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1.
Nutr Metab Cardiovasc Dis ; 31(4): 1035-1043, 2021 04 09.
Artigo em Inglês | MEDLINE | ID: mdl-33573921

RESUMO

BACKGROUND AND AIMS: The present study investigated the association between abdominal aortic calcification (AAC) and handgrip strength (HGS) and the ability of HGS to predict an increased AAC phenotype in adults. METHODS AND RESULTS: The analysis consisted of data for 3140 men and women aged ≥40 years (51.7% women) from the 2013-2014 NHANES. Lateral scans of the thoraco-lumbar spine (L1-L4) were scored for AAC using a validated 8-point scale (AAC-8); subjects with a score of ≥3 were considered at increased risk for cardiovascular disease due to a high AAC phenotype. HGS was assessed using a grip dynamometer. The prevalence of severe AAC in the population was 9.0%. Decline in HGS was associated with higher AAC-8 scores in men and women (p < 0.001). General linear model analysis showed that HGS levels were negatively associated with high AAC (p < 0.001) and AAC-8 status for both sexes. Likewise, for each 5-kg higher HGS, there lower odds of a high AAC phenotype (in men OR = 0.73, CI95%, 0.64-0.84) and (women OR = 0.58, CI95%, 0.47-0.70). Receiver operating characteristic curve analysis showed that the HGS threshold value to detect high risk of AAC in adults was ≥37.3 kg (AUC = 0.692) in men and 25.1 kg (AUC = 0.705) in women. CONCLUSION: Lower muscular strength, as measured by HGS, is associated with higher AAC scores in the U.S. population ≥40 years of age. Accordingly, maintenance of muscular strength during aging may protect adults against vascular calcification, an independent predictor of cardiovascular events. HGS measurement seems to be a valid screening tool for detecting a high ACC phenotype in adults.


Assuntos
Aorta Abdominal , Doenças da Aorta/epidemiologia , Força da Mão , Sarcopenia/epidemiologia , Calcificação Vascular/epidemiologia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Aorta Abdominal/diagnóstico por imagem , Doenças da Aorta/diagnóstico por imagem , Doenças da Aorta/fisiopatologia , Estudos Transversais , Feminino , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Dinamômetro de Força Muscular , Inquéritos Nutricionais , Fenótipo , Exame Físico/instrumentação , Valor Preditivo dos Testes , Prevalência , Medição de Risco , Sarcopenia/diagnóstico , Sarcopenia/fisiopatologia , Estados Unidos/epidemiologia , Calcificação Vascular/diagnóstico por imagem , Calcificação Vascular/fisiopatologia
2.
Curr Opin Clin Nutr Metab Care ; 24(3): 229-235, 2021 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-33587365

RESUMO

PURPOSE OF REVIEW: This manuscript reviews evidence collected during COVID-19 pandemic and provides information on the impact of body composition on severity and outcomes of the disease, analysing methods used for body composition assessment. Malnutrition-screening tools will also be discussed to screen and diagnose the patients at higher risk of COVID-19 severity and related worse outcomes. RECENT FINDINGS: COVID-19 can occur in a wide range of presentation, from asymptomatic to severe forms. Among the major risk factors for worse severity, overnutrition, undernutrition and body composition play a role in the ability to respond to SARS-CoV-2 infection. Excess fat accumulation (i.e. obesity) or lean mass loss and functionality (i.e. sarcopenia) or a combination of both (i.e. sarcopenic obesity) can affect whole-body functioning. These body composition alterations in the short-term can influence susceptibility and immunological responses to the virus, inflammatory reaction, metabolic and respiratory distress, while in the long-term can modulate disease outcomes, namely length of stay, time required for recovery, risk of ICU-acquired weakness and long-term disabilities, and potentially increase the risk of death. SUMMARY: Individuals with malnutrition, sarcopenia, obesity, sarcopenic obesity and older adults with abnormal body composition or malnutrition risk may require tailored medical nutrition therapy to improve short and long-term COVID-19 outcomes.


Assuntos
Composição Corporal , Desnutrição/virologia , Estado Nutricional , Adulto , Idoso , Idoso de 80 Anos ou mais , /virologia , Feminino , Humanos , Masculino , Desnutrição/fisiopatologia , Pessoa de Meia-Idade , Terapia Nutricional , Obesidade/fisiopatologia , Obesidade/virologia , Hipernutrição/fisiopatologia , Hipernutrição/virologia , Sarcopenia/fisiopatologia , Sarcopenia/virologia , Índice de Gravidade de Doença
3.
Orv Hetil ; 162(1): 3-12, 2021 01 03.
Artigo em Húngaro | MEDLINE | ID: mdl-33388736

RESUMO

Összefoglaló. A sarcopenia progresszív, generalizált vázizombetegség az izomtömeg fogyásával és az izomfunkció romlásával, számos szövodménnyel, rossz prognózissal. A sarcopeniát eredetileg életkorfüggo, idosekben jelentkezo kórképnek írták le (primaer sarcopenia). Késobb derült ki, hogy fiatal- és középkorú személyeknél is elofordul, különbözo betegségekhez társulva (secundaer sarcopenia). A közlemény áttekintést ad a betegség patofiziológiájáról, a fizikai inaktivitás, az inzulinrezisztencia, a krónikus gyulladás, a citokinek, hepatokinek és miokinek szerepérol az izomkárosodásban, valamint az izom, a zsírszövet és a máj funkcionális kapcsolatairól nem alkoholos zsírmájban és cirrhosisban. A diagnózis felállítását számos funkcionális próba, illetve vizsgálóeljárás teszi lehetové. Az izomero-csökkenés igazolása a legfontosabb paraméter (kézszorító ero). Az izomtömegvesztést kettos energiájú röntgenabszorpciometria, bioelektromosimpedancia-analízis, komputertomográfia vagy mágneses rezonanciás képalkotó vizsgálat mutathatja ki, megerosítve a kórismét, a fizikai teljesítmény csökkenése pedig a sarcopenia súlyosságát jelzi. A sarcopenia kezelése és a progresszió prevenciója a fiatalkorban elkezdett és élethosszig tartó rendszeres fizikai aktivitáson, a protein-kalória túltápláláson és a gyógyszeres terápián alapul, beleértve a D-vitamin és a tesztoszteron pótlását, az elágazó láncú aminosavak és az L-karnitin adását. Másodlagos sarcopeniában az alapbetegség kezelése is szükséges. Orv Hetil. 2021; 162(1): 3-12. Summary. Sarcopenia is a progressive, generalized skeletal muscle disease with the loss of muscle mass and function, associated with adverse outcomes and poor prognosis. Sarcopenia first was regarded as an age-related disorder of older people (primary sarcopenia). Later it turned out that it can also occur in young age due to a range of chronic disorders such as cancer, anorexia or malnutrition (secondary sarcopenia). This paper overviews the pathophysiology of sarcopenia and the factors involved in the muscle mass loss, i.e., physical inactivity, insulin resistance, low-grade chronic inflammation, hepatokines and myokines. The basic feature is the imbalance between proteolysis and protein synthesis that leads to muscle atrophy. We discuss the relationship between liver, muscle and adipose tissue in non-alcoholic fatty liver disease and cirrhosis. To diagnose sarcopenia, there are a range of tests and tools that measure muscle strength and muscle mass as well as physical performance. The low muscle strength (hand grip strength) is the primary parameter of the diagnosis, the best measure of muscle function. The loss of skeletal muscle mass assessed by dual-energy X-ray absorptiometry, bioelectric impedance analysis, computer tomography, or magnetic resonance imaging confirms diagnosis, while the decrease in physical performance reflects severe sarcopenia. For the treatment and prevention of progression, the most important is the regular physical activity started from early adulthood, and healthy diet containing protein-calorie hyperalimentation. In addition, a pharmacotherapy with the supplementation of vitamin D and testosterone, furthermore, the administration of L-carnitine and branched-chain amino acids can be recommended. In the case of secondary sarcopenia, the underlying disease also requires treatment. Orv Hetil. 2021; 162(1): 3-12.


Assuntos
Imagem por Ressonância Magnética/métodos , Músculo Esquelético/diagnóstico por imagem , Sarcopenia , Vitamina D/administração & dosagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Doença Crônica , Força da Mão , Humanos , Sarcopenia/diagnóstico , Sarcopenia/fisiopatologia , Sarcopenia/terapia
4.
Nat Commun ; 12(1): 654, 2021 01 28.
Artigo em Inglês | MEDLINE | ID: mdl-33510174

RESUMO

Low muscle strength is an important heritable indicator of poor health linked to morbidity and mortality in older people. In a genome-wide association study meta-analysis of 256,523 Europeans aged 60 years and over from 22 cohorts we identify 15 loci associated with muscle weakness (European Working Group on Sarcopenia in Older People definition: n = 48,596 cases, 18.9% of total), including 12 loci not implicated in previous analyses of continuous measures of grip strength. Loci include genes reportedly involved in autoimmune disease (HLA-DQA1 p = 4 × 10-17), arthritis (GDF5 p = 4 × 10-13), cell cycle control and cancer protection, regulation of transcription, and others involved in the development and maintenance of the musculoskeletal system. Using Mendelian randomization we report possible overlapping causal pathways, including diabetes susceptibility, haematological parameters, and the immune system. We conclude that muscle weakness in older adults has distinct mechanisms from continuous strength, including several pathways considered to be hallmarks of ageing.


Assuntos
Predisposição Genética para Doença/genética , Estudo de Associação Genômica Ampla/métodos , Debilidade Muscular/genética , Sarcopenia/genética , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/genética , Estudos de Coortes , Europa (Continente) , Feminino , Fator 5 de Diferenciação de Crescimento/genética , Cadeias alfa de HLA-DQ/genética , Humanos , Masculino , Pessoa de Meia-Idade , Força Muscular/genética , Força Muscular/fisiologia , Debilidade Muscular/fisiopatologia , Polimorfismo de Nucleotídeo Único , Sarcopenia/fisiopatologia
5.
Endocrinol. diabetes nutr. (Ed. impr.) ; 67(10): 672-681, dic. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-197680

RESUMO

La obesidad sarcopénica se ha asociado con mayor discapacidad y morbimortalidad. Sin embargo, todavía existen pocos estudios sobre el papel de la sarcopenia en las comorbilidades asociadas a la obesidad en individuos con edad inferior a 65 años. La etiopatogenia es multifactorial pero parece que los mediadores inflamatorios y la resistencia a la insulina desempeñan un papel relevante. Aunque no existe un consenso claro sobre su definición y métodos diagnósticos, hay un creciente interés por disponer de biomarcadores que ayuden a su detección y seguimiento. Respecto al tratamiento, se postula el abordaje multimodal, que básicamente se fundamenta en recomendaciones dietéticas, ejercicio y eventualmente cirugía bariátrica


Sarcopenic obesity has been associated with greater disability, morbidity and mortality. However, at present, there are few studies regarding the role of sarcopenia in the evolution of the comorbidities associated with obesity in individuals less than 65 years of age. The pathogenesis is multifactorial and uncompletely ilucidated, but it seems that inflammatory mediators and insulin resistance play an important role. Although there is no clear consensus on its definition and diagnostic methods, there is a growing interest in finding biomarkers useful for the detection and monitoring. Regarding the treatment, a multimodal approach is recomended, based on dietary recommendations, exercise and eventually bariatric surgery


Assuntos
Humanos , Obesidade/complicações , Sarcopenia/patologia , Obesidade/diagnóstico , Obesidade/fisiopatologia , Sarcopenia/fisiopatologia , Inquéritos e Questionários , Antropometria , Absorciometria de Fóton/métodos , Tomografia Computadorizada por Raios X , Diabetes Mellitus Tipo 2 , Disfunção Cognitiva , Qualidade de Vida , Exercício Físico
7.
Arch Osteoporos ; 15(1): 166, 2020 10 20.
Artigo em Inglês | MEDLINE | ID: mdl-33079259

RESUMO

In our study investigating the prevalence of osteosarcopenic obesity (OSO) in community-dwelling older adults and possible factors responsible for falls, we have found that prevalence of OSO is 10.7%. OSO does not significantly increase the odds of falling, whereas lower handgrip strength, ALMi and gait speed were independent factors associated with falls. PURPOSES: The purposes of the study were (a) to determine the prevalence of osteosarcopenic obesity (OSO) in community-dwelling older adults and (b) to investigate the association between falls and possible factors in individuals with and without OSO. METHODS: Medical records of patients aged ≥ 65 years were retrospectively reviewed. Individuals were diagnosed with OSO based on their T-score assessed by dual x-ray absorptiometry, handgrip strength, appendicular lean mass index (ALMi), gait speed and body fat percentile. Comorbidities, history of falls, depressive state, medications and anthropometric measures were also noted. RESULTS: A sample of 460 individuals were assessed (337 females; 123 males) and 49 patients were diagnosed with OSO. There was no statistically significant difference in falls between the two groups (OR: 0.768, 95% CI: 0.409-1.440, p: 0.41) and the presence of OSO was not significantly associated with increased odds of falling (OR: 1.755, 95% CI: 0.547-5.628, p: 0.344). Handgrip strength (OR: 0.931, 95% CI: 0.893-0.971, p: 0.001), ALMi (OR: 0.799, 95% CI: 0.708-0.901, p < 0.0001) and gait speed (OR: 0.529, 95% CI: 0.283-0.988, p: 0.046) were independently associated with falls in overall group, whereas interaction analysis did not reveal any significant moderator effect of OSO vs. non-OSO in the associations between risk factors and falls. CONCLUSION: The prevalence of OSO was 10.7%. OSO was not associated with elevated odds of falling, whereas lower handgrip strength, ALMi and gait speed were independent factors associated with falls. Further prospective research is needed to clarify the effect of OSO on odds of falling, in consideration with possible risk factors. TRIAL REGISTRATION NUMBER AND DATE: NCT04288401 /26.02.2020.


Assuntos
Fragilidade/fisiopatologia , Avaliação Geriátrica/métodos , Força da Mão/fisiologia , Obesidade/epidemiologia , Osteoporose Pós-Menopausa/epidemiologia , Osteoporose/epidemiologia , Sarcopenia/epidemiologia , Absorciometria de Fóton/métodos , Idoso , Antropometria/métodos , Estudos Transversais , Feminino , Humanos , Vida Independente , Masculino , Obesidade/fisiopatologia , Osteoporose/fisiopatologia , Equilíbrio Postural/fisiologia , Prevalência , Estudos Retrospectivos , Sarcopenia/fisiopatologia
8.
Nat Commun ; 11(1): 4510, 2020 09 09.
Artigo em Inglês | MEDLINE | ID: mdl-32908143

RESUMO

With human median lifespan extending into the 80s in many developed countries, the societal burden of age-related muscle loss (sarcopenia) is increasing. mTORC1 promotes skeletal muscle hypertrophy, but also drives organismal aging. Here, we address the question of whether mTORC1 activation or suppression is beneficial for skeletal muscle aging. We demonstrate that chronic mTORC1 inhibition with rapamycin is overwhelmingly, but not entirely, positive for aging mouse skeletal muscle, while genetic, muscle fiber-specific activation of mTORC1 is sufficient to induce molecular signatures of sarcopenia. Through integration of comprehensive physiological and extensive gene expression profiling in young and old mice, and following genetic activation or pharmacological inhibition of mTORC1, we establish the phenotypically-backed, mTORC1-focused, multi-muscle gene expression atlas, SarcoAtlas (https://sarcoatlas.scicore.unibas.ch/), as a user-friendly gene discovery tool. We uncover inter-muscle divergence in the primary drivers of sarcopenia and identify the neuromuscular junction as a focal point of mTORC1-driven muscle aging.


Assuntos
Envelhecimento/fisiologia , Alvo Mecanístico do Complexo 1 de Rapamicina/metabolismo , Fibras Musculares Esqueléticas/patologia , Junção Neuromuscular/patologia , Sarcopenia/patologia , Envelhecimento/efeitos dos fármacos , Animais , Linhagem Celular , Modelos Animais de Doenças , Eletromiografia , Regulação da Expressão Gênica/efeitos dos fármacos , Regulação da Expressão Gênica/fisiologia , Humanos , Microdissecção e Captura a Laser , Masculino , Alvo Mecanístico do Complexo 1 de Rapamicina/antagonistas & inibidores , Alvo Mecanístico do Complexo 1 de Rapamicina/genética , Camundongos , Mioblastos , Junção Neuromuscular/efeitos dos fármacos , Técnicas de Patch-Clamp , RNA-Seq , Sarcopenia/genética , Sarcopenia/fisiopatologia , Sarcopenia/prevenção & controle , Transdução de Sinais/efeitos dos fármacos , Transdução de Sinais/genética , Sirolimo/administração & dosagem
9.
Maturitas ; 140: 27-33, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32972632

RESUMO

Advances in medicine have paved the way for older persons to live longer, but with more years spent living with disability and dependency. Many older persons are living with comorbidities such as osteoporosis (loss of bone mass) and sarcopenia (loss of muscle mass and function), two diseases that, when concurrent, form osteosarcopenia, a newly identified musculoskeletal syndrome. Osteosarcopenia impedes mobility and diminishes independence and thus quality of life. Evidence suggests the pathology of this syndrome comprises genetic polymorphisms, alterations in mechanotransduction, and localized or systemic crosstalk between growth factors and other proteins (myokines, osteokines, adipokines). As a direct result of an aging society, health outcomes such as falls and fractures will rise as the prevalence of osteosarcopenia increases. Two major risk factors for osteosarcopenia (other than age itself) are physical inactivity and poor nutrition. Addressing these modifiable risk factors can prevent, or at least delay, the onset of osteosarcopenia. Pharmaceutical treatments for osteosarcopenia are currently unavailable, although research trials are underway. This review provides an update from basic and clinical sciences on the biology, epidemiology (prevalence, risk factors and diagnosis) and treatments for osteosarcopenia, and recommends future research priorities to improve health outcomes for those living with or at risk of osteosarcopenia.


Assuntos
Osteoporose , Sarcopenia , Humanos , Osteoporose/diagnóstico , Osteoporose/epidemiologia , Osteoporose/fisiopatologia , Osteoporose/terapia , Sarcopenia/diagnóstico , Sarcopenia/epidemiologia , Sarcopenia/fisiopatologia , Sarcopenia/terapia
10.
Geriatr Gerontol Int ; 20(10): 980-987, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32886834

RESUMO

AIMS: Sarcopenia is a serious problem because of its poor prognosis. Growth differentiation factor 15 (GDF15) is associated with mitochondrial dysfunction, inflammation, insulin resistance and oxidative stress, which may play crucial roles for the development of sarcopenia. We aimed to examine whether serum GDF15 level is associated with muscle mass, strength and lower extremity function in older patients with cardiometabolic disease. METHODS: Serum GDF15 levels were measured in 257 patients with cardiometabolic diseases (including 133 patients with diabetes) who had visited the frailty clinic, using a latex turbidimetric immunoassay. Appendicular skeletal muscle index, handgrip strength, timed-up-and-go test and gait speed were evaluated. Power, speed, balance and total scores based on the sit-to-stand test were calculated to assess lower extremity function. RESULTS: The highest tertile of serum GDF15 was independently associated with low handgrip strength, low gait speed, long timed-up-and-go time and scores of lower extremity function but not an appendicular skeletal muscle index in multiple logistic regression analyses after adjustment for covariates. Patients in the highest tertile of GDF15 were at the risk of having three to nine times lower grip strength, three times lower gait speed, five to six times lower mobility and five to 11 times reduction in lower extremity function as compared with those in the lowest GDF15 tertile dependent on the models. CONCLUSIONS: Elevated serum GDF15 level was independently associated with low muscle strength and lower extremity function in older patients with cardiometabolic disease. Serum GDF15 could be one of the biomarkers for muscle weakness and low physical performance. Geriatr Gerontol Int 2020; 20: 980-987.


Assuntos
Doenças Cardiovasculares/sangue , Diabetes Mellitus/sangue , Fator 15 de Diferenciação de Crescimento/sangue , Extremidade Inferior/fisiopatologia , Força Muscular/fisiologia , Sarcopenia/sangue , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Doenças Cardiovasculares/fisiopatologia , Diabetes Mellitus/fisiopatologia , Feminino , Fragilidade , Força da Mão , Humanos , Masculino , Músculo Esquelético/fisiopatologia , Sarcopenia/fisiopatologia , Estudos de Tempo e Movimento , Velocidade de Caminhada/fisiologia
11.
Nutrients ; 12(8)2020 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-32785021

RESUMO

Old age is associated with lower physical activity levels, suboptimal protein intake, and desensitization to anabolic stimuli, predisposing for age-related muscle loss (sarcopenia). Although resistance exercise (RE) and protein supplementation partially protect against sarcopenia under controlled conditions, the efficacy of home-based, unsupervised RE (HBRE) and multi-ingredient supplementation (MIS) is largely unknown. In this randomized, placebo-controlled and double-blind trial, we examined the effects of HBRE/MIS on muscle mass, strength, and function in free-living, older men. Thirty-two sedentary men underwent twelve weeks of home-based resistance band training (3 d/week), in combination with daily intake of a novel five-nutrient supplement ('Muscle5'; M5, n = 16, 77.4 ± 2.8 y) containing whey, micellar casein, creatine, vitamin D, and omega-3 fatty acids, or an isocaloric/isonitrogenous placebo (PLA; n = 16, 74.4 ± 1.3 y), containing collagen and sunflower oil. Appendicular and total lean mass (ASM; +3%, TLM; +2%), lean mass to fat ratios (ASM/% body fat; +6%, TLM/% body fat; +5%), maximal strength (grip; +8%, leg press; +17%), and function (5-Times Sit-to-Stand time; -9%) were significantly improved in the M5 group following HBRE/MIS therapy (pre vs. post tests; p < 0.05). Fast-twitch muscle fiber cross-sectional areas of the quadriceps muscle were also significantly increased in the M5 group post intervention (Type IIa; +30.9%, Type IIx, +28.5%, p < 0.05). Sub-group analysis indicated even greater gains in total lean mass in sarcopenic individuals following HBRE/MIS therapy (TLM; +1.65 kg/+3.4%, p < 0.05). We conclude that the Muscle5 supplement is a safe, well-tolerated, and effective complement to low-intensity, home-based resistance exercise and improves lean mass, strength, and overall muscle quality in old age.


Assuntos
Composição Corporal , Suplementos Nutricionais , Força Muscular , Músculo Esquelético/fisiologia , Treinamento de Resistência , Sarcopenia/terapia , Idoso , Anabolizantes/uso terapêutico , Compartimentos de Líquidos Corporais , Caseínas/uso terapêutico , Terapia Combinada , Creatina/uso terapêutico , Método Duplo-Cego , Exercício Físico , Ácidos Graxos Ômega-3/uso terapêutico , Humanos , Masculino , Fibras Musculares de Contração Rápida , Proteínas Musculares , Músculo Esquelético/efeitos dos fármacos , Músculo Esquelético/metabolismo , Músculo Quadríceps , Sarcopenia/fisiopatologia , Autocuidado , Vitamina D/uso terapêutico , Vitaminas , Proteínas do Soro do Leite/uso terapêutico
12.
J Stroke Cerebrovasc Dis ; 29(9): 105017, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32807432

RESUMO

OBJECTIVE: Intervention for treating sarcopenia is of great concern in clinical settings. The aim of this study was to investigate the relationship between changes in skeletal muscle mass and functional outcomes in patients with sarcopenia after stroke. METHODS: A retrospective cohort study of stroke patients with sarcopenia consecutively admitted to a single center's convalescent rehabilitation wards was conducted from 2015 to 2018. Sarcopenia was defined as a loss of skeletal muscle mass index (SMI) with bioelectrical impedance and decreased muscle strength as measured by handgrip strength; cut-off values were adopted from the 2019 Asian Working Group for Sarcopenia. Changes in SMI during hospitalization were measured. Outcomes included the motor domain of Functional Independence Measure at discharge and its gain. Multivariate analysis determined whether the changes in SMI were associated with these outcomes. RESULTS: During the study period, 272 stroke patients were enrolled. Of those, 120 patients (44%) (mean age 79 years, 70 females) were diagnosed with sarcopenia. The mean (SD) for changes in SMI was 0.2 (0.5) kg/m2. Multiple linear regression analysis showed that changes in SMI were significantly associated with Functional Independence Measure - motor at discharge (ß=0.175, P=0.003) and Functional Independence Measure - motor gain (ß=0.247, P=0.003). CONCLUSIONS: Muscle mass gain may be positively associated with functional recovery in patients with sarcopenia after stroke. Exercise and nutritional therapy to increase skeletal muscle mass, in addition to conventional stroke rehabilitation, is needed for these patients.


Assuntos
Composição Corporal , Músculo Esquelético/fisiopatologia , Sarcopenia/fisiopatologia , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral/terapia , Atividades Cotidianas , Idoso , Idoso de 80 Anos ou mais , Avaliação da Deficiência , Impedância Elétrica , Feminino , Força da Mão , Humanos , Masculino , Tamanho do Órgão , Recuperação de Função Fisiológica , Estudos Retrospectivos , Sarcopenia/diagnóstico , Sarcopenia/etiologia , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/fisiopatologia , Fatores de Tempo , Resultado do Tratamento
13.
J Stroke Cerebrovasc Dis ; 29(9): 105092, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32807486

RESUMO

OBJECTIVES: Although the skeletal muscle is the main effector of disability in stroke, evidence on post-stroke skeletal muscle is scarce; especially, the prevalence of stroke-related sarcopenia remains unclear. Thus, we aimed to systematically search the prevalence of sarcopenia in stroke survivors and synthesize pooled estimates of overall prevalence of stroke-related sarcopenia and prevalence stratified by sex, country, time since stroke onset, and diagnostic criteria of sarcopenia. METHODS: We performed systematic searches in the MEDLINE, CINAHL, Embase, and Cochrane Library databases. English-language searches to identify included studies were completed August 25, 2019. Meta-analysis of data collected from cross-sectional or observational studies which were reported the prevalence of sarcopenia among stroke participants. All statistical analyses were performed using R version 3.5.2. RESULTS: A total of 855 articles were initially identified. Seven articles were included in this study. Total sample size across all included studies was 1695. Three studies were conducted in Japan, 2 in South Korea, 1 in Taiwan, and 1 in the U.S. Four included studies had a cross-sectional design, and 3 were retrospective cohort studies. Four and 3 studies included participants at <1 month and ≥6 months since stroke onset, respectively. The pooled prevalence estimate was 42% (95% confidence interval: 33%-52%), with a substantial heterogeneity (I2=91%). CONCLUSIONS AND IMPLICATIONS: Sarcopenia is frequently observed in stroke survivors, and a higher prevalence of sarcopenia is noted during the early phase after stroke. This study would be useful for researchers to design sarcopenia studies in this population. Further prospective longitudinal studies for sarcopenia and their prognostic outcomes in stroke survivors are urgently needed to propose appropriate physical and nutritional strategies in geriatric rehabilitation.


Assuntos
Composição Corporal , Músculo Esquelético/fisiopatologia , Sarcopenia/epidemiologia , Acidente Vascular Cerebral/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Ásia/epidemiologia , Feminino , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Prognóstico , Fatores de Risco , Sarcopenia/diagnóstico , Sarcopenia/fisiopatologia , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/fisiopatologia , Estados Unidos/epidemiologia
15.
Medicine (Baltimore) ; 99(28): e21061, 2020 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-32664122

RESUMO

Sarcopenia has a negative impact on the prognosis of patients with liver cirrhosis (LC). We investigated the significance of skeletal muscle volume and its changes in LC patients taking levocarnitine (L-carnitine).We retrospectively analyzed 51 LC patients taking L-carnitine from December 2012 to March 2019. Skeletal mass index was calculated as the left-right sum of the major × minor axis of psoas muscle at the third lumbar vertebra, divided by height squared (psoas muscle index [PMI]). Patients were classified into 2 groups (low and normal PMI) depending on PMI < 6.0 and < 3.4 cm/m for men and women, respectively. Changes in PMI per month during L-carnitine administration (ΔPMI/m) were calculated, and we classified the patients into 2 groups (severe and mild muscle atrophy) depending on ΔPMI/m below the lower quartile. We assessed overall survival (OS).At the start of L-carnitine administration, there were no significant differences in OS between groups with low and normal PMI. Multivariate analysis showed that ΔPMI/m (hazard ratio [HR], 0.007; P = .005) and L-carnitine administration period (HR, 0.956; P = .021) were significantly associated with OS. Patients with severe muscle atrophy had a significantly lower OS than those with mild muscle atrophy. There was the positive correlation relationship between ΔPMI/m and L-carnitine administration period.Among LC patients taking L-carnitine, progressive muscle volume loss was a predictor of poor prognosis. L-carnitine administration for longer may be able to prevent muscle volume loss and lead to a better prognosis in LC patients.


Assuntos
Carnitina/uso terapêutico , Cirrose Hepática/epidemiologia , Sarcopenia/tratamento farmacológico , Sarcopenia/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Amônia/sangue , Feminino , Humanos , Cirrose Hepática/mortalidade , Masculino , Pessoa de Meia-Idade , Prognóstico , Modelos de Riscos Proporcionais , Músculos Psoas , Estudos Retrospectivos , Sarcopenia/fisiopatologia , Índice de Gravidade de Doença , Fatores Sexuais
16.
Clin Interv Aging ; 15: 953-967, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32612355

RESUMO

Purpose: Whole-body electromyostimulation (WB-EMS) especially in combination with a high-protein supplementation has been established as an efficient treatment against sarcopenia. However, there are several case reports of rhabdomyolysis after WB-EMS application. Thus, we asked if this training could potentially lead to deteriorations of the cardiac as well as the renal function. Materials and Methods: One hundred sarcopenic obese men aged 70 years and older were randomly balanced (1-1-1) and allocated to one of the three study arms. During 16 weeks of intervention, these groups either performed WB-EMS and took a protein supplement (WB-EMS&P), solely received the protein supplement (Protein) or served as control group (CG). WB-EMS consisted of 1.5×20 min (85 Hz, 350 µs, 4 s of strain to 4 s of rest) applied with moderate-to-high intensity while moving. We further generated a daily protein intake of 1.7-1.8 g/kg/body mass per day. At baseline and 8-10 days after completion of the intervention, blood was drawn and biomarkers of muscle, cardiac and renal health were assessed. Results: Hereby, we found slight but significant elevations of creatine kinase (CK) levels in the WB-EMS group pointing to minor damages of the skeletal muscle (140 U/l [81-210], p < 0.001). This was accompanied by a significant, low-grade increase of creatine kinase-muscle brain (CK-MB, 0.43 ng/mL [-0.29-0.96], p < 0.01) and high-sensitivity troponin T (hsTnT, 0.001 ng/mL. [0.000-0.003], p < 0.001) but without a higher risk of developing heart failure according to N-terminal prohormone of brain natriuretic peptide (NT-proBNP, -5.7 pg/mL [-38.8-24.6], p = 0.17). Estimated glomerular filtration rate (eGFR) was impaired neither by the high-protein supplementation alone nor in combination with WB-EMS (CG 76.0 mL/min/1.73 m2 [71.9-82.2] vs Protein 73.2 mL/min/1.73 m2 [63.0-78.9] vs WB-EMS&P 74.6 mL/min/1.73 m2 [62.8-84.1], p = 0.478). Conclusion: In conclusion, even in the vulnerable group of sarcopenic obese seniors, the combination of WB-EMS with a high-protein intake revealed no short-term, negative impact on the eGFR, but potential consequences for the cardiovascular system need to be addressed in future studies.


Assuntos
Dieta Rica em Proteínas/métodos , Terapia por Estimulação Elétrica/métodos , Obesidade/terapia , Sarcopenia/terapia , Idoso , Idoso de 80 Anos ou mais , Biomarcadores , Suplementos Nutricionais , Humanos , Masculino , Músculo Esquelético/fisiopatologia , Obesidade/complicações , Obesidade/fisiopatologia , Sarcopenia/complicações , Sarcopenia/fisiopatologia
17.
Int Heart J ; 61(4): 769-775, 2020 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-32684606

RESUMO

The number of heart failure patients is increasing rapidly in Japan because of its large elderly population. As age increases, arterial stiffness and physical dysfunction progress. This study aimed to evaluate the association between the physical function and arterial stiffness in elderly heart failure patients.This retrospective, observational study includes data from 100 heart failure patients aged ≥ 65 years who were admitted to our hospital and underwent cardiac rehabilitation. The Cardio-Ankle Vascular Index (CAVI) was measured as an indicator of arterial stiffness. Body composition was assessed by bioelectrical impedance analysis. To determine the degree of physical function, we assessed handgrip strength, five-meter walk speed (5MWS), five-repetition sit-to-stand time (5RSST) and six-minute walk distance (6MWD). Sarcopenia was defined using Asian guidelines based on physical function and body composition.Among 100 patients, 47.0% of patients had sarcopenia. After adjustments for age, sex, atrial fibrillation, and ischemic cardiomyopathy, CAVI was significantly higher in with sarcopenia patients than those without sarcopenia. Age, handgrip strength, 5MWS, 5RSST, and 6MWD were associated with CAVI, and 6MWD was as an independent determinant factor of CAVI.6MWD was recognized as an accurate physical function indicator. These findings suggested that physical function and arterial stiffness complement each other. To restore cardiac dysfunction, improving both arterial stiffness and physical function might be useful.


Assuntos
Índice Vascular Coração-Tornozelo , Insuficiência Cardíaca/fisiopatologia , Sarcopenia/fisiopatologia , Rigidez Vascular , Idoso , Idoso de 80 Anos ou mais , Composição Corporal , Impedância Elétrica , Feminino , Insuficiência Cardíaca/complicações , Humanos , Masculino , Músculo Esquelético , Estudos Retrospectivos , Sarcopenia/complicações
18.
Khirurgiia (Mosk) ; (5): 12-19, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32500684

RESUMO

OBJECTIVE: To compare different clinical and morphometric features of patients undergoing TPAIT for prediction of postoperative outcomes. MATERIAL AND METHODS: A retrospective review enrolled patients who underwent TPAIT for the period from January 2007 to October 2017. Morphometric parameters were analyzed using preoperative CT scans and patients were grouped to examine association of these characteristics with postoperative morbidity. Sarcopenia was defined as the presence of a TPA in the lowest sex-specific quartile. The impact of sarcopenia on pancreatic islet features, perioperative blood transfusion, ICU- and hospital-stay, complications, repeated admission within 90 days and islet function was assessed. RESULTS: A total of 34 patients were included in this study (12 males and 24 females). At the time of diagnosis, mean age of patients was 43.1 years. Mean body mass index (BMI) in sarcopenic patients was 24.9 kg/m2, mean BMI in those without sarcopenia - 24.8 kg/m2 (p=1.00). Various surgical complications were observed in 11 patients (32.3%). Patients with sarcopenia experienced more complications (83.3%) compared with patients without sarcopenia (50%). However, differences were not significant (p=0.31). Islet characteristics (islet numbers, purity), readmission, ICU- and hospital-stay, incidence of blood transfusion and islet function were also similar in both groups. CONCLUSION: Sarcopenia is not a predictor of postoperative complications and islet cell function in chronic pancreatitis patients following TPAIT.


Assuntos
Transplante das Ilhotas Pancreáticas , Pancreatectomia , Pancreatite Crônica/cirurgia , Sarcopenia/fisiopatologia , Tecido Adiposo/fisiopatologia , Adulto , Feminino , Humanos , Masculino , Pancreatite Crônica/complicações , Pancreatite Crônica/fisiopatologia , Estudos Retrospectivos , Sarcopenia/complicações , Transplante Autólogo , Resultado do Tratamento
19.
Clin Interv Aging ; 15: 695-714, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32546988

RESUMO

Skeletal muscle aging manifests as a decline in muscle quantity and quality that accelerates with aging, increasing the risk of sarcopenia. Sarcopenia is characterized by a loss of muscle strength and mass, and contributes to adverse health outcomes in older adults. Intervention studies have shown that sarcopenia may be treated by higher protein intake in combination with resistance exercise (RE). In comparison, less is known about the role of whole protein-containing foods in preventing or treating sarcopenia. Liquid milk contains multiple nutrients and bioactive components that may be beneficial for muscle, including proteins for muscle anabolism that, alone or with RE, may have myoprotective properties. However, there is a lack of evidence about the role of milk and its effects on muscle aging. This narrative review considers evidence from three observational and eight intervention studies that used milk or fortified milk, with or without exercise, as an intervention to promote muscle health and function in older adults (aged 50-99 years). The observational studies showed no association between higher habitual milk consumption and muscle-related outcomes. The results of intervention studies using fortified milk in relation to elements of sarcopenia were also negative, with further inconclusive results from the studies using a combination of (fortified) milk and exercise. Although milk contains nutrients that may be myoprotective, current evidence does not show beneficial effects of milk on muscle health in older adults. This could be due to high habitual protein intakes (>1.0 g/kg BW/d) in study participants, differences in the type of milk (low-fat vs whole) and timing of milk consumption, length of interventions, as well as differences in the sarcopenia status of participants in trials. Adequately powered intervention studies of individuals likely to benefit are needed to test the effectiveness of a whole food approach, including milk, for healthy muscle aging.


Assuntos
Envelhecimento/fisiologia , Senescência Celular/fisiologia , Proteínas do Leite/metabolismo , Músculo Esquelético/fisiologia , Sarcopenia , Idoso , Exercício Físico/fisiologia , Comportamento Alimentar , Humanos , Força Muscular , Estudos Observacionais como Assunto , Sarcopenia/fisiopatologia , Sarcopenia/prevenção & controle
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