Appendicular Muscle Mass Index Research Articles

Appendicular Muscle Mass Index as the Most Important Determinant of Bone Mineral Content and Density in Small for Gestational Age Children.

Preterm small for gestational age (SGA) children are at increased risk for low bone mineral content later in life; however, data on SGA children born at term are scarce. We included 44 SGA and 57 adequate for gestational age (AGA) children aged 6 to 11 years to compare bone mineral density (BMD) and bone mineral content (BMC) and to identify which anthropometric and biochemical values influence bone mineralization in these children. Fat mass, appendicular skeletal muscle mass index (ASMMI), BMC, and BMD were significantly lower in SGA children than in AGA (P ≤ .005). Appendicular muscle mass index correlated with BMC(TBLH,FN,L1-L4) and BMD(TBLH,FN,L1-L4) in both groups (r2 = 0.7, P < .05). In multivariate analysis, ASMMI was strongly associated with BMC and BMD in both groups. There were no differences in clinical biomarkers, calcium intake, and physical activity between the groups. Achieving adequate muscle mass contributes to adequate bone mineralization and a lower risk for low BMC and BMD in SGA children.

Estimation of the appendicular skeletal muscle mass and phase angle cut-off values from a young Turkish reference population using multifrequency bioelectrical impedance analysis.

Population-specific muscle mass cut-off values are recommended for the diagnosis of sarcopenia. In this study, we aimed to determine the appendicular muscle mass index (ASMI) and phase angle (PA) cut-off values for the Turkish population using multi-frequency bioelectrical impedance analysis (mBIA). A total of 250 healthy volunteers aged 18-40 years were included in the study between September 2020 and December 2021. PA was measured by mBIA, and appendicular skeletal muscle mass (ASM) was calculated by the Sergi formula using the resistance and reactance measurements from mBIA. ASMI was calculated as ASM (kg)/(height in meters)2. Two standard deviations (SD) below the mean values were accepted as cut-off points. 134 women and 116 men were included in the study (26.0±5.6 years). The ASMI cut-offs for men and women were 5.86 and 4.36 kg/m2, respectively. The PA cut-offs were 5.66° in men and 4.38° in women. The present study reported the ASMI and PA cut-off values specific to the Turkish population using the Sergi formula, which was suggested by the European Working Group on Sarcopenia in Older People (EWGSOP).

P311 Prevalence and impact of sarcopenia in patients with inflammatory bowel diseases: a prospective cohort study

Abstract Background Sarcopenia is associated with increased morbidity and mortality in IBD. The main objective of this study was to prospectively evaluate sarcopenia by combining morphological and functional criteria in an outpatient IBD population. Methods In a prospective cohort study, we included all IBD patients admitted to the Day Hospital (DH) of our department between March 1st and 31st, 2023. Patients with short bowel syndrome were not included. Muscle mass was assessed using a Bodystat®1500MDD dual-frequency impedance meter, and muscle function was assessed by measuring handgrip strength, Carym® digital dynamometer. Pre-sarcopenia was defined by a handgrip measurement &amp;lt; 16 to 26, and myopenia was defined by an appendicular muscle mass index (AMMI) &amp;lt; 5.5 to 7 kg/m2 or a fat-free mass index (FFMI) &amp;lt; 15 to 17 in women or men. Sarcopenia was defined by the association of pre-sarcopenia and myopenia. Patients were followed-up at 6 months to measure a composite criterion of disease activity combining one of the factors: FC &amp;gt; 250µg/g, endoscopic activity, therapeutic change, hospitalization, or IBD-related surgery. Results In total, 60 patients were included, median age 37 years (IQR 28-54), 55% women, with CD (52%) or UC (48%) diagnosed 9 years (4-17) ago, mostly in remission (67%, n=40). Patients with CD had ileocolic (48%), ileal (35%), or colonic (16%) involvement. Patients with UC had E1 (7%), E2 (41%), or E3 (52%) involvement. A history of digestive surgery linked to IBD was noted in 30% of cases. The biologics administered were infliximab (61%), vedolizumab (25%), or ustekinumab (14%). The BMI was 24 (21-27) and serum albumin was 41g/l (39-44). The prevalence of sarcopenia, pre-sarcopenia and myopenia was 10%, 11% and 20%, respectively. Sarcopenic patients were significantly older (59 vs. 36 years, p=0.01), with older disease (20 vs. 8 years, p=0.003), and associated joint damage (40% vs. 2%, p=0.002) and tended to involve CD more frequently (80 vs. 49%, p=0.36). There was no significant difference between biologics, BMI or albuminemia in sarcopenic patients, but vitamin D levels tended to be lower (15 vs. 43, p=0.27). Myopenia was significantly associated with a history of surgery (67 vs. 21%, p=0.004), a lower BMI (21 vs. 24, p=0.001) and a more active disease at M6 according to the composite criterion (50 vs. 21%, p=0.04 after adjustment for age, sex, and disease activity at baseline). Myopenia indices were strongly correlated with handgrip values (r=0.7, p&amp;lt;0.001). Conclusion In a prospective study of Day Hospital IBD patients, sarcopenia was identified by impedancemetry in 11% and myopenia in 20% of cases, and associated with an increase in morbidity.

Relationship between appendicular muscular mass index and physical function in older people.

This study aimed to establish the relationship between the appendicular muscle mass index (AMMI), assessed from anthropometric variables, and the physical function of older people. Seventy-six older people participated in this study (72.03 ± 7.03 years). The participants underwent evaluations to determine their AMMI using anthropometry (weight, calf circumference, hip circumference, and knee height) and manual grip strength. Additionally, their physical function was evaluated using the 5-chair stand test, the 3-meter walk test, and the timed up and go test (TUG) to determine the strength of the lower limbs, the gait speed, and the dynamic balance, respectively. The results show that the AMMI did not present a significant relationship with the 5-chair stand test in both women (r = -0.135; p = 0.204) and men (r = -0.067; p = 0.349). The AMMI was moderately correlated with the gait speed in both women (r = 0.542; p < 0.001) and men (r = 0.556; p < 0.001). Finally, a statistical significance was observed in the relationship between the AMMI and the TUG test in women (r = -0.273; p = 0.047) and older men evaluated in this study (r = -0.284; p = 0.042). In conclusion, there is a relationship between the AMMI and both the dynamic balance and the gait speed. Therefore, the AMMI emerges as a potential public health assessment by enabling the clinical quantification of muscle mass and an estimation of physical function in the elderly population.

Muscle strength, not muscle mass, determines the health-related quality of life in Indonesian women with systemic lupus erythematosus

ObjectiveNo study evaluated the impact of low muscle strength and mass on the Sarcopenia-related Quality of Life (SarQoL) in women with SLE.MethodsThis cross-sectional study recruited 145 women with SLE consecutively;...

Spot Urinary Creatinine Concentration in Patients with Chronic Heart Failure Identifies a Distinct Muscle-Wasting Phenotype with a Strikingly Different Risk of Mortality.

There is a raising awareness that heart failure (HF) is a highly heterogeneous, multiorgan syndrome with an increasing global prevalence and still poor prognosis. The comorbidities of HF are one of the key reasons for presence of various phenotypes with different clinical profile and outcome. Heterogeneity of skeletal muscles (SMs) quantity and function may have an impact on patient's phenotype. We intended to compare clinical characteristics of phenotypes defined by a combination of various SM mass taken as a fat-free compartment from DEXA scans and different levels of SUCR (Spot Urinary Creatinine). All-cause mortality with mortality predicted by MAGGIC in such phenotypes were compared. In 720 HF patients with reduced ejection fraction (age: 52.3 ± 10 years, female: 14%, NYHA: 2.7 ± 0.7, LVEF: 24.3 ± 7.3%), admitted to the hospital for heart transplantation candidacy assessment, morning SUCR along with body composition scanning (DEXA) was performed. All study participants were dichotomized twice, first by low or normal appendicular muscle mass index (ASMI) and second by SUCR (Spot Urinary Creatinine) < and ≥of 1.34 g/L. Four study groups (phenotypes) were created as combinations of lower or higher SUCR and low or normal ASMI. Low ASMI was found in 242 (33.6%) patients, while the remaining 478 had normal muscle mass. In 446 patients (61.9%), SUCR was <1.34 g/L. During 3 years of follow-up, 223 (31.0%) patients died (all-cause). The phenotype of lower both ASMI and SUCR was associated with the highest mortality. The death rate in phenotype with both low ASMI and SUCR exceeded by 70% the risk estimated by MAGGIC. This difference was significant as judged by the 95% confidence interval for MAGGIC estimation. In Cox regression analysis adjusted for MAGGIC and parameters known to increase risk, the relative risk of patients with phenotype of low both ASMI and SUCR was elevated by 45-55% as compared to patients with all other phenotypes. The protective role of higher SUCR in patients with muscle wasting was, therefore, confirmed in Cox analysis. Measurement of SUCR in HF patients can identify clinical phenotypes with skeletal muscle wasting but strikingly different risk of death that is actually not captured by MAGGIC score. The higher level of SUCR was associated with similar risk independently of presence of muscle wasting. As the analysis of SUCR is cheap and easy to perform, it should be further tested as a potentially useful biomarker, which may precisely phenotype HF patients independently of their skeletal muscle status.

Pre-existing sarcopenia and swallowing outcomes in acute stroke patients

This study aimed to investigate the associations of pre-existing sarcopenia with swallowing function, oral intake level, and aspiration pneumonia in patients with acute stroke. This observational study included patients (≥60 years of age) with acute ischemic stroke or intracerebral hemorrhage within 7 days of onset who were screened for sarcopenia, malnutrition, and swallowing difficulties in a stroke-care unit within 48h of admission. Sarcopenia was defined by the Asian Working Group on Sarcopenia 2019 as having a low calf circumference, handgrip strength, and appendicular muscle mass index. The primary outcome was impaired oral intake (functional oral intake scale <5 points) at 3, 7, and 14 days after admission, and the secondary outcome was aspiration pneumonia during hospitalization. We enrolled 350 patients (median age of 77 years; 63% males) who underwent the aforementioned screening. Sarcopenia was diagnosed in 34% of patients, and malnutrition was found in 66% of patients with sarcopenia. When compared with the comparison group (defined as patients with either or both normal calf circumference and handgrip strength), the sarcopenia group had significantly lower tongue pressure and a higher prevalence of dysphagia. Sarcopenia was associated with functional oral intake scale <5at 7 days (adjusted odds ratio [OR], 4.72; 95% confidence interval [CI], 1.91-11.71); p=0.002) and 14 days (adjusted OR, 3.93; 95% CI, 1.47-10.53; p=0.006) and with aspiration pneumonia during hospitalization (adjusted OR, 6.12; 95% CI, 1.63-22.94; p=0.007). Acute stroke patients with sarcopenia may have weakness of the swallowing-related muscles which may lead to impaired oral intake and aspiration pneumonia.

Prevalence of sarcopenia in patients older than 75 years admitted for hip fracture

BackgroundHip fracture in the population aged 75 years and older is one of the most disabling pathologies. Likewise, disease related malnutrition (DRM) and sarcopenia are two frequent diagnoses in this age group, whose prevalence may be increased in patients with hip fracture. AimsTo determine the prevalence of malnutrition and/or sarcopenia in patients admitted for hip fracture and evaluate the existence of malnutrition related to disease and sarcopenia, and the differences between the sarcopenic and non-sarcopenic group. Methods186 patients aged 75 years or over, hospitalised for hip fracture from March 2018 to June 2019 were included. Demographic, nutritional and biochemical variables were collected. Nutritional screening was carried out with the Mini-Nutritional Assessment (MNA), the presence of DRM was established with The Global Leadership Initiative on Malnutrition (GLIM) criteria. For sarcopenia screening, the Strength, Assistance with walking, Rising from a chair, Climbing stairs and Falls (SARC-F) was used and the diagnosis of sarcopenia was made using the criteria from the European Working Group on Sarcopenia in Older People (EWGSOP) reviewed in 2019 (EWGSOP2). Muscle strength was determined by hand-grip strength, body composition by measurement of bioelectrical impedance. ResultsThe mean age was 86.2 years, most of the patients were women (81.7%). 37.1% of patients were at nutritional risk (MNA 17−23.5) and 16.7% were malnourished (MNA < 17). 72.4% of women and 79.4% of men, were diagnosed with DRM. 77.6% of the women and 73.5% of the men had low muscle strength. The appendicular muscle mass index was below the cut-off points for sarcopenia in 72.4% of the women and 79.4% of the men. Patients with sarcopenia had a lower body mass index, older age, poorer previous functional status and higher disease burden. The relationship between weight loss and hand grip strength (HGS) was significant (p = 0.007). Conclusions53.8% of patients admitted for hip fracture present malnutrition or are at risk after screening with MNA. Sarcopenia and DRM affects at least three out of four patients older than 75 years admitted for hip fracture. Older age, worse functional status, lower body mass index and high number of comorbidities, are associated with these two entities. There is a relationship between DRM and sarcopenia.

Association between Nutritional Intake Status and Appendicular Muscle Mass in Female University Students with a High Physical Activity Level*

This study investigated the association between nutritional intake and indices of muscle mass or strength in 104 female Japanese university students who participated in sports activities during their junior and senior high school periods and had a high current physical activity level (PAL). Body composition was measured by the bioelectrical impedance method, and appendicular muscle mass (AMM) and skeletal muscle mass index (SMI) were evaluated as muscle mass. PAL was estimated using a factorial method and nutritional intake status was investigated using a food frequency questionnaire based on food groups (FFQg). Grip strength was measured as an index of muscle strength. According to the criteria for diagnosis of sarcopenia, four of the participants had low muscle mass and one also had low grip strength. Although there were no significant differences in body size or grip strength between participants with a high versus low SMI, participants with a low SMI had a significantly higher percentage of body fat (27.7 ± 4.7% vs. 23.3 ± 4.1%), and significantly lower AMM (16.0 ± 1.4 kg vs. 20.6 ± 1.5 kg), total energy intake (1770.4 ± 386.5 kcal/d vs. 2017.1 ± 389.9 kcal/d), and protein intake (57.3 ± 15.0 g/d vs. 67.0 ± 14.2 g/d), as well as a tendency to have a significantly lower carbohydrate intake (239.6 ± 49.3 g/d vs. 268.1 ± 54.4 g/d), than those with a high SMI. These results indicate that even some female university students with a high PAL have a lower muscle mass and might have a low dietary intake, mainly protein and carbohydrate. The results of multiple regression analysis of AMM, SMI, or grip strength with PAL and nutrient intake revealed that PAL and total energy intake or protein intake were significantly and positively associated with muscle mass and strength. These results suggest that a high PAL as well as total energy intake and protein intake among the macronutrients contribute to high muscle mass and muscle strength in young women.

Appendicular Muscle Mass Index was Stronger than Body Mass Index in Association with Atherosclerosis in the Community-Dwelling Elderly.

Low muscle mass is associated with advanced atherosclerosis. However, only very few studies on the elderly have investigated a dose-response relationship between muscle mass and atherosclerosis. Furthermore, whether the relationship between muscle mass and atherosclerosis is stronger than that between body mass index (BMI) and atherosclerosis among the elderly population remains to be determined. A community-based sample of apparently healthy elderlies (≥ 65 years) was cross-sectionally examined for the association between appendicular skeletal muscle mass (ASM) and brachial-ankle pulse wave velocity (baPWV), a measure of atherosclerosis. We categorized the participants according to sex-specific quintiles of the ASM index (ASM/height2) or BMI. Using multivariable linear regression, we compared the slope of one standard deviation higher ASM index for baPWV with the corresponding slope of BMI, separately (single-index model) and jointly (simltaneously-adjusted model). The ASM index and BMI of a total of 995 participants (60.0% women, mean age 73 years) were significantly inversely associated with baPWV in a dose-response manner across the quintiles in both sexes. The slope for the ASM index tended to be greater than that for BMI in the single-index and simultaneously-adjusted models in both sexes after adjusting for confounders. Among a community-dwelling elderly population, the association between ASM and baPWV was stronger than, and independent of that between BMI and baPWV. These findings suggest that ASM provides more important information on atherosclerosis in the elderly than BMI does.

Low muscle strength and low phase angle predicts greater risk to mortality than severity scales (APACHE, SOFA, and CURB-65) in adults hospitalized for SARS-CoV-2 pneumonia.

The acute physiology and chronic health evaluation (APACHE), sepsis-related organ failure assessment (SOFA), score for pneumonia severity (CURB-65) scales, a low phase angle (PA) and low muscle strength (MS) have demonstrated their prognostic risk for mortality in hospitalized adults. However, no study has compared the prognostic risk between these scales and changes in body composition in a single study in adults with SARS-CoV-2 pneumonia. The great inflammation and complications that this disease presents promotes immobility and altered nutritional status, therefore a low PA and low MS could have a higher prognostic risk for mortality than the scales. The aim of the present study was to evaluate the prognostic risk for mortality of PA, MS, APACHE, SOFA, and CURB-65 in adults hospitalized with SARS-CoV-2 pneumonia. This was a longitudinal study that included n = 104 SARS-CoV-2-positive adults hospitalized at General Hospital Penjamo, Guanajuato, Mexico, the PA was assessed using bioelectrical impedance and MS was measured with manual dynamometry. The following disease severity scales were applied as well: CURB-65, APACHE, and SOFA. Other variables analyzed were: sex, age, CO-RADS index, fat mass index, body mass index (BMI), and appendicular muscle mass index. A descriptive analysis of the study variables and a comparison between the group that did not survive and survived were performed, as well as a Cox regression to assess the predictive risk to mortality. Mean age was 62.79 ± 15.02 years (31-96). Comparative results showed a mean PA of 5.43 ± 1.53 in the group that survived vs. 4.81 ± 1.72 in the group that died, p = 0.030. The mean MS was 16.61 ± 10.39 kg vs. 9.33 ± 9.82 in the group that died, p = 0.001. The cut-off points for low PA was determined at 3.66° and ≤ 5.0 kg/force for low grip strength. In the Cox multiple regression, a low PA [heart rate (HR) = 2.571 0.726, 95% CI = 1.217-5.430] and a low MS (HR = 4.519, 95% CI = 1.992-10.252) were associated with mortality. Phase angle and MS were higher risk predictors of mortality than APACHE, SOFA, and CURB-65 in patients hospitalized for COVID-19. It is important to include the assessment of these indicators in patients positive for SARS-CoV-2 and to be able to implement interventions to improve them.

Serum uric acid is not associated with appendicular muscle mass index in young and middle-aged adults: Results from NHANES 2011-2012.

Recent studies have evaluated the association between uric acid (UA) and muscle mass in older adults; however, little is known about this relationship in young and middle-aged individuals. Our aim was to investigate whether serum UA is associated with appendicular muscle mass index (AMMI) in young and middle-aged individuals. We also aimed to evaluate whether this association is sex-specific. A cross-sectional study was performed with young and middle-aged individuals aged from 20 to 59 years from National Health and Nutrition Examination Survey (NHANES) 2011-2012. A total of 2255 individuals (1440 young and 815 middle-aged individuals; 1167 men and 1088 women) were evaluated. Body composition was assessed by Dual Energy X-ray absorptiometry (DXA) and AMMI was calculated using the arms plus legs lean mass divided by the height squared. UA levels were measured by colorimetric method. Regression analyzes were performed to evaluate whether AMMI is associated with the tertiles of UA levels after adjustments for potential confounders. In the unadjusted analyzes, serum UA was positively associated with AMMI for total sample, young, and middle-aged individuals of both sexes. However, after adjustments for confounders, UA levels were no longer associated with AMMI independent of the age-rage and sex. Serum UA is not associated with AMMI in young or middle-aged individuals independent of the sex.

Plasma omega-3 fatty acids are positively associated with appendicular muscle mass index only in adults with low protein intake: Results from NHANES 2011–2012

Omega-3 (ω-3) fatty acids may indirectly increase muscle protein synthesis making the muscle more sensitive to amino acids uptake; therefore, ω-3 could promote benefits on muscle mass mainly when protein intake is low. However, no study has evaluated the association between ω-3 fatty acids and muscle mass according to protein intake. To evaluate the association between plasma ω-3 fatty acids and appendicular muscle mass index (AMMI) in adults according to the protein intake. A cross-sectional study was performed evaluating 1037 individuals aged 20-59 years from a sub-sample of the National Health and Nutrition Examination Survey (NHANES) 2011-2012. Gas chromatography-mass spectrometry method was used to assess plasma ω-3 fatty acids. The lean mass was evaluated by dual-energy x-ray absorptiometry (DXA) and AMMI (kg/m2) was calculated by appendicular lean mass (kg) divided by height squared. The evaluation of protein intake was performed using two 24-h dietary recalls. Linear regression analysis was performed to assess the association of total plasma ω-3, docosahexaenoic acid (DHA), eicosapentaenoic acid (EPA), alpha-linolenic acid (ALA), and EPA plus DHA with AMMI according to protein intake (<0.8; ≥0.8; ≥0.8 -<1.2; ≥1.2 -<1.6; and ≥1.6g/kg/d). Total plasma ω-3 (β=0.0030; CI=0.0013-0.0046; p=0.002), ALA (β=0.0063; CI=0.0020-0.0107; p=0.008), EPA (β=0.0073; CI=0.0005-0.0142, p=0.037), DHA (β=0.0057; CI=0.0022-0.0093; p=0.004) and EPA+DHA (β=0.0040; CI=0.0010-0.0071; p=0.013) were positively associated with AMMI in individuals with low protein intake (<0.8g/kg). However, no association was observed in individuals with protein intake higher than 0.8g/kg. Plasma ω-3 fatty acids were positively associated with AMMI only in individuals with low protein intake.

Impact of Low Skeletal Muscle Mass and Obesity on Hearing Loss in Asymptomatic Individuals: A Population-Based Study.

The relationship between low muscle mass (LMM) with obesity and hearing loss has been poorly studied. We aimed to investigate the association of LMM and obesity on hearing loss in the general population. A total of 265,792 adults who underwent a hearing test and body composition analyses were included. Pre-sarcopenia was defined as having an appendicular muscle mass index <5.7 kg/m2 for women and <7.0 kg/m2 for men, and obesity as a body mass index ≥25 kg/m2, while pre-sarcopenic obesity was defined as the co-presence of LMM and obesity. Participants were divided into four groups according to the presence of pre-sarcopenia and/or obesity. The prevalence of hearing loss was 1.8% in the control, 2.5% in the pre-sarcopenia alone, 3.0% in the obesity alone, and 6.2% in the pre-sarcopenic obesity group (p < 0.001). Hearing Thresholds were the highest in the pre-sarcopenic obesity group compared with the other three groups. In multivariable-adjusted models, the risk of hearing loss was the highest in the pre-sarcopenic obesity group (odds ratio: 1.30 [95% confidence interval: 1.10–1.56]), followed by the obesity alone (1.20 [1.12–1.28]) and pre-sarcopenia alone (1.19 [1.06–1.34]) group compared with the control group (p < 0.001). Pre-sarcopenic obesity was independently associated with a higher prevalence of hearing loss, supporting pre-sarcopenic obesity itself as a risk for the decline in hearing function.

Relationship between sarcopenia/paravertebral muscles and the incidence of vertebral refractures following percutaneous kyphoplasty: a retrospective study

BackgroundThis study aimed to reveal the associations of osteoporotic vertebral compression refracture (OVCRF) incidence with sarcopenia and paravertebral muscles (PVM).MethodsA total of 214 elderly patients who underwent percutaneous kyphoplasty in our hospital between January 2017 and December 2019 were analyzed. Data on possible risk factors, including sex, age, weight, height, diabetes, treated vertebral levels (thoracolumbar junction [(T10–L2]), vacuum clefts, and body mass index (BMI), were collected. Preoperative bone mineral density (BMD) and appendicular muscle mass were evaluated using dual-energy X-ray absorptiometry. Nutritional status was evaluated using the Mini Nutritional Assessment. Magnetic resonance imaging was performed to evaluate the physiological cross-sectional area of the PVM.ResultsOverall, 74 (15 men and 59 women) and 60 (55 women and 14 men) patients developed OVCRF and sarcopenia, respectively. Sarcopenia is related to advanced age, ower BMD and BMI values. Sarcopenia-related indicators (PVM fat rate, appendicular muscle mass index, grip strength) were significantly lower in the sarcopenia group. Univariate analysis showed a correlation between OVCRF and BMD, BMI, diabetes, sarcopenia, and age. Multivariate analysis suggested that fatty infiltration of the PVM, BMD, sarcopenia, diabetes, BMI, and treated vertebral level remained as the independent predictors of OVCRF (p < 0.05).ConclusionsThe association between sarcopenia and PVM as independent risk factors for OVCRF was established in this study; therefore, sarcopenia should be greatly considered in OVCRF prevention.

Nutritional status and osteoporotic phenotype of body composition in patients with rheumatoid arthritis

Aim. To evaluate the nutritional status and its relationship with osteoporotic phenotype of body composition in women with rheumatoid arthritis (RA).Material and methods. The study included 91 women aged 40 to 75 years with RA according to ACR/EULAR criteria (2010). A questionnaire, laboratory examination and dual X-ray absorptiometry of whole body, lumbar spine and proximal femur were conducted. Nutritional status was assessed using a MNA (Mini Nutricial Assessment) questionnaire.Results. Risk of malnutrition and malnutrition according to the MNA were detected in 42.9 % and 1.1 % of patients with RA, respectively. These patients differed from those with normal nutritional status with a higher risk of osteoporotic hip fracture according to FRAX (p = 0.035), lower appendicular muscle mass (AMM) (p = 0.048) and lower QOL according to VAS (p = 0.012). A positive correlation was established between the nutritional status by MNA and BMI (r = 0.280; p = 0.007), as well as total muscle mass (r = 0.280; p = 0.008), AMM (r = 0.320; p = 0.002) and AMM index (r = 0.280; p = 0.009). In multivariate logistic regression analysis, age above 55 years (OR = 7.76; 95 % CI: 2.17–27.69), nutritional status by MNA (OR = 0.68; 95 % CI: 0.51–0.92) and AMM index less than 6 kg/m2 (OR = 3.43; 95 % CI: 1.16–10.21) were independent factors associated with osteoporotic phenotype in RA patients.Conclusion. Malnutrition occurred in 44.0 % of RA patients. Women at risk of malnutrition had a higher 10-year probability of hip fracture according to FRAX. Age and AMM index were positively associated, while nutrition status according to MNA was negatively associated with osteoporotic phenotype of body composition.

The frequency of sarcopenia and factors affecting appendicular muscle mass in patients with systemic sclerosis

Aim. To determine the frequency of sarcopenia (SP) and to identify factors associated with the muscle mass in women with systemic sclerosis (SSc).Materials and methods. The study included 64 women with SSc aged 40–70 years. Questionnaires, clinical, instrumental, laboratory examinations and absorptiometry. Linear regression analysis was performed to identify factors associat ed with appendicular muscle mass (AMM).Results. Probable SP was detected in 35 (54.7 %), and confirmed SP – 17 (26.5 %) women with SSc. The frequency of SP did not differ depending on the form of the disease. Univariate linear analysis revealed the relationship between the AMM and BMI, nutritional status; mid-upper arm, waist, hip and calf circumferences, skin Rodnan score, cumulative dose of glucocorticoids (GC) and BMD of the proximal hip. Multivariate linear analysis confirmed the presence of associations between the AMM index and BMI (b = 0.65; p &lt;0.001), the Rodnan skin score (b = –0.19; p = 0.047), the cumulative dose of GC (b = –0.22; p = 0.021).Conclusion. The study demonstrated that more than a quarter of patients with SSc had a confirmed SP. Although age is the main risk factor for SP in the general population, in our study it did not differ between patients with low and normal AMM. The cumulative dose of GC and the Rodnan skin score were negatively, and BMI was positively associated with the value of AMМ.

Prevalencia de sarcopenia en pacientes mayores de 75 años ingresados por fractura de cadera

IntroductionHip fracture in the population aged 75 years and older is one of the most disabling pathologies. Likewise, disease related malnutrition (DRM) and sarcopenia are two frequent diagnoses in this age group, whose prevalence may be increased in patients with hip fracture. AimTo determine the prevalence of malnutrition and/or sarcopenia in patients admitted for hip fracture and evaluate the existence of malnutrition related to disease and sarcopenia, and the differences between the sarcopenic and non-sarcopenic group. Methods186 patients aged 75 years or over, hospitalised for hip fracture from March 2018 to June 2019 were included. Demographic, nutritional and biochemical variables were collected. Nutritional screening was carried out with the Mini-Nutritional Assessment (MNA), the presence of DRM was established with The Global Leadership Initiative on Malnutrition (GLIM) criteria. For sarcopenia screening, the Strength, Assistance with walking, Rising from a chair, Climbing stairs and Falls (SARC-F) was used and the diagnosis of sarcopenia was made using the criteria from the European Working Group on Sarcopenia in Older People (EWGSOP) reviewed in 2019 (EWGSOP2). Muscle strength was determined by hand-grip strength, body composition by measurement of bioelectrical impedance. ResultsThe mean age was 86.2 years, most of the patients were women (81.7%). 37.1% of patients were at nutritional risk (MNA 17-23.5) and 16.7% were malnourished (MNA<17). 72.4% of women and 79,4% of men, were diagnosed with DRM. 77.6% of the women and 73.5% of the men had low muscle strength. The appendicular muscle mass index was below the cut-off points for sarcopenia in 72.4% of the women and 79.4% of the men. Patients with sarcopenia had a lower body mass index, older age, poorer previous functional status and higher disease burden. The relationship between weight loss and hand grip strength (HGS) was significant (p=0.007) Conclusions53.8% of patients admitted for hip fracture present malnutrition or are at risk after screening with MNA. Sarcopenia and DRM affects at least three out of four patients older than 75 years admitted for hip fracture. Older age, worse functional status, lower body mass index and high number of comorbidities, are associated with these two entities. There is a relationship between DRM and sarcopenia.

Bone mineral density and muscle mass in adults with developmental skeletal discrepancies

BackgroundIt was aimed to investigate the musculoskeletal status in individuals diagnosed with skeletal discrepancies.MethodsThis case–control study was performed on 35 patients with developmental skeletal discrepancies listed for orthognathic surgery as a case group and 33 patients who were nominated for wisdom tooth removal as a control group. All participants were aged 18–40 years and the research was carried out in the period between May 2018 and May 2019. Dual X-ray absorptiometry (DEXA) was used to assess bone mass density at three bone sites: total hip, femoral neck, and the spinal lumbar vertebrae (L1-L4). The appendicular muscle mass index (ASMI) was measured based on the four limbs from the DEXA scan.ResultsOur data showed that 45.7% (16) of the case group were osteopenic or osteoporotic while in the control group only 21.2% (7) were osteopenic in at least one region (total hip, femoral neck, or lumbar) (p-value = 0.03).Regarding muscle mass, there was significantly lower SMI in subjects with skeletal discrepancies (case group) compared with the control group (median (IQR) 5.9 (2.5) vs. 6.8 (2.9) (kg/m2), respectively, p = 0.04).ConclusionsThere is an essential need for more studies to understand the exact interrelationship between musculoskeletal status and skeletal jaw discrepancies.

Associations of muscle mass, strength, and quality with all-cause mortality in China: a population-based cohort study.

BackgroundIt remains unclear about the association of muscle mass, strength, and quality with death in the general Chinese population of diverse economical and geographical backgrounds. The present study aimed to comprehensively examine such associations across different regions in China.MethodsBased on the China Kadoorie Biobank study, the present study included 23,290 participants who were aged 38 to 88 years and had no prevalent cardiovascular diseases or cancer. Muscle mass and grip strength were measured using calibrated instruments. Arm muscle quality was defined as the ratio of grip strength to arm muscle mass. Low muscle mass, grip strength, and arm muscle quality were defined as the sex-specific lowest quintiles of muscle mass index, grip strength, and arm muscle quality, respectively. Cox proportional hazards models yielded hazard ratios (HRs) and 95% confidence intervals (CIs) for risks of all-cause mortality in relation to muscle mass, strength, and quality.ResultsDuring a median follow-up of 3.98 years, 739 participants died. The HR (95% CI) of all-cause mortality risk was 1.28 (1.08–1.51) for low appendicular muscle mass index, 1.38 (1.16–1.62) for low total muscle mass index, 1.68 (1.41–2.00) for low grip strength, and 1.41 (1.20–1.66) for low arm muscle quality in models adjusted for sociodemographic characteristics, lifestyle factors, and medical histories.ConclusionLow muscle mass, grip strength, and arm muscle quality are all associated with short-term increased risks of mortality, indicating the importance of maintaining normal muscle mass, strength, and quality for general Chinese adults.