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1.
Medicine (Baltimore) ; 99(9): e19245, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32118729

RESUMO

This study aimed to investigate whether trunk fat mass measured using dual-energy X-ray absorptiometry (DEXA) correlates with balance and physical performance.This study utilized 2-year baseline data pertaining to 3014 participants from the database of the Korean frailty and aging cohort study. The trunk lean mass and fat mass were measured by DEXA. Trunk fat mass index (tFMI) was established using the following standard equation: Trunk fat mass (Kg)/height (m). The clinical balance tests were performed using the timed up and go test (TUG), total balance score in short physical performance battery (SPPB). We performed SPPB and evaluated independence of daily living using activities of daily living, instrumental activities of daily living (IADL), sarcopenia screening tool (SARC-F) and both hand grip power. In our study, we tried to check the correlation of tFMI with balance and physical performance and to determine the factors associated with tFMI.The tFMI was positively correlated with mean values of 4 m gait speed, repeat chair stand time in SPPB, TUG, and SARC-F and negatively correlated with hand grip, IADL, total balance test score in SPPB, total SPPB score, and age. The results of the multiple generalized linear model analysis that assessed the factors associated with balance and physical performance indicated that tFMI had a significant correlation with repeat chair stand time in SPPB (seconds) (Beta estimate [B]: 0.252), TUG (seconds) (B: 0.25), 4 m gait speed (seconds) (B: 0.055), and total balance score in SPPB (B: -0.035).Higher tFMI using DEXA was correlated with low physical performance and balance, indicating that trunk fat mass was associated with balance and physical performance in community-dwelling older people.


Assuntos
Gordura Abdominal/fisiopatologia , Idoso Fragilizado , Desempenho Físico Funcional , Sarcopenia/fisiopatologia , Absorciometria de Fóton , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Avaliação Geriátrica , Força da Mão , Humanos , Vida Independente , Masculino , Equilíbrio Postural , República da Coreia , Inquéritos e Questionários
2.
J Frailty Aging ; 9(1): 9-13, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32150208

RESUMO

For clinical studies of sarcopenia and frailty, clinically meaningful outcome measures are needed to monitor disease progression, evaluate efficacy of interventions, and plan clinical trials. Physical performance measures including measures of gait speed and other aspects of mobility and strength have been used in many studies, although a definition of clinically meaningful change in performance has remained unclear. The International Conference on Frailty and Sarcopenia Research Task Force (ICFSR-TF), a group of academic and industry scientists investigating frailty and sarcopenia, met in Miami Beach, Florida, USA in February 2019 to explore approaches for establishing clinical meaningfulness in a manner aligned with regulatory authorities. They concluded that clinical meaningful change is contextually dependent, and that both anchor- based and distribution-based methods of quantifying physical function are informative and should be evaluated relative to patient-reported outcomes. In addition, they identified additional research needed to enable setting criteria for clinical meaningful change in trials.


Assuntos
Fragilidade/fisiopatologia , Desempenho Físico Funcional , Sarcopenia/fisiopatologia , Comitês Consultivos , Congressos como Assunto , Humanos
3.
J Frailty Aging ; 9(1): 37-43, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32150212

RESUMO

BACKGROUND: Sarcopenic obesity (SO) is associated with poorer physical performance in the elderly and will increase in relevance with population ageing and the obesity epidemic. The lack of a consensus definition for SO has resulted in variability in its reported prevalence, poor inter-definitional agreement, and disagreement on its impact on physical performance, impeding further development in the field. While sarcopenia definitions have been compared, the impact of obesity definitions in SO has been less well-studied. OBJECTIVES: To compare 3 widely-adopted definitions of obesity in terms of SO prevalence, inter-definitional agreement, and association with muscle function. DESIGN: Cross-sectional. SETTING: GERILABS study, Singapore Participants: 200 community-dwelling, functionally-independent older adults. MEASUREMENTS: We utilized three commonly-used definitions of obesity: body mass index (BMI), waist circumference (WC) and DXA-derived fat mass percentage (FM%). Sarcopenia was defined using Asian Working Group for Sarcopenia criteria. For muscle function, we assessed handgrip strength, gait speed and Short Physical Performance Battery (SPPB). Subjects were classified into 4 body composition phenotypes (normal, obese, sarcopenic and SO), and outcomes were compared between groups. RESULTS: The prevalence rate for SO was lowest for BMI (0.5%) compared to FM% (10.0%) and WC (10.5%). Inter-definitional agreement was lowest between BMI and WC (κ=0.364), and at best moderate between FM% and WC (κ=0.583). SO performed the worst amongst body composition phenotypes in handgrip strength, gait speed and SPPB (all p<0.01) only when defined using WC. In regression analyses, SO was associated with decreased SPPB scores (ß=-0.261, p=0.001) only for the WC definition. CONCLUSION: There is large variation in the prevalence of SO across different obesity definitions, with low-to-moderate agreement between them. Our results corroborate recent evidence that WC, and thus central obesity, is best associated with poorer muscle function in SO. Thus, WC should be further explored in defining obesity for accurate and early characterization of SO among older adults in Asian populations.


Assuntos
Obesidade , Sarcopenia , Terminologia como Assunto , Idoso , Estudos Transversais , Humanos , Força Muscular/fisiologia , Obesidade/epidemiologia , Obesidade/fisiopatologia , Prevalência , Reprodutibilidade dos Testes , Sarcopenia/epidemiologia , Sarcopenia/fisiopatologia
4.
Medicine (Baltimore) ; 99(2): e18708, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31914078

RESUMO

Sarcopenia is a geriatric syndrome and it impairs physical function. Patients with type 2 diabetes mellitus (T2DM) are at a higher risk of sarcopenia. The purpose of this study is to explore characteristics of general information and metabolic factors of sarcopenia in patients with T2DM in the northeast of China, and provide information for the prevention and treatment of sarcopenia in clinical practice.Patients with T2DM aged ≥65 were recruited in Changchun from March 2017 to February 2018. Questionnaires of general information, physical examination, laboratory and imaging examination were conducted. The patients were assigned into sarcopenia group and non-sarcopenia group according to the diagnostic criteria proposed by Asian working group for sarcopenia (AWGS), and the differences between 2 groups were analyzed.A total of 132 participants were included in this study, of which, 38 (28.8%) were diagnosed with sarcopenia. 94 (71.2%) were with no sarcopenia. Logistic regression analysis showed that age (OR: 1.182, 95%CI: 1.038-1.346), trunk fat mass (TFM) (OR: 1.499, 95%CI: 1.146-1.960) and free thyroxine (FT4) (OR: 1.342, 95%CI: 1.102-1.635) were independent risk factors for sarcopenia. BMI (body mass index) (OR: 0.365, 95%CI: 0.236-0.661), exercise (OR: 0.016, 95%CI: 0.001-0.169), female (OR: 0.000, 95%CI: 0.00-0.012), metformin (OR: 0.159, 95%CI: 0.026-0.967) and TSM (trunk skeletal muscle mass) (OR: 0.395, 95%CI: 0.236-0.661) were protective factors for sarcopenia.Sarcopenia in patients with T2DM is associated with increased age, increased TFM and increased FT4 level. Regular exercise, female, metformin administrations, high BMI and increased TSM are associated with lower risk of sarcopenia.


Assuntos
Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/fisiopatologia , Sarcopenia/epidemiologia , Sarcopenia/fisiopatologia , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Composição Corporal/fisiologia , Índice de Massa Corporal , China/epidemiologia , Estudos Transversais , Exercício/fisiologia , Feminino , Humanos , Modelos Logísticos , Masculino , Metformina/uso terapêutico , Músculo Esquelético/fisiopatologia , Fatores de Risco , Fatores Sexuais , Tiroxina/sangue
5.
Nutr Metab Cardiovasc Dis ; 29(12): 1390-1399, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31668791

RESUMO

BACKGROUND AND AIMS: A progressive decrease in muscle mass until full-blown sarcopenia may occur in patients on peritoneal dialysis (PD) and worsen their life quality and expectancy. Here we investigate the prevalence of obesity and obesity-associated muscle wasting in PD patients. PATIENTS AND METHODS: The study design was observational, cross sectional. Body composition was assessed with BIA and BIVA in 88 PD patients (53.4 ± 13.1 years; 67% male). Patients with obesity and/or with reduced muscle mass were identified using FMI and SM/BW cutoff values, respectively. Inflammatory status was assessed by measuring CRP and fibrinogen blood levels. RESULTS: A total of 44.3% of the patients showed a reduced muscle mass (37.5% moderate and 6.8% severe). The prevalence of obesity was 6.1%, 81.8%, and 100% in patients with normal, moderately, and severely reduced muscle mass, respectively (p < 0.05). Of the total, 15.2% of the patients with normal muscle mass, 18.4% of those with moderately reduced muscle mass, and 66.7% of those with severely reduced muscle mass had diabetes. The prevalence of severe muscle mass loss was higher in those with diabetes than in those without diabetes (22.2% vs. 2.8%, p < 0.05). Patients with obesity-associated muscle wasting showed higher fibrinogen (613.9 ± 155.1 vs. 512.9 ± 159.5 mg/dL, p < 0.05) and CPR (1.4 ± 1.3 vs. 0.6 ± 0.8 mg/dL, p < 0.05) blood concentrations than those with normal body composition. CONCLUSION: Obesity and diabetes were strongly associated with muscle mass loss in our PD patients. It remains to be established whether prevention of obesity with nutritional interventions can halt the occurrence of muscle mass loss in patients on PD.


Assuntos
Falência Renal Crônica/terapia , Obesidade/epidemiologia , Diálise Peritoneal/efeitos adversos , Sarcopenia/epidemiologia , Adulto , Idoso , Biomarcadores/sangue , Composição Corporal , Proteína C-Reativa , Estudos Transversais , Diabetes Mellitus/epidemiologia , Feminino , Fibrinogênio , Humanos , Mediadores da Inflamação/sangue , Itália/epidemiologia , Falência Renal Crônica/diagnóstico , Falência Renal Crônica/epidemiologia , Falência Renal Crônica/fisiopatologia , Masculino , Pessoa de Meia-Idade , Obesidade/sangue , Obesidade/diagnóstico , Obesidade/fisiopatologia , Prevalência , Medição de Risco , Fatores de Risco , Sarcopenia/sangue , Sarcopenia/diagnóstico , Sarcopenia/fisiopatologia
6.
J Bras Pneumol ; 45(6): e20180252, 2019.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31644702

RESUMO

OBJECTIVE: To establish a cut-off point for clinical and functional variables to determinate sarcopenia and dynapenia in COPD patients, and to analyze the impact of skeletal muscle dysfunction (SMD) on these variables. METHODS: Cross-sectional study, screened COPD patients for sarcopenia or dynapenia through low muscle mass and hand grip strength (HGS). Clinical variables: pulmonary function, respiratory muscle strength and functional capacity (FC). The precision of the variables in determining points of predictive cut-off for sarcopenia or dynapenia were performed using the Receiver Operating Characteristic curve and two-way analysis of variance. RESULTS: 20 COPD patients stratified for sarcopenia (n = 11) and dynapenia (n = 07). Sarcopenia group presented lower lean mass and lower maximal inspiratory pressure (MIP), decreased HGS, reduced FC (p<0.050). Dynapenia group presented reduced MIP, lower HGS and walked a shorter distance at Incremental shuttle walk test (ISWT) (p<0.050). We found cut-off points of forced expiratory volume in one second (FEV1), MIP and maximal expiratory pressure (MEP) and ISWT. It is possible to identify sarcopenia or dynapenia in these patients. We found the coexistence of the conditions (SMD effect) in COPD - reduction in the distance in the ISWT (p = 0.002) and %ISWT (p = 0.017). CONCLUSION: In moderate to very severe COPD patients the sarcopenia could be predicted by FEV1 (%predicted) < 52, MIP < 73 cmH2O, MEP < 126 cmH2O and distance traveled of < 295 m in ISWT. Whereas dynapenia could be predicted by FEV1 < 40%, MIP < 71 cmH2O, MEP < 110 cmH2O and distance of < 230 m traveled in ISWT.


Assuntos
Pulmão/fisiopatologia , Debilidade Muscular/fisiopatologia , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Músculos Respiratórios/fisiopatologia , Sarcopenia/fisiopatologia , Idoso , Análise de Variância , Estudos Transversais , Feminino , Volume Expiratório Forçado/fisiologia , Força da Mão/fisiologia , Humanos , Masculino , Pressões Respiratórias Máximas , Pessoa de Meia-Idade , Força Muscular/fisiologia , Curva ROC , Valores de Referência , Índice de Gravidade de Doença , Estatísticas não Paramétricas , Capacidade Vital/fisiologia , Teste de Caminhada
7.
Surgery ; 166(6): 1041-1047, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31607486

RESUMO

BACKGROUND: Some studies have reported that sarcopenia is linked to clinical outcomes in multiple types of malignancies, but this association has not been established in esophageal cancer. We assessed how sarcopenia affects clinical outcomes of multidisciplinary treatments for esophageal cancer. METHODS: We included 165 esophageal cancer patients who had undergone neoadjuvant chemotherapy followed by esophagectomy. Computed tomography was used for cross-sectional measurement of the psoas muscle at the third lumbar vertebra; we then calculated the height-adjusted psoas muscle index. Pre- and postneoadjuvant chemotherapy psoas muscle indices were evaluated for associations with neoadjuvant chemotherapy response and neoadjuvant chemotherapy -related adverse events and postoperative complications, in addition to survival. Psoas muscle index cutoffs were 6.36 cm2/m2 for men and 3.92 cm2/m2 for women. RESULTS: Psoas muscle index decreased after neoadjuvant chemotherapy (from 7.17 to 6.96 cm2/m2; P = .0008), and specifically in men (from 7.45 to 7.23 cm2/m2; P = .0001) but not in women (from 5.21 to 5.17 cm2/m2; P = .810). Preneoadjuvant chemotherapy psoas muscle index (low versus high) was associated with neoadjuvant chemotherapy response (response rate: 65.1% vs 80.3%; P = .0494) and neoadjuvant chemotherapy-related adverse events (neutropenia: 93.0% vs 78.7%; P = .0337; febrile neutropenia: 53.5% vs 34.3%; P = .0278; hyponatremia: 51.2% vs 31.2%; P = .0190). Post-neoadjuvant chemotherapy psoas muscle index correlated with postoperative rate of complications (56.9% vs 33.3%; P = .0046), especially pneumonia (31.4% vs 9.7% P = .0008). Psoas muscle index was not associated with survival. CONCLUSION: Cross sectional measures of sarcopenia before and after neoadjuvant chemotherapy could predict tumor response, neoadjuvant chemotherapy -related adverse events, and postoperative complications in multidisciplinary treatments for esophageal cancer.


Assuntos
Neoplasias Esofágicas/terapia , Esofagectomia/efeitos adversos , Terapia Neoadjuvante/efeitos adversos , Complicações Pós-Operatórias/epidemiologia , Músculos Psoas/diagnóstico por imagem , Sarcopenia/diagnóstico , Fatores Etários , Idoso , Antineoplásicos/efeitos adversos , Intervalo Livre de Doença , Neoplasias Esofágicas/complicações , Neoplasias Esofágicas/mortalidade , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Valor Preditivo dos Testes , Prognóstico , Músculos Psoas/efeitos dos fármacos , Músculos Psoas/fisiopatologia , Estudos Retrospectivos , Fatores de Risco , Sarcopenia/etiologia , Sarcopenia/fisiopatologia , Taxa de Sobrevida , Tomografia Computadorizada por Raios X
8.
J Cardiovasc Surg (Torino) ; 60(6): 672-678, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31603293

RESUMO

BACKGROUND: Sarcopenia, commonly determined by measuring skeletal muscle mass index (SMI) at the third lumbar level, has been identified as a predictor of clinical outcome in a variety of diseases. For patients with peripheral arterial occlusive disease (PAOD), we hypothesized that lower extremity SMI (LESMI) might be a more precise predictor of outcome and the extent of chronic ischemia than the systemic muscle mass at the L3 level. We investigated the association between complete muscle volume and muscle area derived with single-slice 2-dimensional measurements in the legs to identify at which level cross-sectional single-slice measurements are most representative of the muscle volume and investigated whether LESMI is associated with systemic sarcopenia and PAOD severity. METHODS: Muscle volumes and areas were semiautomatically segmented from computed tomography (CT) scans of the affected and contralateral legs of 50 PAOD patients with Fontaine stage IIb and 50 PAOD patients with Fontaine stage IV. The muscle mass was determined for the complete volumes of the upper and lower legs and for cross-sectional slices at 40%, 50%, and 60% of the length of the femur and tibia. Patients were determined as sarcopenic based on sex-specific cut-off values at the L3 spinal segment. Two observers segmented 20 randomly selected patients to determine the interobserver reliability with the intraclass correlation coefficient. RESULTS: The correlation between the LESMI of the complete muscle volume and the three cross-sectional slices in all 200 upper and 200 lower legs was moderately strong to strong. Interobserver reliability of cross-sectional slice segmentation was excellent. The LESMI, both measured volumetrically and cross-sectionally, were significantly lower in patients with sarcopenia compared to patients without sarcopenia. The LESMI was lower in patients with Fontaine stage IV compared to patients with Fontaine stage IIb for both volumetric and cross-sectional measurements. CONCLUSIONS: Segmentation of skeletal muscle mass from cross-sectional single-slice CT in the upper and lower leg can accurately and precisely substitute complete volume segmentations. These findings warrant the use of measurements based on cross-sectional single-slice CT for assessing the LESMI. Patients with systemic sarcopenia are also at increased risk for muscle mass loss in the lower extremities. In the current study, LESMI was lower in patients with Fontaine class IV PAOD compared to patients with Fontaine class IIb PAOD. Future studies should assess the predictive value of the LESMI on clinical outcomes in PAOD patients.


Assuntos
Composição Corporal , Isquemia/diagnóstico por imagem , Extremidade Inferior/irrigação sanguínea , Músculo Esquelético/diagnóstico por imagem , Atrofia Muscular/diagnóstico por imagem , Doença Arterial Periférica/diagnóstico por imagem , Sarcopenia/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Idoso , Feminino , Humanos , Isquemia/fisiopatologia , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/fisiopatologia , Atrofia Muscular/fisiopatologia , Variações Dependentes do Observador , Doença Arterial Periférica/fisiopatologia , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Estudos Retrospectivos , Sarcopenia/fisiopatologia , Índice de Gravidade de Doença
9.
World J Gastroenterol ; 25(35): 5257-5265, 2019 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-31558871

RESUMO

Minimal hepatic encephalopathy (MHE) represents the mildest type of hepatic encephalopathy (HE). MHE is considered as a preclinical stage of HE and is part of a wide spectrum of typical neurocognitive alterations characteristic of patients with liver cirrhosis, particularly involving the areas of attention, alertness, response inhibition, and executive functions. MHE can be detected by testing the patients' psychometric performance, attention, working memory, psychomotor speed, and visuospatial ability, as well as by means of electrophysiological and other functional brain measures. MHE is very frequent, affecting from 20% up to 80% of patients tested, depending of the diagnostic tools used. Although subclinical, MHE is considered to be clinically relevant. In fact, MHE has been related to the patients' falls, fitness to drive, and working ability. As a consequence, MHE affects the patients and caregivers lives by altering their quality of life and even their socioeconomic status. Recently sarcopenia, a very common condition in patients with advanced liver disease, has been shown to be strictly related to both minimal and overt HE. Aim of this review is to summarize the most recently published evidences about the emerging relationship between sarcopenia and cognitive impairment in cirrhotic patients and provide suggestions for future research.


Assuntos
Disfunção Cognitiva/fisiopatologia , Encefalopatia Hepática/etiologia , Cirrose Hepática/complicações , Qualidade de Vida , Sarcopenia/etiologia , Encéfalo/fisiopatologia , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/etiologia , Feminino , Encefalopatia Hepática/diagnóstico , Encefalopatia Hepática/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Sarcopenia/fisiopatologia , Classe Social
10.
Braz J Med Biol Res ; 52(9): e8204, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31482974

RESUMO

Sarcopenia remains poorly managed in clinical practice due to the lack of simple and accurate screening tools. This study aimed to identify the cutoff values of the SARC-F questionnaire and Ishii's score using the variables age, grip strength, and calf circumference in older inpatients in China to compare the accuracy of the two methods and to explore their predictive ability for adverse outcomes (rehospitalization, falls, fracture, and death). Hospitalized patients (n=138) aged ≥60 years were included. The accuracy of the two tools was evaluated using the reference diagnosis recommended by the Asian Working Group on Sarcopenia (assessing patients with measurements of muscle mass, handgrip strength, and usual gait speed). Follow-up data were obtained by telephone and clinical visits combined with the inpatient medical record system after discharge for at least one year. The results showed that the SARC-F score reached the highest Youden's index when a score of 3 was set as the cutoff value. Ishii's score presented a higher accuracy than SARC-F (area under the receiver operating curve: 0.78 vs 0.64, P=0.01). The Kaplan-Meier survival analysis demonstrated a higher cumulative incidence of rehospitalization in sarcopenic individuals compared to non-sarcopenic individuals according to SARC-F (log-rank test, P<0.001). Cox analysis revealed that SARC-F was an independent risk factor for rehospitalization (adjusted hazard ratio: 4.23, 95%CI: 2.12-9.79, P<0.001). The SARC-F and Ishii's scores might facilitate the early detection of sarcopenia and help identify older adults at risk for adverse outcomes in clinical practice.


Assuntos
Índice de Massa Corporal , Avaliação Geriátrica/métodos , Força da Mão/fisiologia , Sarcopenia/diagnóstico , Inquéritos e Questionários , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Pacientes Internados , Estimativa de Kaplan-Meier , Masculino , Valor Preditivo dos Testes , Prognóstico , Reprodutibilidade dos Testes , Sarcopenia/fisiopatologia
11.
Artigo em Inglês | MEDLINE | ID: mdl-31370245

RESUMO

There is a growing body of evidence that links nutrition to muscle mass and function in the elderly, suggesting that it has an important role to play both in the prevention and management of age-related sarcopenia. Some nutrients have been studied, but less is known about the influence of overall diet quality on the loss of skeletal muscle mass and function. This study investigated the interrelationship between the recommended food score (RFS), as an indicator of overall diet quality, and muscle mass function among the Korean elderly. The sample consisted of 521 participants (263 men and 258 women), aged >65 years, who participated in the 2014-2015 National Fitness Award project. Appendicular skeletal muscle mass (ASM) was assessed by bioelectrical impedance analysis. Low muscle mass was defined as having an ASM corrected for height lower than the cutoff value established by the European Working Group on Sarcopenia in Older People. Muscle function, assessed by handgrip strength (HGS), was defined as low if it was below the 20th percentile of elderly men and women. Low muscle mass-function, defined as low muscle mass with low muscle strength (HGS), was found in 29 men (11.0%) and 22 women (8.5%). In elderly men, the low muscle mass-function group had significantly lower RFS values than the normal group after adjustments for age, body fat percentage, drinking, smoking, education, and physical activity (p = 0.019). However, there was no association between RFS and muscle mass-function in elderly women. Our findings suggest that better diet quality may be associated with higher muscle mass in elderly Korean men.


Assuntos
Dieta , Valor Nutritivo , Sarcopenia/etiologia , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Força da Mão , Inquéritos Epidemiológicos , Humanos , Masculino , Fatores de Proteção , República da Coreia , Fatores de Risco , Sarcopenia/diagnóstico , Sarcopenia/fisiopatologia , Fatores Sexuais
12.
Int J Mol Sci ; 20(15)2019 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-31387214

RESUMO

Sarcopenia is characterized by the progressive loss of skeletal muscle mass and strength. In older people, malnutrition and physical inactivity are often associated with sarcopenia, and, therefore, dietary interventions and exercise must be considered to prevent, delay, or treat it. Among the pathophysiological mechanisms leading to sarcopenia, a key role is played by an increase in reactive oxygen and nitrogen species (ROS/RNS) levels and a decrease in enzymatic antioxidant protection leading to oxidative stress. Many studies have evaluated, in addition to the effects of exercise, the effects of antioxidant dietary supplements in limiting age-related muscle mass and performance, but the data which have been reported are conflicting. In skeletal muscle, ROS/RNS have a dual function: at low levels they increase muscle force and adaptation to exercise, while at high levels they lead to a decline of muscle performance. Controversial results obtained with antioxidant supplementation in older persons could in part reflect the lack of univocal effects of ROS on muscle mass and function. The purpose of this review is to examine the molecular mechanisms underlying the dual effects of ROS in skeletal muscle function and the analysis of literature data on dietary antioxidant supplementation associated with exercise in normal and sarcopenic subjects.


Assuntos
Músculo Esquelético/metabolismo , Espécies Reativas de Oxigênio/metabolismo , Adaptação Fisiológica , Envelhecimento/metabolismo , Animais , Antioxidantes/metabolismo , Antioxidantes/farmacologia , Suplementos Nutricionais , Exercício , Humanos , Oxirredução , Espécies Reativas de Nitrogênio/metabolismo , Sarcopenia/etiologia , Sarcopenia/metabolismo , Sarcopenia/fisiopatologia , Sarcopenia/prevenção & controle , Transdução de Sinais
13.
Acta Med Indones ; 51(2): 117-127, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31383826

RESUMO

BACKGROUND: sarcopenia is one of many geriatric problems that may lead to major clinical outcomes. Calf and thigh circumference have good correlation with muscle mass, whereas SARC-F questionnaire is very predictive of muscle function. There has not been a study that evaluates the diagnostic performance of calf and thigh circumference in combination with SARC-F questionnaire in detecting sarcopenia. The aim of this study was to investigate the diagnostic performance of calf and thigh circumference in combination with SARC-F questionnaire compared to standard diagnostic methods of sarcopenia according to the Asian Working Group for Sarcopenia (AWGS) to predict sarcopenia in patient aged 60 years or older. METHODS: this cross-sectional study was conducted in Geriatric Clinic Cipto Mangunkusumo Hospital, Jakarta, Indonesia during April-June 2018. Analysis was performed using receiver operating characteristic (ROC) curve to determine the cut-off point as well as sensitivity (Sn), specificity (Sp), positive and negative predictive value (PPV and NPV), positive and negative likelihood ratio (LR+ and LR-) of calf and thigh circumference as an indicator of low muscle mass, and SARC-F questionnaire score to detect decreased muscle function. RESULTS: from 120 participants, there were 46 men (38.3%) and 74 women (61.7%). The combination of calf circumference with cut-off point below 34 cm in men and below 29 cm in women, thigh circumference below 49 cm in men and below 44 cm in women with SARC-F questionnaire score of ≥4 have Sn, Sp, PPV, NPV, LR+, and LR- of 15.79%; 99.01%; 75.00%; 86.21%; 15.95; and 0.85 respectively. CONCLUSION: combination of calf and thigh circumference with SARC-F questionnaire showed good diagnostic accuracy in predicting sarcopenia in elderly outpatients.


Assuntos
Sarcopenia/diagnóstico , Sarcopenia/fisiopatologia , Inquéritos e Questionários , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Indonésia , Perna (Membro)/anatomia & histologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Força Muscular , Desempenho Físico Funcional , Valor Preditivo dos Testes , Curva ROC , Coxa da Perna/anatomia & histologia
14.
Nutrients ; 11(9)2019 Aug 23.
Artigo em Inglês | MEDLINE | ID: mdl-31443594

RESUMO

Sarcopenia is an age-related and accelerated process characterized by a progressive loss of muscle mass and strength/function. It is a multifactorial process associated with several adverse outcomes including falls, frailty, functional decline, hospitalization, and mortality. Hence, sarcopenia represents a major public health problem and has become the focus of intense research. Unfortunately, no pharmacological treatments are yet available to prevent or treat this age-related condition. At present, the only strategies for the management of sarcopenia are mainly based on nutritional and physical exercise interventions. The purpose of this review is, thus, to provide an overview on the role of proteins and other key nutrients, alone or in combination with physical exercise, on muscle parameters.


Assuntos
Terapia por Exercício , Força Muscular , Músculo Esquelético/fisiopatologia , Apoio Nutricional , Sarcopenia/terapia , Fatores Etários , Idoso , Terapia Combinada , Humanos , Pessoa de Meia-Idade , Músculo Esquelético/patologia , Estado Nutricional , Valor Nutritivo , Recuperação de Função Fisiológica , Sarcopenia/diagnóstico , Sarcopenia/fisiopatologia , Resultado do Tratamento
15.
Einstein (Sao Paulo) ; 17(4): eAO4632, 2019 Aug 19.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31433007

RESUMO

OBJECTIVE: To investigate the potential value of sarcopenia and sarcopenic obesity as prognostic predictors in hospitalized elderly patients with acute myocardial infarction. METHODS: A cross-sectional study based on data collected from elderly patients with acute myocardial infarction, admitted to a public hospital located in the Northeastern region of Brazil, from April to July 2015. The diagnosis of sarcopenia was based on muscle mass, muscle strength and physical performance measurements. Cardiovascular risk and prognostic markers, such as troponin and creatine kynase MB isoenzyme values, acute myocardial infarction classification according to ST segment elevation, and thrombolysis in myocardial infarction score were used. RESULTS: The sample comprised 99 patients with mean age of 71.6 (±7.4) years. Prevalence of sarcopenia and sarcopenic obesity was 64.6% and 35.4%, respectively. Sarcopenia was more prevalent among males (p=0.017) aged >80 years (p=0.008). Thrombolysis in myocardial infarction was the only marker of cardiovascular risk significantly associated with sarcopenia (p=0.002). CONCLUSION: Prevalence of sarcopenia was high and associated with thrombolysis in myocardial infarction risk score. Sarcopenic obesity affected approximately one-third of patients and was not associated with any of the prognostic predictors.


Assuntos
Atividade Motora/fisiologia , Força Muscular/fisiologia , Infarto do Miocárdio/etiologia , Obesidade/complicações , Sarcopenia/complicações , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Estudos Transversais , Feminino , Avaliação Geriátrica , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/fisiopatologia , Obesidade/fisiopatologia , Valor Preditivo dos Testes , Prognóstico , Fatores de Risco , Sarcopenia/fisiopatologia
16.
Transplant Proc ; 51(6): 1853-1860, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31256871

RESUMO

OBJECTIVE: The development of sarcopenia leads to adverse postoperative outcomes. However, no study has investigated perioperative loss in core muscle and the correlation between core muscle and residual liver volume in living donors for liver transplant. PATIENTS AND METHODS: A total of 457 adult healthy donors who underwent a right lobe hepatectomy without the middle hepatic vein for elective liver transplant were retrospectively analyzed. Abdominal computed tomography was performed within 1 month before surgery and the first week and 3 months after the surgery. The average psoas muscle area between lumbar vertebrae 3 and 4 was measured and normalized by height squared (psoas muscle index [PMI] = psoas muscle area/height2). The initial whole liver volume and remnant left lobe volume were measured on computed tomography images. RESULTS: The study cohort included 279 men (61.1%) and 178 women (38.9%). The median preoperative PMIs were 420.9 mm2/m2 (interquartile range, 360.6-487.0 mm2/m2) in men and 280.9 mm2/m2 (interquartile range, 243.5-318.7 mm2/m2) in women. The PMIs in men and women significantly decreased during the first week after surgery, and gradually recovered to preoperative levels during the first 3 months after surgery. Based on the ratio between the remnant left lobe and initial whole liver volume (≥30%), the increase in remnant left lobe volume was not correlated with the decrease in PMI on postoperative day 7. A postoperative U-shaped recovery in the core muscles was present in both male and female donors, independent of the remnant liver ratio. CONCLUSIONS: Despite the requirements of partial liver regeneration and surgical wound repair, healthy donors did not suffer from sustained core muscle loss after surgery.


Assuntos
Hepatectomia/efeitos adversos , Doadores Vivos , Complicações Pós-Operatórias/fisiopatologia , Músculos Psoas/fisiopatologia , Coleta de Tecidos e Órgãos/efeitos adversos , Adulto , Feminino , Hepatectomia/métodos , Veias Hepáticas , Humanos , Fígado/patologia , Fígado/cirurgia , Regeneração Hepática , Transplante de Fígado , Masculino , Pessoa de Meia-Idade , Tamanho do Órgão , Complicações Pós-Operatórias/etiologia , Período Pós-Operatório , Músculos Psoas/cirurgia , Recuperação de Função Fisiológica , Estudos Retrospectivos , Sarcopenia/etiologia , Sarcopenia/fisiopatologia , Tomografia Computadorizada por Raios X
17.
Percept Mot Skills ; 126(5): 828-842, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31284844

RESUMO

Sarcopenia is defined as an age-related decrease in muscle mass, strength, and function. We investigated the effect of circuit training on body composition, balance, muscle mass and strength, and pulmonary function in Korean women with sarcopenia. We randomly assigned 26 Korean women with sarcopenia (Mage = 74.9, SD = 4.5 years) to either an exercise group (EG) (n = 13) or a control group (CG) (n = 13). The EG performed 25-75 minutes of circuit exercise training (gradually increasing time periods) three times per week over 12 weeks, while the CG maintained their usual daily lifestyle during the intervention period. We measured body weight, body mass index, percent body fat, free fat mass, balance ability, peak torque in shoulder, knee, and lumbar joints normalized for bodyweight (BW), forced vital capacity, percentage of forced expiratory volume in one second, and forced expiratory flow 25-75% before and after the intervention. The EG showed improved body composition (i.e., body mass index, fat-free body mass, fat mass; all p < .032, η2 > 0.180), balance (i.e., right and left of static and dynamic balance and fast 10-m walk; all p < .050, η2 > 0.151), muscular function (i.e., 90°/s and 180°/s peak power per kilogram BW, 90°/s average power per kilogram BW, 180°/s total work, and 180°/s endurance ratio; all p < .045, η2 > 0.157), and pulmonary function (all p < .005, η2 > 0.292). On the other hand, the CG showed no significant changes. Circuit exercise training improves muscle mass and strength, body composition, balance, and pulmonary function in women with sarcopenia.


Assuntos
Composição Corporal , Exercícios em Circuitos/métodos , Força Muscular , Sarcopenia/reabilitação , Idoso , Grupo com Ancestrais do Continente Asiático , Índice de Massa Corporal , Peso Corporal , Exercício/fisiologia , Feminino , Volume Expiratório Forçado , Humanos , Fluxo Máximo Médio Expiratório , Músculo Esquelético/fisiologia , Músculo Esquelético/fisiopatologia , República da Coreia , Sarcopenia/fisiopatologia , Capacidade Vital , Mulheres
18.
Aging Clin Exp Res ; 31(11): 1549-1556, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31317519

RESUMO

BACKGROUND: As the general population is aging worldwide, the incidence of sarcopenia and osteoporosis is also rapidly increasing. Studies have found the link between sarcopenia and osteoporosis, but the relationship between sarcopenia and osteoporosis, especially bone microarchitecture, remains unclear. AIMS: To investigate the relationship between components of sarcopenia (muscle mass, handgrip strength, and gait speed) and components of osteoporosis [bone mass measured by bone mineral density (BMD) and bone microarchitecture measured by trabecular bone score (TBS)] in Chinese subjects. METHODS: 318 Chinese men and 203 Chinese women were included in our study. Muscle mass and BMD were measured by dual-energy X-ray absorptiometry (DXA). TBS iNsight® software was used for TBS. Jamar hydraulic hand dynamometer was used to assess muscle strength, and gait speed was used to assess physical performance. RESULTS: We found that the relative appendicular skeletal muscle mass (RASM) in both genders and handgrip strength in women correlated positively with TBS, RASM in men and handgrip strength in women correlated positively with BMDs. In the multiple linear regression model, RASM was positively associated with TBS in both genders, but no significant association was observed between RASM and BMDs. Interestingly, handgrip strength showed positive association with all evaluated BMDs and TBS in women, but not in men. Women with sarcopenia had lower TBS and BMDs at all evaluated sites. Men with sarcopenia had lower BMDs only at femur neck and total hip. CONCLUSIONS: The reduction of muscle mass and strength was significantly associated with decreased bone mass and deteriorated bone microarchitecture. More importantly, low muscle mass is an independent risk factor for bone microarchitecture in Chinese subjects.


Assuntos
Densidade Óssea/fisiologia , Osso Esponjoso/fisiologia , Osteoporose/fisiopatologia , Sarcopenia/fisiopatologia , Absorciometria de Fóton , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Força Muscular/fisiologia , Osteoporose/diagnóstico , Sarcopenia/diagnóstico , Fatores Sexuais , Velocidade de Caminhada
19.
Nutrients ; 11(7)2019 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-31319564

RESUMO

Human gut microbiota is able to influence the host physiology by regulating multiple processes, including nutrient absorption, inflammation, oxidative stress, immune function, and anabolic balance. Aging is associated with reduced microbiota biodiversity, increased inter-individual variability, and over-representation of pathobionts, and these phenomena may have great relevance for skeletal muscle mass and function. For this reason, the presence of a gut-muscle axis regulating the onset and progression of age-related physical frailty and sarcopenia has been recently hypothesized. In this narrative review, we summarize the studies supporting a possible association between gut microbiota-related parameters with measures of muscle mass, muscle function, and physical performance in animal models and humans. Reduced muscle mass has been associated with distinct microbiota composition and reduced fermentative capacity in mice, and the administration of probiotics or butyrate to mouse models of muscle wasting has been associated with improved muscle mass. However, no studies have targeted the human microbiome associated with sarcopenia. Limited evidence from human studies shows an association between microbiota composition, involving key taxa such as Faecalibacterium and Bifidobacterium, and grip strength. Similarly, few studies conducted on patients with parkinsonism showed a trend towards a different microbiota composition in those with reduced gait speed. No studies have assessed the association of fecal microbiota with other measures of physical performance. However, several studies, mainly with a cross-sectional design, suggest an association between microbiota composition and frailty, mostly assessed according to the deficit accumulation model. Namely, frailty was associated with reduced microbiota biodiversity, and lower representation of butyrate-producing bacteria. Therefore, we conclude that the causal link between microbiota and physical fitness is still uncertain due to the lack of targeted studies and the influence of a large number of covariates, including diet, exercise, multimorbidity, and polypharmacy, on both microbiota composition and physical function in older age. However, the relationship between gut microbiota and physical function remains a very promising area of research for the future.


Assuntos
Fragilidade , Microbioma Gastrointestinal/fisiologia , Músculo Esquelético/fisiologia , Sarcopenia/fisiopatologia , Idoso , Animais , Humanos
20.
Int Urol Nephrol ; 51(8): 1415-1424, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31270740

RESUMO

PURPOSE: To investigate the effect of intradialytic resistance exercise on inflammation markers and sarcopenia indices in maintenance hemodialysis (MHD) patients with sarcopenia. METHODS: Forty-one MHD patients with sarcopenia were divided into an intervention group (group E, n = 21) and a control group (group C, n = 20). Group C patients only received routine hemodialysis care, whereas group E patients received progressive intradialytic resistance exercise with high or moderate intensity for 12 weeks at three times per week (using the weight of the lower limbs and elastic ball movement of the upper limb) on the basis of routine hemodialysis care. RESULTS: After 12 weeks, a significant difference in physical activity status (maximum grip strength, daily pace, and physical activity level), Kt/V, and C-reactive protein was found between groups E and C. Inflammatory factors (interleukin (IL)-6, IL-10, and tumor necrosis factor(TNF)-α) increased or decreased more significantly in group E than in group C. CONCLUSIONS: This study showed that intradialytic resistance exercise can improve physical activity effectively and reduce microinflammatory reactions even if this simple exercise does not affect the muscle mass in MHD patients with sarcopenia.


Assuntos
Exercício , Inflamação/terapia , Diálise Renal , Treinamento de Resistência , Sarcopenia/terapia , Adulto , Idoso , Feminino , Humanos , Inflamação/complicações , Inflamação/fisiopatologia , Masculino , Pessoa de Meia-Idade , Sarcopenia/complicações , Sarcopenia/fisiopatologia
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