Prevalence and risk factors of sarcopenia in Asian adults with type 2 diabetes: A systematic review and meta-analysis.

Objective To investigate the prevalence and risk factors of sarcopenia in peritoneal dialysis (PD) patients. Methods The patients who underwent regular peritoneal dialysis at Renji Hospital affiliated to Shanghai Jiao Tong University School of Medicine between November 2016 and March 2018 were enrolled. Handgrip strength (HGS) was measured to assess muscle strength. Bioelectrical impedance spectroscopy (BIS) was applied to measure the lean tissue index (LTI). Reduced LTI plus decreased HGS was defined as sarcopenia. The prevalence of sarcopenia in PD patients was evaluated. According to the presence or absence of sarcopenia, they were divided into the sarcopenia group and the non-sarcopenia group, and the differences in clinical indicators between the two groups were compared. Multivariate logistic regression was used to explore the risk factors of sarcopenia in PD patients. Results A total of 207 patients were enrolled in the study with age of (55.3±13.7) years and a median PD duration of 22.9(7.3, 60.9) months. Of them, 122 patients (58.9%) were male, 45 patients (21.7%) had diabetics and 32 patients (15.5%) suffered from cardiovascular diseases. There were 27 patients (13.0%) diagnosed with sarcopenia. These patients presented with longer PD duration, more prevalent diabetics, lower residual renal function (RRF) and serum pre-albumin, greater ratio of extracellular water to intracellular water (ECW/ICW) and high sensitive C-reactive protein in contrast with those in the non-sarcopenia group (all P<0.05). Multivariate logistic analysis showed that male (OR=3.94, 95%CI 1.35-11.50, P=0.012), longer PD duration (OR=1.01, 95% CI 1.00-1.02, P=0.029) and higher ECW/ICW (OR=1.09, 95% CI 1.05-1.14, P<0.001) were independent risk factors of sarcopenia in PD patients. Conclusions Sarcopenia is common in PD patients. Male, longer PD duration and higher ECW/ICW were independent risk factors of sarcopenia in PD patients. Key words: Peritoneal dialysis; Prevalence; Risk factors; Sarcopenia

The incidence of atherosclerosis increases with age. Oxidative changes in proteins and lipids are considered to be among the molecular mechanisms leading to endothelial dysfunction. Paraoxonase (PON1) is exclusively associated with high-density lipoprotein (HDL) and protects both HDL and low-density lipoprotein (LDL) from oxidation. PON1 has two cysteine residues for its antioxidant function. We investigated the relation between PON1 activity and protein oxidation parameters such as protein hydroperoxides (P-OOH), protein carbonyl (PCO), total thiol (T-SH) and advanced oxidation protein products (AOPP). Our study also covered other oxidative stress parameters such as oxidised LDL (oxLDL) and superoxide dismutase activity in the plasma of young, middle-aged and elderly individuals. PON1 activity of elderly and middle-aged individuals was decreased significantly compared with that in the young group. oxLDL levels of elderly individuals were increased significantly compared with those of both the young and middle-aged individuals. P-OOH, PCO and AOPP levels of the elderly and middle aged individuals were higher compared with those of the young. On the other hand, T-SH levels of the elderly and middle-aged individuals were lower compared with those of the young. Side by side with the decrease in the T-SH levels in the middle-aged and elderly groups as compared to the young, the increase we have observed in other protein oxidation parameters in the groups leading to decreasing PON1 activity might, we think, create a predisposition to atherosclerosis.

BackgroundOverweight is a known risk factor for various chronic diseases and poses a significant threat to middle-aged and elderly adults. Previous studies have reported a strong association between overweight and air pollution. However, the spatial relationship between the two remains unclear due to the confounding effects of spatial heterogeneity.MethodsWe gathered height and weight data from the 2015 China Health and Retirement Long-term Survey (CHARLS), comprising 16,171 middle-aged and elderly individuals. We also collected regional air pollution data. We then analyzed the spatial pattern of overweight prevalence using Moran's I and Getis-Ord Gi* statistics. To quantify the explanatory power of distinct air pollutants for spatial differences in overweight prevalence across Southern and Northern China, as well as across different age groups, we utilized Geodetector's q-statistic.ResultsThe average prevalence of overweight among middle-aged and elderly individuals in each city was 67.27% and 57.39%, respectively. In general, the q-statistic in southern China was higher than that in northern China. In the north, the prevalence was significantly higher at 54.86% compared to the prevalence of 38.75% in the south. SO2 exhibited a relatively higher q-statistic in middle-aged individuals in both the north and south, while for the elderly in the south, NO2 was the most crucial factor (q = 0.24, p < 0.01). Moreover, fine particulate matter (PM2.5 and PM10) also demonstrated an important effect on overweight. Furthermore, we found that the pairwise interaction between various risk factors improved the explanatory power of the prevalence of overweight, with different effects for different age groups and regions. In northern China, the strongest interaction was found between NO2 and SO2 (q = 0.55) for middle-aged individuals and PM2.5 and SO2 (q = 0.27) for the elderly. Conversely, in southern China, middle-aged individuals demonstrated the strongest interaction between SO2 and PM10 (q = 0.60), while the elderly showed the highest interaction between NO2 and O3 (q = 0.42).ConclusionSignificant spatial heterogeneity was observed in the effects of air pollution on overweight. Specifically, air pollution in southern China was found to have a greater impact on overweight than that in northern China. And, the impact of air pollution on middle-aged individuals was more pronounced than on the elderly, with distinct pollutants demonstrating significant variation in their impact. Moreover, we found that SO2 had a greater impact on overweight prevalence among middle-aged individuals, while NO2 had a greater impact on the elderly. Additionally, we identified significant statistically interactions between O3 and other pollutants.

BackgroundSarcopenia was a frequent chronic complication in patients with type 2 diabetes mellitus (T2DM), and previous evidence showed conflicting results regarding the prevalence and risk factors of sarcopenia in T2DM. In the current study, we aimed at systematically exploring the prevalence and risk factors of sarcopenia in patients with T2DM.MethodsPubMed, Embase, and Cochrane Central Register of Controlled Trials were systematically searched to identify observational studies which investigated the prevalence and risk factors of sarcopenia in patients with T2DM. The quality of individual included studies was evaluated using The Newcastle–Ottawa scale. Pooled effects regarding prevalence and associated factors were calculated using random-effects models. The potential publication bias was assessed via funnel plot and Egger test.ResultsTwenty-eight studies involving 16,800 patients were included in our meta-analysis. The pooled prevalence of sarcopenia in patients with T2DM was 18% (95% CI 0.15–0.22; I2 = 97.4%). The pooled results showed that elder age (OR 4.73; 95% CI 4.30–5.19; I2 = 85.6%), male gender, chronic hyperglycemia (higher HbA1c) (OR 1.16; 95% CI 1.05–2.47; I2 = 99.2%) and osteoporosis (OR 1.16; 95% CI 1.05–2.47; I2 = 99.2%) was predictors for sarcopenia, whereas patients with lower BMI (OR 1.16; 95% CI 1.05–2.47; I2 = 99.2%) and metformin administrations (OR 1.16; 95% CI 1.05–2.47; I2 = 99.2%) were not prone to get sarcopenia. The funnel plot and statistical tests showed no obvious publication bias.ConclusionsSarcopenia was frequent in T2DM patients. Elder age, male gender and chronic hyperglycemia, Osteoporosis were significant risk factors for Sarcopenia. Lower BMI and metformin administrations were associated with lower risk of sarcopenia.

Aims Sarcopenia is a common condition in older individuals, especially in the elderly with type 2 diabetes mellitus (T2DM). The aim of the present study was to examine the risk factors for sarcopenia in elderly individuals with T2DM and the effects of metformin. Methods A total of 1732 elderly with T2DM were recruited to this cross-sectional observational study, and we analyzed the data using logistic regression analyses. Skeletal muscle mass, grip strength, and usual gait speed were measured to diagnose sarcopenia according to the criteria of the Asian Working Group for Sarcopenia, combined with expert consensus on sarcopenia in China. Results The overall prevalence of sarcopenia was 10.37% of the participants. In the multivariate analysis, sex, age, educational level, and BMI were risk factors for sarcopenia, with women more likely to develop sarcopenia relative to men (OR = 2.539, 95% CI = 1.475–4.371; P < 0.05). We observed that sarcopenia increased with age and decreased with increasing BMI and educational level (P < 0.05). Participants who took metformin alone or combined with other drugs exhibited a lower risk for sarcopenia than those who took no medication (OR = 0.510, 95% CI = 0.288–0.904 and OR = 0.398, 95% CI = 0.225–0.702, respectively; P < 0.05). Conclusions We showed that being female and at an older age, lower educational level, and lower BMI were risk factors for sarcopenia in elderly T2DM and that metformin acted as a protective agent against sarcopenia in these patients.

To clarify the prevalence and risk factors of sarcopenia in commuting rehabilitation service users. The 104 participants of the plant [Sorry, the English is unclear: please clarify the meaning of the highlighted text] (56 men, 48 women; average age 78.6±7.7 years). The diagnosis of sarcopenia was classified based on the AWGS diagnostic algorithm. The following 10 items were investigated for their causal relationship with sarcopenia as risk factors: risk factor survey (1) cerebrovascular disease, (2) hypertension, (3) respiratory disease, (4) cardiovascular disease, (5) orthopedic disease, (6) fracture, (7) cancer, (8) intractable diseases, (9) diabetes mellitus, and (10) fall history in the past year. The prevalence of sarcopenia was 51.9%. Significant differences were observed in the items of "cancer" and "fall history in the past year" as risk factors for sarcopenia. Elderly people needing support or care (especially those with cancer and a history of falling) have a very high risk of sarcopenia and are expected to require early intervention.

This study objectively analyzed postural instability and cognitive function in patients with Parkinson's disease (PD) and a group of healthy elderly and middle-aged individuals. The study included ten healthy middle-aged individuals (range 42-57years), 14 healthy elderly individuals (range 60-90years) and 15 PD patients (range 58-93years). Center of pressure (COP) parameters were determined by means of computed static posturography during free standing with open and closed eyes. The level of cognitive functioning was examined with mini mental state examination (MMSE) and counting backwards test (CBT). Parkinson's disease patients showed significantly lower MMSE scores compared to healthy middle-aged (p=0.004) and elderly individuals (p=0.03). Mean duration of CBT in PD patients was significantly longer than in healthy subjects. COP parameters correlated with age of subjects and cognitive function (MMSE score). No significant differences in any stabilographic parameters were observed between healthy elderly subjects and PD patients. Age is the most significant factor impacting upon the static balance of older individuals during free standing. Compared to middle-aged and elderly individuals without central nervous system impairment, patients with PD present with significant delay in cognitive processes associated with executive function.

The relationship between Chlamydia pneumoniae infection and CD4/CD8 ratio, lymphocyte subsets in middle-aged and elderly individuals

Methylmalonic acid (MMA) in plasma or serum is widely used for assessment of vitamin B(12) status. However, data are sparse regarding factors, besides renal function, that may influence MMA concentrations. We searched for important determinants of plasma MMA in the general population. In 6946 middle-aged (47-49 years) and elderly (71-74 years) individuals from the Hordaland Homocysteine Study in Norway, we collected anthropometric measurements, lifestyle data, and plasma MMA, vitamin B(12), and creatinine measurements. For 5820 individuals, we also collected dietary data. Age and plasma creatinine were positively associated with plasma MMA, whereas plasma vitamin B(12) was negatively associated. These variables together with sex were the strongest determinants of plasma MMA, accounting for 16% of the variation (R(2) = 0.16). Addition of anthropometric measures and lifestyle and dietary factors only gave slight improvement (total R(2) = 0.167). Increased plasma MMA was seen when plasma vitamin B(12) was <400 pmol/L. In individuals with vitamin B(12) >or =400 micromol/L (vitamin B(12)-replete), the 2.5th-97.5th percentile reference limits for MMA were 0.10-0.28 micromol/L (middle-aged) and 0.10-0.36 micromol/L (elderly). When plotted against creatinine (nomograms), the 97.5th percentile of MMA was similar in men and women but approximately 0.15 micromol/L higher in elderly than middle-aged individuals. Vitamin B(12)-replete participants had MMA upper limits approximately 0.1 micromol/L (elderly) and 0.04 micromol/L (middle-aged) below those of the unselected population at all creatinine concentrations. Identified determinants accounted for <17% of the overall variation in plasma MMA. The difference in MMA between middle-aged and elderly individuals is only partly explained by creatinine and vitamin B(12) concentrations.

Objective To investigate the prevalence and risk factors of sarcopenia in Wagner grade 2 diabetic foot ulcer (DFU). Methods A total of 273 patients with Wagner grade 2 DFU were recruited from diabetic foot center of Zhongda Hospital, Southeast University in 2016, and divided into sarcopenia group (n=38) and non-sarcopenia group (n=235) according to bioelectrical impedance analysis, appendicular skeletal mass index, short physical performance battery and handgrip strength. Parameters of fasting plasma glucose, 2-hour postprandial blood glucose, glycosylated hemoglobin (HbA1c), total cholesterol, triglyceride, ankle brachial index (ABI), nerve conduction velocity (NCV) and transcutaneous oxygen partial pressure (TcPO2) were compared between these 2 groups;muscle area and density were calculated by computed tomography. Results The prevalence of sarcopenia was 13.97% (38/273). Age, body mass index (BMI), HbA1c, NCV, diabetic course were significantly different between these two groups (P<0.05). Multivariate Logistic regression analysis indicated that age, diabetic course, NCV, TcPO2 and ABI were risk factors of sarcopenia in patients with Wagner grade 2 DFU (OR=4.281, 6.114, 2.895, 1.093, 5.460, 1.160, 95%CI: 1.751-10.543, 1.202-31.094, 1.185-5.846, 1.012-1.180, 1.793-16.624, 1.020-1.300, all P<0.05). Conclusion Sarcopenia tends to present in Wagner grade 2 DFU with advanced age, long diabetic course, long-term poor glucose control and poor vascular and nerval function of extremities. Key words: Diabetic foot; Sarcopenia; Risk factors

BackgroundTraumatic head injury is a leading cause of death and disability worldwide. How clinicopathological features differ by age remains unclear. This epidemiological study analyzed the clinicopathological features of patients with head injury belonging to 3 age groups.Material/MethodsData of patients with traumatic head injury were obtained from the Department of Cerebral Surgery of the Affiliated Hospital of Guizhou Medical University and the Guizhou Provincial People’s Hospital in 2011–2015. Their clinicopathological parameters were assessed. The patients were divided into 3 age groups: elderly (≥65 years), middle-aged (18–64 years), and juvenile (≤17 years) individuals.ResultsAmong 3356 hospitalizations for traumatic head injury (2573 males and 783 females, 654 died (19.49%), the highest and lowest mortality rates were in the elderly and juvenile groups, respectively. Fall was the most common cause in juvenile and elderly individuals (32.79% and 43.95%, respectively), while traffic injury was most common in the elderly group (35.08%). The manners of injury differed considerably among the 3 age groups. Scalp injury, skull fracture, intracranial hematoma, and cerebral injury were the most common mechanisms in juvenile (67.32%), middle-aged (63.50%), elderly (69.56%) and middle-aged (90.44%) individuals, respectively. Scalp injury and skull fracture types differed among the groups. Epidural, subdural, and intracerebral hematomas were most common in juvenile, middle-aged, and elderly individuals, respectively. Cerebral contusion showed the highest frequency in the 3 groups, and concussion the lowest.ConclusionsPatients with traumatic HI show remarkable differences in clinicopathological features among juvenile, middle-aged, and elderly individuals.

Comparative efficacy and safety of bisphosphonate therapy for bone loss in individuals after middle age: A systematic review and network meta-analysis

The cardiometabolic index (CMI) is a marker for evaluating visceral adipose distribution and lipid metabolism. This index is useful for detecting metabolic diseases as well as some cardiovascular diseases. The link between the CMI and heart disease among elderly and middle-aged individuals has yet to be fully explored. This study aimed to investigate the relationship between the CMI and heart disease incidence in individuals aged 45 and over. A total of 987 participants aged 45years and above were enrolled. Only patients without heart disease at baseline were included in the 15-year observation. The CMI was calculated by multiplying the ratio of triglycerides to high-density lipoprotein cholesterol by the waist‒to-height ratio. Participants were then grouped into CMI tertiles. The Kruskal‒Wallis H test and Cox regression analysis were performed. Longitudinal/panel data mixed-effects linear regression models were applied to analyze the relationships between the CMI and nonspecific inflammatory markers. In the highest tertile, there was a 1.60-fold increased risk of coronary heart disease (CHD) after adjusting for age and sex. There was also a positive association between time-varying CMI and hs-CRP. These findings suggest that a higher CMI is related to inflammatory processes and elevated CHD risk, thus highlighting its potential role as a marker for CHD in elderly and middle-aged Chinese individuals.

Does the integration of urban and rural health insurance influence the functional limitations of the middle-aged and elderly in rural China?

Presynaptic accumulation and differential localization of complexin isoforms in neuronal cells