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1.
BMC Geriatr ; 21(1): 622, 2021 11 02.
Artículo en Inglés | MEDLINE | ID: mdl-34727885

RESUMEN

BACKGROUND: Substantial evidence supports an association between physical activity and cognitive function. However, the role of muscle mass and function in brain structural changes is not well known. This study investigated whether sarcopenia, defined as low muscle mass and strength, accelerates brain volume atrophy. METHODS: A total of 1284 participants with sarcopenic measurements and baseline and 4-year follow-up brain magnetic resonance images were recruited from the Korean Genome and Epidemiology Study. Muscle mass was represented as appendicular skeletal muscle mass divided by the body mass index. Muscle function was measured by handgrip strength. The low mass and strength groups were defined as being in the lowest quintile of each variable for one's sex. Sarcopenia was defined as being in the lowest quintile for both muscle mass and handgrip strength. RESULTS: Of the 1284 participants, 12·6%, 10·8%, and 5·4% were classified as the low mass, low strength, and sarcopenia groups, respectively. The adjusted mean changes of gray matter (GM) volume during 4-year follow-up period were - 9·6 mL in the control group, whereas - 11·6 mL in the other three groups (P < 0·001). The significantly greater atrophy in parietal GM was observed in the sarcopenia group compared with the control group. In a joint regression model, low muscle mass, but not muscle strength, was an independent factor associated with a decrease of GM volume. CONCLUSIONS: Sarcopenia is associated with parietal GM volume atrophy, in a middle-aged population. Maintaining good levels of muscle mass could be important for brain health in later adulthood.


Asunto(s)
Sarcopenia , Adulto , Estudios de Cohortes , Sustancia Gris/diagnóstico por imagen , Fuerza de la Mano , Humanos , Estudios Longitudinales , Persona de Mediana Edad , Fuerza Muscular , Músculo Esquelético , Lóbulo Parietal , Sarcopenia/diagnóstico por imagen , Sarcopenia/epidemiología
2.
BMC Geriatr ; 21(1): 639, 2021 11 12.
Artículo en Inglés | MEDLINE | ID: mdl-34772342

RESUMEN

BACKGROUND: Health-promoting interventions are important for preventing frailty and sarcopenia in older adults. However, there is limited evidence that nutritional interventions yield additional effects when combined with resistance training. This systematic review and meta-analysis aimed to compare the effectiveness of nutritional interventions with resistance training and that of resistance training alone. METHODS: Randomized controlled trials published in peer-reviewed journals prior to July 2020 were retrieved from databases and other sources. The articles were screened according to the inclusion and exclusion criteria. The methodological quality of the included studies was assessed using Cochrane's risk of bias tool 2. A meta-analysis was performed using the RevMan 5.4 program and STATA 16 program. RESULTS: A total of 22 studies were included in the meta-analysis. The results of the meta-analysis showed no significant differences between groups in muscle mass, muscle strength, or physical functional performance. In the subgroup analysis regarding the types of nutritional interventions, creatine showed significant effects on lean body mass (n = 4, MD 2.61, 95% CI 0.51 to 4.72). Regarding the other subgroup analyses, there were no significant differences in appendicular skeletal muscle mass (p = .43), hand grip strength (p = .73), knee extension strength (p = .09), chair stand test results (p = .31), or timed up-and-go test results (p = .31). In the meta-regression, moderators such as the mean age of subjects and duration of interventions were not associated with outcome variables. CONCLUSIONS: This meta-analysis showed that nutritional interventions with resistance training have no additional effect on body composition, muscle strength, or physical function. Only creatine showed synergistic effects with resistance training on muscle mass. TRIAL REGISTRATION: CRD42021224843 .


Asunto(s)
Entrenamiento de Fuerza , Sarcopenia , Anciano , Fuerza de la Mano , Humanos , Fuerza Muscular , Músculo Esquelético , Músculos , Sarcopenia/prevención & control
3.
Int J Mol Sci ; 22(21)2021 Oct 27.
Artículo en Inglés | MEDLINE | ID: mdl-34769017

RESUMEN

Muscle fatigue (MF) declines the capacity of muscles to complete a task over time at a constant load. MF is usually short-lasting, reversible, and is experienced as a feeling of tiredness or lack of energy. The leading causes of short-lasting fatigue are related to overtraining, undertraining/deconditioning, or physical injury. Conversely, MF can be persistent and more serious when associated with pathological states or following chronic exposure to certain medication or toxic composites. In conjunction with chronic fatigue, the muscle feels floppy, and the force generated by muscles is always low, causing the individual to feel frail constantly. The leading cause underpinning the development of chronic fatigue is related to muscle wasting mediated by aging, immobilization, insulin resistance (through high-fat dietary intake or pharmacologically mediated Peroxisome Proliferator-Activated Receptor (PPAR) agonism), diseases associated with systemic inflammation (arthritis, sepsis, infections, trauma, cardiovascular and respiratory disorders (heart failure, chronic obstructive pulmonary disease (COPD))), chronic kidney failure, muscle dystrophies, muscle myopathies, multiple sclerosis, and, more recently, coronavirus disease 2019 (COVID-19). The primary outcome of displaying chronic muscle fatigue is a poor quality of life. This type of fatigue represents a significant daily challenge for those affected and for the national health authorities through the financial burden attached to patient support. Although the origin of chronic fatigue is multifactorial, the MF in illness conditions is intrinsically linked to the occurrence of muscle loss. The sequence of events leading to chronic fatigue can be schematically denoted as: trigger (genetic or pathological) -> molecular outcome within the muscle cell -> muscle wasting -> loss of muscle function -> occurrence of chronic muscle fatigue. The present review will only highlight and discuss current knowledge on the molecular mechanisms that contribute to the upregulation of muscle wasting, thereby helping us understand how we could prevent or treat this debilitating condition.


Asunto(s)
Fatiga Muscular/fisiología , Proteínas Musculares/metabolismo , Músculo Esquelético/fisiología , Autofagia , COVID-19/fisiopatología , Enfermedad Crítica , Humanos , Resistencia a la Insulina , Lisosomas/metabolismo , Fatiga Muscular/efectos de los fármacos , Músculo Esquelético/fisiopatología , Atrofia Muscular/etiología , Sarcopenia/fisiopatología
4.
Artículo en Inglés | MEDLINE | ID: mdl-34769606

RESUMEN

(1) Background: As the clinical relevance of constipation and sarcopenia is not well studied, we aimed to investigate the association between them in older adults. (2) Methods: A cross-sectional study was conducted on 1278 community-dwelling older adults in South Korea. The Rome IV criteria were used to identify patients with clinically defined constipation, while sarcopenia was defined by the Asian Working Group for Sarcopenia consensus. The cohort was classified into three groups: no constipation, self-reported constipation only, and clinically defined constipation. (3) Results: The presence of constipation was associated with sarcopenia and slow gait speed (p < 0.001). After adjustment for possible covariates, the association with sarcopenia attenuated, while that for slow gait speed persisted. In terms of geriatric parameters, both groups with clinically defined and self-reported constipation had a higher burden of cognitive impairment, IADL disability, and lower QOL scores (p < 0.05) compared with those without constipation. (4) Conclusions: Sarcopenia and slow gait speed associated with constipation in community-dwelling older adults. Individuals with self-reported constipation symptoms alone showed comparable sarcopenic and geriatric burden to those with clinically defined constipation. Clinical suspicion for possible co-existing sarcopenia is warranted in older patients with constipation.


Asunto(s)
Sarcopenia , Anciano , Estudios de Cohortes , Estreñimiento/epidemiología , Estudios Transversales , Evaluación Geriátrica , Fuerza de la Mano , Humanos , Vida Independiente , Calidad de Vida , Sarcopenia/epidemiología
5.
Anticancer Res ; 41(11): 5775-5783, 2021 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-34732451

RESUMEN

BACKGROUND/AIM: Sarcopenia has been reported to be a significant prognostic factor in patients with hepatocellular carcinoma in recent years. This study aimed to clarify the prognostic significance of sarcopenia in advanced hepatocellular carcinoma treated with reductive hepatectomy. PATIENTS AND METHODS: We retrospectively analyzed 93 patients who underwent reductive hepatectomy for advanced hepatocellular carcinoma. RESULTS: Median survival time of the sarcopenia group (16.4 months) was significantly shorter than that of the non-sarcopenia group (20.4 months). The overall survival rates at 1, 3, and 5 years of the sarcopenia group were significantly lower than those of the non-sarcopenia group (57.9%, 8.6%, and 2.9% vs. 67.3%, 29.2%, and 15.7%, respectively; p=0.035). On multivariate analysis, sarcopenia was a significant risk factor of overall survival (hazard ratio=1.60, 95% confidence interval=1.00-2.56, p=0.049). CONCLUSION: Sarcopenia was a significant prognostic factor of survival after reductive hepatectomy in advanced hepatocellular carcinoma.


Asunto(s)
Carcinoma Hepatocelular/cirugía , Hepatectomía , Neoplasias Hepáticas/cirugía , Sarcopenia/complicaciones , Anciano , Carcinoma Hepatocelular/complicaciones , Carcinoma Hepatocelular/mortalidad , Carcinoma Hepatocelular/patología , Bases de Datos Factuales , Femenino , Hepatectomía/efectos adversos , Hepatectomía/mortalidad , Humanos , Neoplasias Hepáticas/complicaciones , Neoplasias Hepáticas/mortalidad , Neoplasias Hepáticas/patología , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Medición de Riesgo , Factores de Riesgo , Sarcopenia/diagnóstico por imagen , Sarcopenia/mortalidad , Factores de Tiempo , Tomografía Computarizada por Rayos X , Resultado del Tratamiento
6.
J Assoc Physicians India ; 69(11): 11-12, 2021 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-34781614

RESUMEN

BACKGROUND & OBJECTIVES: Sarcopenia is one of the most common complication associated with mortality in cirrhotic patients. However, the lack of an objective and reliable method to quantify muscle mass has limited the general incorporation of sarcopenia into cirrhosis prognostic scores. In this article, we highlight crosssectional imaging-based estimation of skeletal muscle mass for diagnosing sarcopenia in cirrhotic patients and its effect on health related quality of life. METHODS: After getting ethical clearance and informed consent, all patients with cirrhosis were taken and assessed for sarcopenia using thigh muscle based index The average feather index was used in conjunction with BMI in determining the probability of sarcopenia. The CLDQ was used to assess the health related quality of life. The chi-square and Pearsons coefficient were used for analyzing correlation between sarcopenia and other variables. RESULTS & DISCUSSION: In our study, out of the 288 patients, sarcopenia was present in 132 patients (45.83%). Sarcopenia was present in 18.2% in CHILD A,42.4 % in CHID B and 90.5 % in CHILD C cirrhotics. Sarcopenia was highest in autoimmune hepatitis related cirrhosis (80%), followed by NASH (61.9%),followed by ethanol (42.4%), followed by HCV (28.5%) and HBV (16.6%). Sarcopenia had a moderate negative correlation with health related Quality of life as assessed by CLD Q particularly in relation with systemic symptoms and activity. CONCLUSION: The factors like high MELD, CHILD C cirrhosis, NASH as etiology, were associated with higher prevalence of sarcopenia.NASH related cirrhotics have high prevalance of sarcopenia even in CHILD A patients. The patients with sarcopenia were having a low overall quality of life as per CLDQ,especially in specific aspects related to systemic symptoms and activity.


Asunto(s)
Calidad de Vida , Sarcopenia , Humanos , Cirrosis Hepática/complicaciones , Cirrosis Hepática/epidemiología , Músculo Esquelético , Sarcopenia/epidemiología , Sarcopenia/etiología
7.
Rev Assoc Med Bras (1992) ; 67(8): 1161-1166, 2021 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-34669863

RESUMEN

OBJECTIVE: The aim was to evaluate the prevalence of oropharyngeal dysphagia (OD) and its association with body composition by bioelectrical impedance analysis (BIA) and functionality among institutionalized older adults. METHODS: A cross-sectional study was conducted. The swallowing function and diagnosis of OD were evaluated with a volume-viscosity swallow test. Activities of daily living were evaluated by the Barthel Index. Body composition was evaluated by BIA, and phase angle (PhA) was determined. RESULTS: Eighty institutionalized older adults were evaluated. The mean age of the study population was 82±9.5 years, and 65% were females. The OD prevalence was 30%, dependence was 30%, and sarcopenia was 16%. In the multivariate analysis, a low PhA (<3.5°) was independently associated with the presence of OD adjusted by sex and age (OR: 2.60, 95%CI 2.41-2.90, p=0.01). CONCLUSIONS: A higher prevalence of OD was found. Significant and independent associations were found between low PhA, dependence, and sarcopenia with the presence of OD among institutionalized older persons.


Asunto(s)
Trastornos de Deglución , Sarcopenia , Actividades Cotidianas , Anciano , Anciano de 80 o más Años , Composición Corporal , Estudios Transversales , Trastornos de Deglución/diagnóstico , Trastornos de Deglución/epidemiología , Impedancia Eléctrica , Femenino , Humanos , Sarcopenia/diagnóstico , Sarcopenia/epidemiología
8.
BMC Musculoskelet Disord ; 22(1): 885, 2021 Oct 18.
Artículo en Inglés | MEDLINE | ID: mdl-34663280

RESUMEN

BACKGROUND: Patients with rheumatoid arthritis (RA) are at increased risk of falls and fractures. Sarcopenia occurs more frequently in RA patients due to the inflammatory processes. Early diagnosis and prevention programmes are essential to avoid serious complications. The present study aims to identify risk factors for falls related to sarcopenia and physical performance. METHODS: In a 1-year prospective study, a total of 289 patients with RA, ages 24-85 years, were followed using quarterly fall diaries to report falls. At the baseline, medical data such as RA disease duration and Disease Activity Score (DAS28CRP) were collected. Self-reported disability was assessed using the Health Assessment Questionnaire (HAQ). Appendicular skeletal mass was determined by Dual X-ray-Absorptiometry (DXA). Physical performance was evaluated by handgrip strength, gait speed, chair rise test, Short Physical Performance Battery, and FICSIT-4. Muscle mechanography was measured with the Leonardo Mechanograph®. Sarcopenia was assessed according to established definitions by the European Working Group on Sarcopenia in Older People (EWGSOP2) and The Foundation for the National Institutes of Health (FNIH). Univariate and multiple logistic regression analysis were used to explore associations with falling. Receiver-operating characteristics (ROC) were performed, and the area under the curve is reported. RESULTS: A total of 238 subjects with RA completed the 1-year follow-up, 48 (20.2%) experienced at least one fall during the observational period. No association was found between sarcopenia and prospective falls. Age (OR = 1.04, CI 1.01-1.07), HAQ (OR = 1.62, 1.1-2.38), and low FICSIT-4 score (OR = 2.38, 1.13-5.0) showed significant associations with falls. CONCLUSIONS: In clinical practice, a fall assessment including age, self-reported activities of daily life and a physical performance measure can identify RA patients at risk of falling. TRIAL REGISTRATION: The study has been registered at the German Clinical Trials Register and the WHO International Clinical Trials Registry Platform (ICTRP) since 16 March 2017 ( DRKS00011873 ).


Asunto(s)
Artritis Reumatoide , Sarcopenia , Accidentes por Caídas/prevención & control , Adulto , Anciano , Anciano de 80 o más Años , Artritis Reumatoide/diagnóstico , Artritis Reumatoide/epidemiología , Fuerza de la Mano , Humanos , Persona de Mediana Edad , Rendimiento Físico Funcional , Estudios Prospectivos , Sarcopenia/diagnóstico , Sarcopenia/epidemiología , Estados Unidos , Adulto Joven
9.
Int J Mol Sci ; 22(19)2021 Oct 04.
Artículo en Inglés | MEDLINE | ID: mdl-34639076

RESUMEN

Skeletal muscle suffers atrophy and weakness with aging. Denervation, oxidative stress, and mitochondrial dysfunction are all proposed as contributors to age-associated muscle loss, but connections between these factors have not been established. We examined contractility, mitochondrial function, and intracellular calcium transients (ICTs) in muscles of mice throughout the life span to define their sequential relationships. We performed these same measures and analyzed neuromuscular junction (NMJ) morphology in mice with postnatal deletion of neuronal Sod1 (i-mn-Sod1-/- mice), previously shown to display accelerated age-associated muscle loss and exacerbation of denervation in old age, to test relationships between neuronal redox homeostasis, NMJ degeneration and mitochondrial function. In control mice, the amount and rate of the decrease in mitochondrial NADH during contraction was greater in middle than young age although force was not reduced, suggesting decreased efficiency of NADH utilization prior to the onset of weakness. Declines in both the peak of the ICT and force were observed in old age. Muscles of i-mn-Sod1-/- mice showed degeneration of mitochondrial and calcium handling functions in middle-age and a decline in force generation to a level not different from the old control mice, with maintenance of NMJ morphology. Together, the findings support the conclusion that muscle mitochondrial function decreases during aging and in response to altered neuronal redox status prior to NMJ deterioration or loss of mass and force suggesting mitochondrial defects contribute to sarcopenia independent of denervation.


Asunto(s)
Envejecimiento , Calcio/metabolismo , Mitocondrias Musculares/patología , Neuronas/patología , Estrés Oxidativo , Sarcopenia/patología , Superóxido Dismutasa-1/fisiología , Animales , Desnervación , Femenino , Masculino , Ratones , Ratones Endogámicos C57BL , Ratones Noqueados , Mitocondrias Musculares/metabolismo , Contracción Muscular , Neuronas/metabolismo , Oxidación-Reducción , Sarcopenia/etiología
10.
Artículo en Inglés | MEDLINE | ID: mdl-34639432

RESUMEN

This study examined the relationship of low appendicular skeletal muscle mass and low muscle function with depressive symptoms in Korean older adults. Community-dwelling Korean older adults aged 65 years and older (n = 521) participated in this study. Appendicular muscle mass (ASM) and muscle function (MF) scores were assessed using dual-energy X-ray absorptiometry (DXA) scanning and sit-to-stand mean power based on a 30 s chair stand test, respectively. Depressive symptoms were evaluated using the Korean form of the Center for Epidemiologic Studies Depression Scale. Logistic regression was used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) of depressive symptoms according to ASM- and MF-based subgroups; normal ASM/normal MF, low ASM/normal MF, normal ASM/low MF, and low ASM/low MF. The prevalence of depressive symptoms was 21.3% in all patients: 20.7% in women and 21.5% in men. Compared to the normal ASM/normal MF participants (OR = 1), the risk of depressive symptoms rose incrementally in subjects with low ASM/normal MF (OR = 2.963, p = 0.019), normal AMS/low MF (OR = 3.843, p = 0.002), and low ASM/low MF (OR = 7.907, p < 0.001), respectively. The current findings suggest that the coexistence of low ASM and low MF is significantly and independently associated with an increased risk for depressive symptoms, with dynapenia having a stronger relationship.


Asunto(s)
Depresión , Sarcopenia , Absorciometría de Fotón , Anciano , Índice de Masa Corporal , Estudios Transversales , Depresión/epidemiología , Femenino , Humanos , Masculino , Músculo Esquelético , República de Corea/epidemiología , Sarcopenia/epidemiología , Sarcopenia/patología
11.
Clin Nutr ESPEN ; 45: 299-305, 2021 10.
Artículo en Inglés | MEDLINE | ID: mdl-34620332

RESUMEN

INTRODUCTION: Sarcopenia is a muscle disease that is associated with a decline in muscle strength and function. When this condition coexists with sarcopenia, it is characterized as sarcopenic obesity (OS), and is associated with worse outcomes of physical functions. The aim of this study was to investigate sarcopenia in obesity and its relationship with body composition in young adults with grade II and grade III obesity. METHODS: Analytical, cross-sectional study. Volunteers of both sexes were selected, aged between 20 and 59 years, and who had a BMI ≥35 kg/m2 with the presence of comorbidities or BMI> 40 kg/m2. Body composition was measured by dual-energy X ray absorptiometry (DEXA). The following parameters of sarcopenia included handgrip strength (HGS), chair stand, appendicular skeletal muscle mass (ASM), ASM adjusted by weight and ASM adjusted by BMI; HGS adjusted by ASM and gait speed. RESULTS: 108 volunteers, of both sexes, with a mean age of 43, ±11.7 years, were evaluated. 2% had dinapenia and 33% low leg muscle strength. The prevalence of sarcopenia varied between 11.1% and 13.9%, corresponding to the confirmatory criteria of low muscle quantity and low muscle quality, respectively, particularly affecting middle-aged women. We found a reduction in HGS by ASM with an increase in BMI and fat mass (kg) in both age groups, being significant among middle-aged adults (40-59 years). CONCLUSION: Even with young adults, we observed changes in all parameters with a negative impact on strength, mass and muscle function. Muscle quality can be considered an important risk factor for functional disability and should be considered in the assessment of sarcopenia. The results show the need to standardize criteria for the assessment of sarcopenia in young adults with severe obesity, since the prevalence differed widely.


Asunto(s)
Obesidad Mórbida , Sarcopenia , Adulto , Estudios Transversales , Femenino , Fuerza de la Mano , Humanos , Masculino , Persona de Mediana Edad , Músculo Esquelético , Sarcopenia/diagnóstico , Sarcopenia/epidemiología , Adulto Joven
12.
Clin Nutr ESPEN ; 45: 442-448, 2021 10.
Artículo en Inglés | MEDLINE | ID: mdl-34620352

RESUMEN

BACKGROUND AND AIM: The definition of sarcopenia was recently updated by the European Working Group on Sarcopenia (EWGSOP2), and consensus criteria for the diagnosis of malnutrition have been presented by the Global Leadership Initiative on Malnutrition (GLIM). The aim of this study was to investigate prevalence and mortality related to categorisation of patients according to these definitions in a geriatric hospital setting. METHOD: Fifty-six consecutive geriatric inpatients (84y (SD 7.3), 68% women) underwent test of handgrip strength (HGS) and five-rise chair stand test (5CST). Muscle mass and fat free mass (FFM) were evaluated by Dual X-ray Absorptiometry (DXA). Calf circumference (CC) was recorded. Probable sarcopenia was defined, according to EWGSOP2, as low HGS (<27/16 kg for men/women) and/or 5CST >15 s; sarcopenia was confirmed when coupled with low appendicular skeletal muscle index (ASMI <7.0 and <5.5 kg/m2 (m/w)). Malnutrition was defined according to GLIM as weight loss >5% (past 6 mo); BMI <20/22 kg/m2 (<70/>70y); and FFM-index <17/15 kg/m2 (m/w) combined with reduced food intake and/or disease burden/inflammatory condition. Alternatively, CC <31 cm was used as a proxy for low muscle mass for both sarcopenia and malnutrition. One- and two-year mortality was registered. RESULTS: All participants displayed probable sarcopenia; 46% and 20% were sarcopenic depending on whether muscle mass was estimated by DXA or CC. Malnutrition according to the GLIM criteria was prevalent in 64% or 60% (muscle mass by DXA or CC, respectively). Nine in ten with sarcopenia were also malnourished. Twenty-six participants (46%) died within two years. Sarcopenia defined by CC <31 cm, but not by DXA, was associated with increased mortality; e.g. 2-y mortality HR was 3.19 (95% CI 1.31-7.75). Similarly, malnutrition according to GLIM related to increased 1-y mortality (HR 4.83, 95% CI 1.04-22.39) when DXA was used for muscle mass estimation. All of the participants with CC <31 cm were categorised as both sarcopenic and malnourished. CONCLUSION: In this small set of well-characterised geriatric inpatients all displayed probable sarcopenia. Prevalence of sarcopenia (EWGSOP2) and malnutrition (GLIM) was 20-46% and 60-64%, respectively. Both conditions related to mortality. CC <31 cm hold promises to be an acceptable alternative for DXA as a proxy for low muscle mass.


Asunto(s)
Desnutrición , Sarcopenia , Absorciometría de Fotón , Anciano , Femenino , Fuerza de la Mano , Humanos , Pacientes Internos , Masculino , Desnutrición/diagnóstico , Sarcopenia/diagnóstico , Sarcopenia/epidemiología
13.
Clin Nutr ESPEN ; 45: 492-498, 2021 10.
Artículo en Inglés | MEDLINE | ID: mdl-34620360

RESUMEN

BACKGROUND: Cardiac rehabilitation (CR) is an essential component of long-term recovery following a cardiac event. Typical CR may not be optimal for patients presenting with sarcopenic obesity (SO) who present with reduced muscle mass and elevated adipose tissue, and may indicate greater cardiovascular disease (CVD) risk. Resistance exercise and high-protein diets are known to increase muscle mass, while Mediterranean-style diets have been shown to reduce CVD risk. A high-protein Mediterranean-style diet combined with resistance exercise intervention is yet to be trialled in cardiac rehabilitation populations. OBJECTIVES: Primary outcome: to determine the feasibility of such an intervention by investigating the perceptions, acceptance and adherence to a resistance exercise protocol and high-protein Mediterranean style diet in a UK cardiac rehabilitation population with SO. Secondary outcome: to trial this protocol ahead of a fully powered clinical study. METHODS: Eligible cardiac rehabilitation patients will be randomised to one of the following: 1) a control group (standard CR), 2) high-protein Mediterranean-style diet, 3) resistance exercise group, or 4) both high-protein Mediterranean-style diet and resistance exercise group. The pilot study will last 12 weeks. Measures of body composition (dual energy x-ray absorptiometry) grip strength, CVD risk (e.g., fasting triglycerides, glucose, cholesterol) and dietary adherence will be assessed at baseline and after 12 weeks. To compare groups, a mixed model ANOVA (time x intervention) will be performed. Patient participant involvement throughout the development of this project will be used to determine the feasibility of a future, fully powered, randomised control trial. A feasibility questionnaire will help establish the proportion of eligible participants, their willingness to be randomised, response rates, and ethical considerations. Furthermore, focus groups, food tasting and telephone interviews will be conducted to assess the acceptability of recipes and exercise protocols provided. DISCUSSION: This pilot trial will determine whether a fully powered, multi-centred randomised control trial in CR patients with SO can be implemented. The information received from patient involvement will be invaluable for identifying possible barriers to participation and tailoring interventions to participant needs, helping to increase the likelihood of long-term compliance to health-promoting lifestyle changes. REGISTRATION: This study is registered at clinicaltrials.gov (NCT04272073), registered on 17/02/2020, https://clinicaltrials.gov/ct2/show/NCT04272073. DATE AND VERSION: 28/12/20 version 3.0.


Asunto(s)
Rehabilitación Cardiaca , Dieta Rica en Proteínas , Dieta Mediterránea , Entrenamiento de Fuerza , Sarcopenia , Estudios de Factibilidad , Humanos , Estudios Multicéntricos como Asunto , Obesidad , Proyectos Piloto , Ensayos Clínicos Controlados Aleatorios como Asunto
14.
Arch Osteoporos ; 16(1): 145, 2021 10 03.
Artículo en Inglés | MEDLINE | ID: mdl-34601644

RESUMEN

Patients with rheumatoid arthritis (RA) had higher incidences of sarcopenia, falls, osteoporosis, and vertebral osteoporotic fractures (VOPF). Sarcopenia was associated with longer disease duration, higher disease activity, and more severe RA. The interactive effect of sarcopenia and falls was associated with a higher risk of VOPF in patients with RA. PURPOSE: Whether sarcopenia and falls are a risk factor for vertebral fracture in RA patients has not been demonstrated. This study aimed to explore the incidence of vertebral osteoporotic fracture (VOPF) and its relationship with sarcopenia and falls in RA patients. METHODS: A total of 474 RA patients and 156 controls were enrolled in this study. Anteroposterior and lateral X-ray examinations of the vertebral column (T4-L4) were used for the semiquantitative assessment of VOPF. Bone mineral density was measured by dual-energy X-ray absorptiometry. Skeletal muscle mass was measured by direct segmental multifrequency bioelectrical impedance analysis (DSM-BIA method). RESULTS: RA patients had an increased risk of sarcopenia (62.4% vs 9.0%, x2 = 47.478, P < 0.001), falls (30.2% vs 3.2%), osteoporosis (OP) (33.5% vs 12.8%, x2 = 134.276, P < 0.001), and VOPF (20.3% vs 3.8%, x2 = 47.478, P < 0.001) than controls. Patients with sarcopenia were more likely to have VOPF than RA without sarcopenia (24.0% vs 14.0%, x2 = 6.802, P = 0.009). RA with sarcopenia and prior falls had the highest incidences of VOPF (36.7%). Older age (OR = 1.056, P < 0.001, 95% CI 1.030-1.083), falls (OR = 2.043, P = 0.003, 95% CI 1.238-3.371), OP (OR = 1.819, P = 0.034, 95% CI 1.046-3.163), and usage of glucocorticoids (GCs) (OR = 1.862, P = 0.022, 95% CI 1.093-3.172) were risk factors for VOPF in RA patients, while a higher skeletal muscle index (SMI) was a protective factor (OR = 0.754, P = 0.038, 95% CI 0.578-0.984) for VOPF in RA patients. CONCLUSIONS: The interactive effect of sarcopenia and falls is associated with a higher risk of VOPF in patients with RA.


Asunto(s)
Artritis Reumatoide , Osteoporosis , Fracturas Osteoporóticas , Sarcopenia , Fracturas de la Columna Vertebral , Anciano , Artritis Reumatoide/epidemiología , Densidad Ósea , Humanos , Osteoporosis/diagnóstico por imagen , Osteoporosis/epidemiología , Fracturas Osteoporóticas/diagnóstico por imagen , Fracturas Osteoporóticas/epidemiología , Factores de Riesgo , Sarcopenia/diagnóstico por imagen , Sarcopenia/epidemiología , Fracturas de la Columna Vertebral/diagnóstico por imagen , Fracturas de la Columna Vertebral/epidemiología
15.
Int J Mol Sci ; 22(19)2021 Sep 23.
Artículo en Inglés | MEDLINE | ID: mdl-34638584

RESUMEN

Skeletal muscle is a vital organ for a healthy life, but its mass and function decline with aging, resulting in a condition termed sarcopenia. The etiology of sarcopenia remains unclear. We recently demonstrated that interstitial mesenchymal progenitors are essential for homeostatic muscle maintenance, and a diminished expression of the mesenchymal-specific gene Bmp3b is associated with sarcopenia. Here, we assessed the protective function of Bmp3b against sarcopenia by generating conditional transgenic (Tg) mice that enable a forced expression of Bmp3b specifically in mesenchymal progenitors. The mice were grown until they reached the geriatric stage, and the age-related muscle phenotypes were examined. The Tg mice had significantly heavier muscles compared to control mice, and the type IIB myofiber cross-sectional areas were preserved in Tg mice. The composition of the myofiber types did not differ between the genotypes. The Tg mice showed a decreasing trend of fibrosis, but the degree of fat infiltration was as low as that in the control mice. Finally, we observed the preservation of innervated neuromuscular junctions (NMJs) in the Tg muscle in contrast to the control muscle, where the NMJ degeneration was conspicuous. Thus, our results indicate that the transgenic expression of Bmp3b in mesenchymal progenitors alleviates age-related muscle deterioration. Collectively, this study strengthens the beneficial role of mesenchymal Bmp3b against sarcopenia and suggests that preserving the youthfulness of mesenchymal progenitors may be an effective means of combating sarcopenia.


Asunto(s)
Células Madre Mesenquimatosas/metabolismo , Músculo Esquelético/metabolismo , Enfermedades Musculares/metabolismo , Unión Neuromuscular/metabolismo , Envejecimiento/metabolismo , Animales , Factor 10 de Diferenciación de Crecimiento/metabolismo , Masculino , Ratones , Ratones Endogámicos C57BL , Ratones Transgénicos/metabolismo , Sarcopenia/metabolismo
16.
BMC Geriatr ; 21(1): 542, 2021 10 12.
Artículo en Inglés | MEDLINE | ID: mdl-34641817

RESUMEN

BACKGROUND: Osteoporosis and sarcopenia are major health issues in postmenopausal women due to their high prevalence and association with several adverse outcomes. However, no biomarkers may be used for screening and diagnosis. The current study investigated potential biomarkers for osteoporosis and/or sarcopenia in postmenopausal women. METHODS: A cross-sectional study on 478 healthy community-dwelling postmenopausal women aged 50-90 years was performed. Osteoporosis and sarcopenia were defined according to the World Health Organization (WHO) and Asian Working Group for Sarcopenia (AWGS). RESULTS: Dehydroepiandrosterone (DHEA) was related to muscle strength (ß = 0.19, p = 0.041) and function (ß = 0.58, p = 0.004). Follistatin (ß = - 0.27, p = 0.01) was related to muscle mass. Oxytocin (ß = 0.59, p = 0.044) and DHEA (ß = 0.51, p = 0.017) were related to bone mass. After adjusting for age, oxytocin (odds ratio (OR) 0.75; 95% confidence intervals (CI) 0.63-0.98; p = 0.019) was associated with osteoporosis, and DHEA (OR 0.73; 95% CI 0.51-0.96; p = 0.032) and follistatin (OR 1.66; 95% CI 1.19-3.57; p = 0.022) were associated with sarcopenia. CONCLUSIONS: Postmenopausal women with sarcopenia were more likely to have lower DHEA levels and higher follistatin levels, and postmenopausal women with osteoporosis were more likely to have lower oxytocin levels.


Asunto(s)
Osteoporosis , Sarcopenia , Anciano , Anciano de 80 o más Años , Estudios Transversales , Deshidroepiandrosterona/sangre , Femenino , Folistatina/sangre , Humanos , Persona de Mediana Edad , Osteoporosis/diagnóstico , Osteoporosis/epidemiología , Oxitocina/sangre , Posmenopausia , Sarcopenia/diagnóstico , Sarcopenia/epidemiología
17.
BMC Geriatr ; 21(1): 600, 2021 10 26.
Artículo en Inglés | MEDLINE | ID: mdl-34702174

RESUMEN

BACKGROUND: The operational definition of sarcopenia has been updated (EWGSOP2) and apply different cut-off points compared to previous criteria (EWGSOP1). Therefore, we aim to compare the sarcopenia prevalence and the association with mortality and dependence in activities of daily living using the 2010 (EWGSOP1 and 2019 (EWGSOP2 operational definition, applying cut-offs at two levels using T-scores. METHODS: Two birth cohorts, 70 and 85-years-old (n = 884 and n = 157, respectively), were assessed cross-sectionally (57% women). Low grip strength, low muscle mass and slow gait speed were defined below - 2.0 and - 2.5 SD from a young reference population (T-score). Muscle mass was defined as appendicular lean soft tissue index by DXA. The EWGSOP1 and EWGSOP2 were applied and compared with McNemar tests and Cohen's kappa. All-cause mortality was analyzed with the Cox-proportional hazard model. RESULTS: Sarcopenia prevalence was 1.4-7.8% in 70-year-olds and 42-62% in 85 years-old's, depending on diagnostic criteria. Overall, the prevalence of sarcopenia was 0.9-1.0 percentage points lower using the EWGSOP2 compared to EWGSOP1 when applying uniform T-score cut-offs (P <  0.005). The prevalence was doubled (15.0 vs. 7.5%) using the - 2.0 vs. -2.5 T-scores with EWGSOP2 in the whole sample. The increase in prevalence when changing the cut-offs was 5.7% (P <  0.001) in the 70-year-olds and 17.8% (P <  0.001) in the 85-year-olds (EWGSP2). Sarcopenia with cut-offs at - 2.5 T-score was associated with increased mortality (hazard ratio 2.4-2.8, P <  0.05) but not at T-score - 2.0. CONCLUSIONS: The prevalence of sarcopenia was higher in 85-year-olds compared to 70-year-olds. Overall, the differences between the EWGSOP1 and EWGSOP2 classifications are small. Meaningful differences between EWGSOP1 and 2 in the 85-year-olds could not be ruled out. Prevalence was more dependent on cut-offs than on the operational definition.


Asunto(s)
Sarcopenia , Actividades Cotidianas , Anciano , Anciano de 80 o más Años , Femenino , Fuerza de la Mano , Humanos , Masculino , Prevalencia , Sarcopenia/diagnóstico , Sarcopenia/epidemiología , Suecia , Velocidad al Caminar
18.
Nutrients ; 13(10)2021 Oct 14.
Artículo en Inglés | MEDLINE | ID: mdl-34684590

RESUMEN

Sarcopenia is a disease of gradual loss of muscle mass in elderly people, and the most common treatment options include nutritional supplementation and exercise. Vitamin D has potential beneficial effects for skeletal muscle tissue and has often been included in nutritional therapy formulations. However, the therapeutic effect of vitamin D for the treatment of sarcopenia has not yet been determine and there is a lack of high-quality supporting evidence. We searched three databases for randomized controlled trials (RCTs) on this topic. Changes in hand grip strength, gait speed, chair-stand test, fat mass, relative skeletal muscle index, and muscle mass were assessed for analysis. Network meta-analysis was further employed, based on the frequentist approach. Outcomes were reported as weighted mean differences (WMD) with 95% confidence intervals (CIs). A total of 9 RCTs (n = 1420) met our eligibility criteria, which treated patients with vitamin D (D), protein (P, n = 165), exercise (E, n = 124), iso-caloric product (I, n = 226), usual care without nutritional supplement (n = 65), P + D (n = 467), D + E (n = 72), P + E (n = 69), D + E + I (n = 73), and P + D + E (n = 159). The pooled estimate showed that the P + D + E intervention induced a greater improvement in hand grip strength than iso-caloric product intervention (WMD = 3.86; 95%CI, 0.52-7.21). Vitamin D intervention could lead to shorter chair-stand time (WMD = -1.32; 95%CI, -1.98 to -0.65), but no significant findings could be found for gait speed and muscle mass outcomes. Our synthesis found that combining vitamin D supplementation with protein supplementation and exercise can significantly increase grip strength and also showed a trend toward increasing muscle mass. This result implies that adding vitamin D to a standard treatment protocol for sarcopenia may be helpful for regaining function.


Asunto(s)
Ensayos Clínicos Controlados Aleatorios como Asunto , Sarcopenia/tratamiento farmacológico , Vitamina D/uso terapéutico , Composición Corporal , Marcha , Fuerza de la Mano , Humanos , Músculos/patología , Tamaño de los Órganos
19.
In Vivo ; 35(6): 3001-3009, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34697131

RESUMEN

The elderly people are characterized by multiple comorbidities, dementia, and are at risk of developing sarcopenia and frailty. Sarcopenia is defined by loss of muscle mass and muscle strength or physical decline. Sarcopenia is a main component of physical frailty. Screening tools for sarcopenia that can be easily determined in daily practice are useful and include the SARC-F screening tool. SARC-F is a questionnaire consisting of five questions: Strength (S), Assistance walking (A), Rising from a chair (R), Climbing stairs (C), and Falls (F) on a scale of 0 to 2. The recommended cutoff value is ≥4 points. The SARC-F has been shown to correlate well with clinical outcomes in the elderly and various underlying diseases, while it is also true that the SARC-F has its shortcomings such as low sensitivity for sarcopenia. In this review, we mainly outline the SARC-F and mention other screening tools for sarcopenia.


Asunto(s)
Sarcopenia , Anciano , Estudios Transversales , Evaluación Geriátrica , Humanos , Tamizaje Masivo , Sarcopenia/diagnóstico , Sarcopenia/epidemiología , Encuestas y Cuestionarios
20.
BMC Geriatr ; 21(1): 531, 2021 10 07.
Artículo en Inglés | MEDLINE | ID: mdl-34620111

RESUMEN

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.


Asunto(s)
Productos Finales de Glicación Avanzada , Sarcopenia , Anciano , Biomarcadores , Femenino , Humanos , Estudios Prospectivos , Receptor para Productos Finales de Glicación Avanzada , Sarcopenia/diagnóstico , Sarcopenia/epidemiología
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