarkers, hemoglobinadducts of AA (HbAA) and of glycidamide (HbGA), in serum samples of the general adult population with regard to different smoking status (smoking vs nonsmoking). PATIENTS AND METHODS: This was a cross­sectional study of 1657 participants aged 18 years or older from the United States National Health and Nutrition Examination Survey (2015-2016) with recorded patient smoking status and concentrations of HbAA and HbGA. Multivariable linear regression models were used to analyze HbAA and HbGA in different smoking groups (nonsmokers, cigarettes smoking only, e­cigarettes smoking only, and dual users). RESULTS: Dual users had the highest HbAA and HbGA concentrations (median [interquartile range], 83.75 [53.28-128.25] pmol/gHb and 61.20 [40.73-89.78] pmol/gHb, respectively). There was a positive association between the use of e­cigarettes and the HbAA concentration. The standardized ß coefficients of HbAA and HbGA between the combustible cigarette smokers and nonsmokers in the fully adjusted model were 0.312 and 0.255 (both P <0.001) and those between the dualusers and nonsmokers in the fully adjusted model were 0.396 and 0.342, respectively (both P <0.001). CONCLUSIONS: E­cigarette users are exposed to AA, and users of both combustible and e­cigarettes have highest measures of HbAA and HbGA. Aside from the adverse effects caused by e­cigarette smoking, coexposure risks of combustible cigarettes and e­cigarettes need to be communicated to the public. Further studies are warranted to aid in health promotion.

Relationship between ideal cardiovascular health metrics and hearing loss: A 10-year retrospective cohort study.

OBJECTIVE: The role of ideal cardiovascular health (CVH) metrics in developing hearing loss remains uncertain. Thus, our objective was to analyse the connection between hearing loss and ideal CVH metrics in a 10-year retrospective cohort. STUDY DESIGN: Retrospective cohort study. SETTING: A health management centre in Taiwan. PARTICIPANTS: Participants who underwent the first annual health check-up between 2000 and 2006 and with a follow-up check-up more than ten years later. MAIN OUTCOME MEASURES: Hearing thresholds were measured at 500 Hz, 1000 Hz, 2000 Hz and 4000 Hz. Individuals with a best ear pure-tone audiometry four-frequency average of >25 dB HL were defined as having hearing loss. The ideal CVH metrics were classified into 7 categories based on the American Heart Association's definition. The associations of hearing loss with the sum of the ideal CVH metrics and each ideal CVH metric were examined by multiple logistic regression analysis. RESULTS: The present study consisted of 6974 participants. The 10-year follow-up showed that the odds ratio (OR) of hearing loss was .74 for participants with 5-7 ideal CVH metrics (95% CI, .59-.93, p = .01) compared with those with 0-2 ideal CVH metrics. Among the CVH metrics, participants with an ideal smoking status might have reduced odds of developing hearing loss; the OR was .72 (95% CI, .58-.89, p = .003). CONCLUSIONS: Participants with an increased number of ideal CVH metrics and better performance on the smoking metric had a significantly protective effect regarding hearing loss development.

Higher Serum Leptin Levels are Associated with a Reduced Risk of Sarcopenia but a Higher Risk of Dynapenia Among Older Adults.

BACKGROUND: Leptin plays an important role in regulating the energy homeostasis of fat and muscle. Paradoxical findings existed between serum leptin levels and muscle health conditions. Here, we aimed to investigate the relationship between serum leptin levels and the risk of sarcopenia or dynapenia among older adults. METHODS: Adults aged 65 and older living in the community were recruited at annual health checkups. Body composition, gait speed, and handgrip strength were examined. The cutoff values of muscle mass and strength to define sarcopenia and dynapenia were based on the consensus by the Asia Working Group of Sarcopenia in 2019. Serum leptin level was measured by an immunoassay. RESULTS: Four hundred sixty participants (55.65% females) were enrolled. There were 16.08% and 23.91% with sarcopenia and dynapenia, respectively. Higher serum leptin levels were positively associated with muscle and fat mass but negatively associated with handgrip strength and gait speed for both sexes. In the logistic regression models adjusted for various confounders, a higher serum leptin level was associated with an increased risk of dynapenia with dose-response effects among both male and female participants (odds ratio [OR]=3.74, 95% confidence interval [CI]= 0.99-14.17; OR= 3.32, 95% CI=1.03-10.74, respectively), and a positive trend existed in both genders (p for trend=0.040 and 0.042, respectively). In contrast, a higher leptin level was associated with a reduced risk of sarcopenia with dose-response trends for both sexes (OR= 0.06, 95% CI=0.01-0.48; OR= 0.26, 95% CI=0.06-1.17, respectively) in models of multivariate logistic regression analyses, and a negative trend existed in both genders (p for trend = 0.002 and 0.023, respectively). CONCLUSION: A positive trend existed between the serum leptin level and the dynapenia risk, whereas it revealed a negative trend in the serum leptin level and sarcopenia risk in both male and female elderly individuals. The biological mechanisms underlying its negative association with muscle strength but its positive association with muscle mass warrants further investigation.

Elevated level of the soluble receptor for advanced glycation end-products involved in sarcopenia: an observational study.

BACKGROUND: The soluble receptor for advanced glycation end products (sRAGE) has been proposed to serve as a marker for disease severity, but its role in sarcopenia, an age-related progressive loss of muscle mass and function, remains elusive. This study examines the association between sRAGE and sarcopenia. METHODS: A total of 314 community-dwelling elderly adults who had their health examination at Tri-Service General Hospital from 2017 to 2019 underwent protein analysis with enzyme-linked immunosorbent assay. The relationship with sarcopenia and its detailed information, including components and diagnosis status, were examined using linear and logistic regressions. RESULTS: As for sarcopenia components, low muscle mass (ß = 162.8, p = 0.012) and strength (ß = 181.31, p = 0.011) were significantly correlated with sRAGE, but not low gait speed (p = 0.066). With regard to disease status, confirmed sarcopenia (ß = 436.93, p < 0.001), but not probable (p = 0.448) or severe sarcopenia (p = 0.488), was significantly correlated with sRAGE. In addition, females revealed a stronger association with sRAGE level by showing significant correlations with low muscle mass (ß = 221.72, p = 0.014) and low muscle strength (ß = 208.68, p = 0.043). CONCLUSIONS: sRAGE level showed a positive association with sarcopenia, illustrating its involvement in the evolution of sarcopenia. This association is more evident in female groups, which may be attributed to the loss of protection from estrogen in postmenopausal women. Utilizing sRAGE level as a prospective marker for sarcopenia deserves further investigation in future studies.

Favorable self­rated health is associated with ideal cardiovascular health: a cohort study.

INTRODUCTION: Both self­rated health (SRH) and the cardiovascular health (CVH) metrics of the American Heart Association have been reported as predictors of cardiovascular events. However, a longitudinal study of the relationships between these metrics has not been conducted before. OBJECTIVES: We investigated the association between SRH and CVH metrics in a longitudinal study involving an Asian population. PATIENTS AND METHODS: Eligible participants were enrolled between 2009 and 2014. Multivariable logistic regression models were used to examine the association between SRH and overall ideal CVH metrics as well as each ideal CVH metric at baseline and during follow­up. Additionally, we classified participants into 3 groups according to the change in SRH after 3 years of follow­up and analyzed the changes in ideal CVH metrics in these groups. RESULTS: Our study group consisted of 15 608 participants. After a mean follow­up of 2.69 years, participants who classified their health as "Poor" or "Very Poor" had reduced odds ratios (ORs) for ideal CVH metrics, with ORs of 0.68 (95% CI, 0.54-0.85; P = 0.001) and 0.59 (95% CI, 0.37-0.96; P = 0.03) for "Poor" and "Very Poor" SRH, respectively. In contrast, the odds for increased ideal CVH metrics rose as SRH improved (OR, 1.20; 95% CI, 1.07-1.36; P = 0.002). CONCLUSIONS: Changes in SRH ratings might accurately reflect changes in CVH metrics. Our longitudinal study demonstrated that SRH was significantly associated with the number of ideal CVH metrics. Our findings provide epidemiological evidence for future public health strategies targeting cardiovascular disease.

Association Between Interleukin-12 and Sarcopenia.

BACKGROUND: Emerging studies have proposed that cytokines secreted following macrophage polarization may contribute to skeletal muscle aging. The current study primarily aimed to determine whether these cytokines have an impact on the progression of sarcopenia in an elderly population. METHODS: In total, 120 elderly adults aged 65 years and older who underwent health examinations from 2015 to 2019 were included in this retrospective study. Sarcopenia was based on the criteria proposed by the European Working Group on Sarcopenia in Older People in 2019. Macrophages and cytokines datasets were obtained from Gene Expression Omnibus (GEO) database. Comprehensive assessments were performed for muscle strength, muscle mass, gait speed, tumor growth factor-ß (TGF-ß), and interleukin-12 (IL-12). Thereafter, the association between sarcopenia and cytokines was analyzed using regression models. RESULTS: Low muscle strength and low-speed gait were negatively associated with IL-12 [ß: -8.96 (95% CI: -14.12, -3.79) and -7.16 (95% CI: -12.54, -1.78), respectively]. Participants with more sarcopenia components and more severe sarcopenia had lower IL-12 (P for trend < 0.001). Conversely, more amount of sarcopenia components were associated with increased TGF-ß (P for trend < 0.05). A definite diagnosis of sarcopenia was associated with decreased IL-12 and increased TGF-ß with ß of -8.96 (95% CI: -14.12, -3.79) and 147.75 (95% CI: 36.27, 259.23). Furthermore, increased IL-12 levels were significantly associated with reduced occurrence of sarcopenia with and odd ratio (OR) of 0.36 (95% CI: 0.15-0.834). CONCLUSION: Our findings on the relationship between cytokines and age-related muscle loss showed that IL-12 may be an early diagnosis indicator for sarcopenia in the elderly population.

Atherogenic index of plasma as predictors for metabolic syndrome, hypertension and diabetes mellitus in Taiwan citizens: a 9-year longitudinal study.

Deeply involved with dyslipidemia, cardiovascular disease has becoming the leading cause of mortality since the early twentieth century in the modern world. Whose correlation with metabolic syndrome (MetS), hypertension and type 2 diabetes mellitus (T2DM) has been well established. We conducted a 9-year longitudinal study to identify the association between easily measured lipid parameters, future MetS, hypertension and T2DM by gender and age distribution. Divided into three groups by age (young age: < 40, middle age: ≥ 40 and < 65 and old age: ≥ 65), 7670 participants, receiving standard medical inspection at Tri-Service General Hospital (TSGH) in Taiwan, had been enrolled in this study. Atherogenic index of plasma (AIP) was a logarithmically transformed ratio of triglyceride (TG)/high-density lipoprotein cholesterol (HDL-C). Through multivariate regression analyses, the hazard ratio (HR) of AIP for MetS, hypertension and T2DM were illustrated. AIP revealed significant association with all the aforementioned diseases through the entire three models for both genders. Additionally, AIP revealed significant correlation which remained still after fully adjustment in MetS, hypertension, and T2DM groups for subjects aged 40-64-year-old. Nevertheless, for participants aged above 65-year-old, AIP only demonstrated significant association in MetS group. Our results explore the promising value of AIP to determine the high-risk subjects, especially meddle-aged ones, having MetS, hypertension, and T2DM in the present and the future.

Relationship between peripheral neuropathy and cognitive performance in the elderly population.

ABSTRACT: There are only a few studies that have shown an association of peripheral neuropathy with cognitive impairment in elderly individuals. Therefore, we investigated the relationship between cognitive performance and peripheral neuropathy.From the database of the National Health and Nutrition Examination Survey (NHANES, 1999-2002), each participant completed a household interview, physical performance test, questionnaire regarding personal health, and Digit Symbol Substitution Test (DSST) to evaluate cognitive performance. The severity of peripheral neuropathy was assessed based on the number of insensate areas in both feet during monofilament examination. We used the multivariate linear regression to analyze the association of the DSST findings with insensate areas of the worse foot.There were 828 participants in our study from NHANES 1999 to 2002; their mean age was 69.96 ±â€Š7.38 years, and 51.3% were male. The ß coefficients of the number of insensate areas associated with the DSST findings were all negative values, and the absolute value increased as the number of insensate areas increased. After adjustment for pertinent variables, the correlations remained significantly negative (all P for trend <.001). In addition, subgroup analysis showed no gender differences in the negative association, but this association was not significant in obese participants (P > .05).Our study provides evidence that the severity of peripheral neuropathy is significantly negatively correlated with cognitive performance.

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.

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.

Impact of adiposity on muscle function and clinical events among elders with dynapenia, presarcopenia and sarcopenia: a community-based cross-sectional study.

INTRODUCTION: Low muscle function determined unfavorable clinical outcome than low muscle mass; nevertheless, comparison of detrimental parameters among dynapenia, presarcopenia and sarcopenia was sparse. We hypothesized that adiposity is implicated in low muscle function related adverse events. METHODS: We recruited community elders to measure handgrip strength and walking speed. Using bioelectronics impedance analyzer to examine body compositions. The faller is indicated of having a fall event in the past one year. Associations of different obesity parameters, metabolic syndrome (MetS) and fall among the groups were analyzed. RESULTS: Among 765 participants, the dynapenia group had higher metabolic profiles, body fat percentage (BFP), waist circumference, and fat to muscle ratio (FMR) than the other groups, whereas the presarcopenia subjects had the lowest obesity parameters. The fallers tended to have poorer muscle function than non-fallers (p<0.001). The dynapenia individuals had the highest risk for MetS (odds ratio [OR]= 5.79; 95% confidence interval [CI]= 2.45-13.73), and the highest fall risk (OR= 3.11; 95% CI=1.41-6.87). Among obesity parameters, FMR had better diagnostic performance to estimate low muscle function, followed by BFP. CONCLUSION: Dynapenia individual had higher risk of obese-related adverse events. Increased adiposity irrespective of muscle mass is relevant to reduced muscle function among elders.

Examining the association between muscle mass, muscle function, and fat indexes in an elderly population.

OBJECTIVES: Skeletal muscle mass with function decline indicated as sarcopenia, which may cause disability in elderly adults. Studies regarding fat composition in sarcopenia have gained attraction recently; however, different fat indexes have yielded different findings. It is necessary to explore the association between muscle mass, muscle function, and fat indexes among elderly adults. METHODS: Community-dwelling elderly adults ages 65 and older who received annual health examination or outpatient services were enrolled. Hand grip strength and gait speed were measured. Muscle and fat mass were estimated by bioelectrical impedance analyzer. Presarcopenia was defined as loss of muscle mass only; sarcopenia was loss of muscle mass accompanied by low grip strength or/and slow gait speed. The relationships between sarcopenia parameters and different fat indexes among elderly adults were analyzed. RESULTS: There were 295 participants recruited. The presarcopenia group showed lower fat indexes compared to the sarcopenia group. Negative correlations existed between sarcopenia parameters (skeletal muscle mass index, grip strength, gait speed) and fat indexes (body-fat percentage, fat-to-muscle ratio). In the multiple hierarchical regression model, gait speed was negatively associated with body-fat percentage (ß = -0.255, P = 0.009) and fat-to-muscle ratio (ß = -0.272, P = 0.005) in the male group. In the female group, grip strength was inversely associated with body-fat percentage (ß = -0.232, P = 0.009) and fat-to-muscle ratio (ß = -0.195, P = 0.031). CONCLUSIONS: Individuals in the presarcopenia group had lower fat indexes than those in the sarcopenia group. Gait speed in men and hand grip strength in women-but not muscle mass for either- were negatively associated with body-fat percentage and fat-to-muscle ratio.

Gender differences in the association between physical activity and health-related quality of life among community-dwelling elders.

BACKGROUND: Physical activity can improve health-related quality of life (HRQoL) in older adults. However, the differential effects of gender on quality of life are unclear. AIMS: To determine the association between physical activity and HRQoL in men and women. METHODS: This was a cross-sectional study conducted from March to August 2011. Community-dwelling older people aged 65 years or older were eligible. Physical activity in kcal per week was measured with the International Physical Activity Questionnaire (IPAQ)-Taiwan version. HRQoL was measured with the 36-Item Short Form Survey (SF-36) questionnaire. Cognitive function and depression were assessed using the Mini-Mental State Examination (MMSE) and Patient Health Questionnaire-9 (PHQ-9). The relationship between physical activity and HRQoL in men and women was investigated by a multiple linear regression model. RESULTS: A total of 188 older people (M: 50.5%) participated in this study. The mean ages of men and women were 71.9 ± 5.3 and 77.1 ± 6.4 years, respectively (p < 0.001). Older women had higher physical activity levels than men (4786.1 ± 1065.6 vs 4422.2 ± 1114.3 kcal/week, p = 0.023). After adjusting for covariates, multiple linear regression analysis showed that older men with higher physical activity levels had better scores on both the physical component summary (PCS) (p = 0.031) and mental component summary (MCS) (p = 0.007) than men with lower levels. Furthermore, older men with higher moderate-vigorous physical activity levels had better scores on the PCS than older men with lower activity levels, and older men with higher walking physical activity levels had better scores on the MCS than older men with lower activity levels. CONCLUSIONS: In this study, older women were more physically active than older men. However, older men (but not older women) with higher physical activity had better HRQoL. The association between physical activity and HRQoL differed between men and women.

Beneficial relevance of vitamin D concentration and urine flow rate.

BACKGROUND & AIMS: Micturition dysfunction is a problem in the general population that progresses with aging in both males and females. In the past few decades, the relationship between voiding symptoms and body biochemical status has been a subject of research in several disciplines. Micronutrition is considered to affect different aspects of urinary flow, including neuroregulation, detrusor muscle function, and the structures around the bladder outlet such as the pelvic floor and prostate. Therefore, the objective of our study was to determine the correlation between urine flow rate (UFR) and 25-hydroxyvitamin D (25(OH)D) in the general healthy population. METHODS: Our study involved 3981 adult participants over age 20 from the U.S. National Health and Nutrition Examination Survey datasets (2011-2012). The associations between UFR and serum 25(OH)D concentration were analyzed through multivariate regression models. RESULTS: There was a significant positive association of serum 25(OH)D concentration with UFR (25(OH)D2+25(OH)D3: ß coefficient: 0.003; 95% CI: 0.002, 0.004; p < 0.001, 25(OH)D3; p = 0.003; epi-25(OH)D3, p = 0.020) in an unadjusted model. The substantial associations were still observed in the gender and age subgroups. In analysis of age subgroup, the association of serum 25(OH)D concentration with urine flow rate was significant in fully adjusted model (age<60: 25(OH)D2+25(OH)D3: ß coefficient: 0.004, p < 0.001; 25(OH)D3: p = <0.001, epi-25(OH)D3: p = 0.007; Age≥60: 25(OH)D2+25(OH)D3: ß coefficient: 0.004, p = 0.002; 25(OH)D3: p = 0.001, epi-25(OH)D3: p = 0.001). In gender subgroup analysis, the ß coefficient of 25(OH)D2+25(OH)D3 in male is 0.004 (p < 0.001), and in female is 0.004 (p < 0.001) in fully adjusted model. The higher quartiles of UFR tended to have higher 25(OH)D3 levels with statistically significant in quartile-based analysis. CONCLUSIONS: UFR was associated with increased level of total vitamin D and bioactive form vitamin D3. Vitamin D supplements may be a simple and effective way of improving of bladder function.