Association Of Sarcopenia Research Articles

Associations of sarcopenia and malnutrition with 30-day in-hospital morbidity and mortality after cardiac surgery.

Sarcopenia and malnutrition often occur simultaneously in adults with cardiovascular diseases. Our objective was to determine the associations of preoperative sarcopenia and malnutrition with major adverse cardiac and cerebral events (MACCE) after cardiac surgery. We retrospectively analyzed 154 consecutive patients who underwent elective cardiac surgery between January 2015 and June 2018 at two institutions in Japan. Sarcopenia and nutritional status were preoperatively assessed by bilateral psoas muscle volume index (PMVI) using CT scans and the prognostic nutritional index (PNI), respectively. The median age in the total cohort was 69 years, and 43% were women. Within 30 days after surgery, 20 patients developed in-hospital MACCE and 7 patients died of any cause. Low PMVI (<72.25 cm3/m2) and low PNI (<48.15) were each independent predictors of postoperative MACCE occurrence with odds ratios (95% confidence interval) of 3.58 (1.22-10.53) and 3.73 (1.25-11.09) when adjusted for age and sex, and 3.25 (1.07-9.87) and 3.27 (1.08-9.89) when adjusted for preoperative left ventricular ejection fraction, angiotensin-converting enzyme inhibitor or angiotensin-receptor blocker, and anticoagulant. In addition, the combination of low PMVI and low PNI conferred the highest risk of in-hospital MACCE among the 4 groups (ie, the low PMVI, low PNI, low PMVI+low PNI, and neither low PMVI nor low PNI groups). Preoperative low PMVI and low PNI were respectively associated with 30-day in-hospital MACCE occurrence after cardiac surgery. Notably, coexistence of these reductions further enhanced the risk of postoperative MACCE.

Association of sarcopenia and its prognostic value in symptomatic knee osteoarthritis among older people in China: the first longitudinal evidence from CHARLS

BackgroundSarcopenia and knee osteoarthritis (KOA) are two common musculoskeletal disorders, often coexisting in aged population and potentially influencing each other. However, the underlying relationship between two conditions remains unclear and controversial. To fill this knowledge gap, we aimed to investigate the longitudinal association among the older Chinese population.MethodsData were attracted from 2 waves of the China Health and Retirement Longitudinal Study (CHARLS), and 6212 individuals aged ≥ 60 years were included. Sarcopenia status was defined by the Asian Working Group for Sarcopenia 2019 criteria. Multivariate logistic regression and generalized estimation equation models were applied to estimate the impact of sarcopenia on KOA. A prognostic nomogram was developed through train-test cross-validation.ResultsAt baseline in CHARLS 2015, the prevalence of symptomatic KOA was 12.7% (792/6212) in total population, 9% (270/2996) in no-sarcopenia group, 17.5% (286/1638) in possible sarcopenia group, and 15.0% (236/1578) in sarcopenia group. Over a 3-year follow-up, 4980 respondents were included, with incident KOA cases identified as 56 (2.2%), 38 (3.0%), and 43 (3.6%) in no-sarcopenia, possible sarcopenia, and sarcopenia groups, respectively. Sarcopenia was significantly associated with increased new-onset KOA compared to no-sarcopenia peers in the fully adjusted model (OR: 1.91, 95% CI: 1.15–3.18), whereas this association was non-significant for possible sarcopenia. In females, low muscle mass alone significantly increased the incident risk of KOA (OR: 2.58, 95% CI: 1.05–6.49). The final prognostic model and nomogram, including sarcopenia status, age, gender, body mass index, self-reported health status, comorbidities, history of falls and physical activity, had a considerable discrimination (AUC = 0.744, C-index = 0.660). The calibration curve indicated significant agreement between predicted and actual observations. Decision curve analysis revealed net benefits for clinical intervention at a probability threshold of 1–17%.ConclusionsSarcopenia was associated with a higher incident risk of symptomatic KOA, wherein low muscle mass may play an important role. The inferior prognosis of sarcopenia in KOA needs more attention in clinical practice.

Sarcopenia and osteoporosis in patients with psoriatic arthritis: A single-center retrospective study

ObjectiveThe risk of both osteoporosis and sarcopenia is high in inflammatory diseases, but there have been few reports of psoriatic arthritis (PsA). This study aimed to evaluate the rate of sarcopenia and osteoporosis, and the association of sarcopenia with osteoporosis in patients with PsA at our institution. MethodsThe data in this study were extracted from 320 patients with PsA meeting CASPAR criteria diagnosed between January 2010 and December 2021. The 156 patients who had undergone body composition measurements with dual-energy X-ray absorptiometry were included. ResultsOverall, the rate of sarcopenia and presarcopenia were 5.1% and 16.7%. Body mass index (BMI) was significantly lower in the presarcopenia and sarcopenia group. Furthermore, the presarcopenia and sarcopenia group had a significantly lower T-score in all regions. Multivariate analysis of the determinants of T-score for each site showed that SMI was significantly involved for the lumbar spine and the femoral neck, and BMI and rheumatoid factor positivity for the total hip. ConclusionsIn patients with PsA, the rate of sarcopenia was 5.1%. Osteoporosis rates for males and females were 5.7% and 7.5%, respectively. SMI, T-score, and BMI are significantly correlated with each other and should be considered in clinical practice.

Association of Dietary Patterns, Suspected Sarcopenia, and Frailty Syndrome among Older Adults in Poland-A Cross-Sectional Study.

The association of sarcopenia and frailty syndrome with dietary patterns is not yet well recognized. The aim of the study was to evaluate the association among dietary patterns, suspected sarcopenia, and frailty syndrome among older people in Poland. The study was conducted in 2022 and 2023 among people aged 55 and older. The sample was chosen arbitrarily. The following questionnaires were used in the study: the KomPAN (assessment of frequency of food intake and sociodemographic characteristics), the SARC-F (assessment of risk of sarcopenia), and the EFS (diagnosis of frailty syndrome). To confirm the suspicion of sarcopenia, muscle strength was assessed using the HGS and FTSST, and physical fitness was assessed using the GST. Based on the frequency of food consumption, 11 DPs (factors) were selected using PCA analysis. SARC-F, HGS, FTSST, and GST results were used to identify homogeneous groups (clusters) using cluster analysis, a k-means method. Two clusters were identified: cluster 1 (the non-sarcopenic cluster, or nSC) and cluster 2 (the sarcopenic cluster, or SC). Associations between variables were assessed using logistic regression. Suspected sarcopenia was found in 32.0% of respondents, more in men than women, and more among those either over 75 or 65 and under. EFS results showed that the risk (22.1%) or presence of frailty syndrome (23.8%) was more common in men than women and more common in those aged 75 and older than in other age groups. Male gender; older age; and unfavorable dietary patterns, i.e., consumption of white bread and bakery products, white rice and pasta, butter, and potatoes (factor 1) and cheese, cured meat, smoked sausages, and hot dogs (factor 9), increased the likelihood of sarcopenia and frailty syndrome, while the pattern associated with fruit and water consumption (factor 7) had the opposite effect. Confirmation of the importance of dietary patterns in the etiology and pathogenesis of sarcopenia and frailty syndrome should be documented in prospective cohort studies.

Espying sarcopenia in gastric cancer: squaring the circle.

This letter to the editor remarks on the recently published article by Chan et al on the association of sarcopenia with chemotherapy toxicities in patients with gastric cancer.

A Prospective Cohort Study Evaluating Impact of Sarcopenia on Hospitalization in Patients on Continuous Ambulatory Peritoneal Dialysis

Data regarding the association of sarcopenia with hospitalization has led to inconclusive results in patients undergoing dialysis. The main goal of this research was to investigate the association between sarcopenia and hospitalization in Chinese individuals on continuous ambulatory peritoneal dialysis (CAPD). Eligible patients on CAPD were prospectively included, and followed up for 48 weeks in our PD center. Sarcopenia was identified utilizing the criteria set by the Asian Working Group on Sarcopenia in 2019 (AWGS 2019). Participants were categorized into sarcopenia (non-severe sarcopenia + severe sarcopenia) and non-sarcopenia groups. The primary outcome was all-cause hospitalization during the 48-week follow-up period. Association of sarcopenia with all-cause hospitalization was examined by employing multivariate logistic regression models. The risk of cumulative incidence of hospitalization in the 48-week follow-up was estimated using relative risk (RR and 95% CI). The cumulative hospitalization time and frequency at the end of 48-week follow-up were described as categorical variables, and compared by χ2 test or fisher's exact test as appropriate. Subgroup and sensitivity analyses were also conducted to examine whether the potential association between sarcopenia and hospitalization was modified. A total of 220 patients on CAPD (5 of whom were lost in follow-up) were included. Prevalences of total sarcopenia and severe sarcopenia were 54.1% (119/220) and 28.2% (62/220) according to AWGS 2019, respectively. A total of 113 (51.4%) participants were hospitalized during the 48-week follow-up period, of which, the sarcopenia group was 65.5% (78/119) and the non-sarcopenia group was 34.7% (35/101), with an estimated RR of 1.90 (95%CI 1.43–2.52). The cumulative hospitalization time and frequency between sarcopenia and non-sarcopenia groups were significantly different (both P < 0.001). Participants with sarcopenia (OR = 3.21, 95%CI 1.75–5.87, P < 0.001), non-severe sarcopenia (OR = 2.84, 95%CI 1.39–5.82, P = 0.004), and severe sarcopenia (OR = 3.66, 95%CI 1.68–8.00, P = 0.001) demonstrated a significant association with all-cause hospitalization compared to individuals in non-sarcopenia group in the 48-week follow-up. Moreover, participants in subgroups (male or female; < 60 or ≥ 60 years) diagnosed with sarcopenia, as per AWGS 2019, were at considerably high risk for hospitalization compared to those with non-sarcopenia. In sensitivity analyses, excluding participants lost in the follow-up, the relationships between sarcopenia and hospitalization (sarcopenia vs. non-sarcopenia; severe sarcopenia/non-severe sarcopenia vs. non-sarcopenia) were consistent. This research involving Chinese patients on CAPD demonstrated a significant association between sarcopenia and incident hospitalization, thereby emphasizing the importance of monitoring sarcopenia health in this population.

Sarcopenia as a predictor of mortality in kidney transplant recipients: A 5-year prospective cohort study with propensity score matching.

Sarcopenia is known to bring about adverse outcomes in elderly populations and dialysis patients. However, whether it is a risk factor in kidney transplant recipients (KTRs) has not yet been established. In the present study, the association of sarcopenia with mortality was investigated in KTRs. We conducted a single-center prospective cohort study and recruited KTRs who were more than 1-year posttransplant from August 2017 to January 2018. The participants were followed for 5 years, and the Kaplan-Meier method and Cox proportional hazards model were used to assess patient survival. A total of 212 KTRs with a median age of 54 years and median transplant vintage of 79 months were enrolled in this study. Among them, 33 (16%) had sarcopenia according to the Asia Working Group for Sarcopenia 2019 at baseline. During the 5-year follow-up period, 20 (9.4%) died, 5 returned to dialysis after graft loss, and 4 were lost to follow-up. The 5-year overall survival rate was 90%. After 1:1 propensity score matching, a matched cohort with 60 KTRs was generated. The overall survival rate was significantly lower in the sarcopenia group compared to the non-sarcopenia group (p = 0.025, log-rank test). Furthermore, mortality risk was significantly higher in the sarcopenia group compared to the non-sarcopenia group (hazard ratio = 7.57, 95% confidence interval = 0.94-62). Sarcopenia was a predictor of mortality in KTRs. KTRs with suboptimal muscle status who were at risk for poor survival could have a clinical benefit by interventions for sarcopenia.

ASO Author Reflections: Prevalence and Association of Sarcopenia with Mortality in Patients with Head and Neck Cancer-A Systematic Review and Meta-analysis.

ASO Author Reflections: Prevalence and Association of Sarcopenia with Mortality in Patients with Head and Neck Cancer-A Systematic Review and Meta-analysis.

Possible sarcopenia and its association with hospital-associated dysphagia and decline in physical function: Findings from a heart failure patients prospective cohort study

Background & AimsThere is limited evidence regarding the association of sarcopenia with dysphagia and physical function in patients with heart failure. This study examined the association between possible sarcopenia and both swallowing and physical function in individuals with acute heart failure (AHF). MethodsThis prospective cohort study included hospitalized patients with AHF. Possible sarcopenia was assessed on admission using calf circumference and grip strength according to an international diagnostic criteria. The primary outcome was dysphagia at discharge using the Food Intake Level Scale (FILS), and the secondary outcome was physical function at discharge using the Barthel Index (BI). Multiple regression analysis and logistic regression, adjusted for potential confounders, were used to examine the association between possible sarcopenia at admission and FILS and BI at discharge. ResultsA total of 320 patients (mean age 81.5 years; 170 women) were included in the analysis; 199 (59.4%) were diagnosed with possible sarcopenia. Multivariate analysis showed that possible sarcopenia at admission was significantly associated with FILS at discharge (β = -0.1204; p = 0.039). Possible sarcopenia at admission was not significantly associated with BI at discharge (OR = 2.066; 95% CI, 0.910-4.692, p = 0.083). ConclusionsPossible sarcopenia was associated with decline in swallowing function during hospitalization in patients with AHF. These findings highlight the need for early detection and treatment of possible sarcopenia in this setting.

Association of Sarcopenia and Its Components with Depression Symptoms in Older Patients with Stroke.

Recent studies have reported an association between sarcopenia and depression symptoms. To date, no reports have investigated the association between sarcopenia and depression symptoms evaluated using the Geriatric Depression Screening Scale (GDS)-15 in patients with stroke. Therefore, this study aimed to investigate the association between sarcopenia and its components and the improvement of depression symptoms in patients with stroke admitted to a convalescent rehabilitation ward. Patients with stroke aged ≥65 years admitted to a convalescent rehabilitation ward were included in the study. Participants were categorized into sarcopenia and non-sarcopenia groups based on the 2019 Asian Working Group for Sarcopenia. Here, depression symptoms were evaluated using the GDS-15, in addition to demographic characteristics. This study's primary outcome was the GDS change from admission to discharge. Multiple regression analysis was performed to investigate the association between GDS change and sarcopenia and its components. Overall, 118 participants were included, with the mean age of 78.7±8.1 years, and 58 (49%) were classified in the sarcopenia group. Multiple regression analysis showed that sarcopenia (β=-0.283, 95% confidence interval [CI] -1.140 to -0.283, p&lt;0.001) and handgrip strength (β=-0.317, 95% CI -0.162 to -0.014, p=0.021) were independently associated with GDS change. Sarcopenia and handgrip strength were significantly associated with improved depression symptoms in patients with stroke admitted to a convalescent rehabilitation ward. However, further prospective studies should investigate the association between sarcopenia and depression symptoms in patients with stroke.

Association of sarcopenia with severe chemotherapy toxicities and survival in patients with advanced gastric cancer.

Sarcopenia or skeletal muscle depletion is a poor prognostic factor for gastric cancer (GC). However, existing cutoff values of skeletal muscle index (SMI) for defining sarcopenia have been found to have limitations when clinically applied. This study aimed to determine the optimal cutoff for SMI to predict severe toxicities of chemotherapy and overall survival (OS) in patients with advanced GC. Patients with metastatic gastric adenocarcinoma who received first-line palliative chemotherapy between January 2014 and December 2021 at Queen Mary Hospital, Hong Kong, were included in this study. The SMI was determined via a pre-chemotherapy computed tomography scan. Optimal cutoff points of SMI were identified by recursive partitioning analysis. Univariate and multivariate analyses evaluating risk factors of severe chemotherapy toxicities and OS were also performed. A total of 158 patients (male: 108 (68.4%), median age: 65.3) were included. The SMI cutoff to define low SMI was ≤33 cm2/m2 for males and ≤28 cm2/m2 for females; 30 patients (19.0%) had low SMI. Patients with low SMI had a higher incidence of hematological toxicities (63.3% vs 32.0%, P = .001) and non-hematological toxicities (66.7% vs 36.7%, P = .003). Multivariable analysis indicated that low SMI and low serum albumin (≤28 g/L) were independent predictive factors of hematological toxicity, while low SMI and neutrophil-lymphocyte ratio ≥5 were predictive factors of non-hematological toxicity. Moreover, patients with low SMI had a significantly shorter OS (P = .011), lower response rate to chemotherapy (P = .045), and lower utilization of subsequent lines of treatment (P < .001). Using pre-chemotherapy SMI cutoff (≤33 cm2/m2 for males and 28 cm2/m2 for females) one can identify individuals with a higher risk of severe chemotherapy toxicities and worse prognosis.

Prevalence and Association of Sarcopenia with Mortality in Patients with Head and Neck Cancer: A Systematic Review and Meta-Analysis.

The objective of this meta-analysis was to assess the association of sarcopenia defined on computed tomography (CT) head and neck with survival in head and neck cancer patients. Following a PROSPERO-registered protocol, two blinded reviewers extracted data and evaluated the quality of the included studies using the Quality In Prognostic Studies (QUIPS) tool, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The quality of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) framework. A meta-analysis was conducted using maximally adjusted hazard ratios (HRs) with the random-effects model. Heterogeneity was measured using the I2 statistic and was investigated using meta-regression and subgroup analyses where appropriate. From 37 studies (11,181 participants), sarcopenia was associated with poorer overall survival (HR 2.11, 95% confidence interval [CI] 1.81-2.45; p<0.01), disease-free survival (HR 1.76, 95% CI 1.38-2.24; p<0.01), disease-specific survival (HR 2.65, 95% CI 1.80-3.90; p<0.01), progression-free survival (HR 2.24, 95% CI 1.21-4.13; p<0.01) and increased chemotherapy or radiotherapy toxicity (risk ratio 2.28, 95% CI 1.31-3.95; p<0.01). The observed association between sarcopenia and overall survival remained significant across different locations of cancer, treatment modality, tumor stages and geographical region, and did not differ between univariate and multivariate HRs. Statistically significant correlations were observed between the C3 and L3 cross-sectional area, skeletal muscle mass, and skeletal muscle index. Among patients with head and neck cancers, CT-defined sarcopenia was consistently associated with poorer survival and greater toxicity.

Association of sarcopenia with the long-term risk of atrial fibrillation: A prospective cohort study.

The relationship between sarcopenia and the long-term risk of atrial fibrillation (AF) remains unclear. This study recruited a large prospective Caucasian cohort from the UK Biobank. Participants were assessed at baseline with handgrip strength and muscle mass and were categorized into groups of non-sarcopenia, probable sarcopenia, and confirmed sarcopenia. Kaplan-Meier method and Cox proportional hazards model were used to explore the association between sarcopenia and the incidence of AF. The genetic predisposition of AF was assessed by polygenic risk score. Sensitivity analyses were performed to validate the results. A total of 384,433 participants with a median age of 58 years and 54.3% women were enrolled in this study. There were 24,007 cases of new-onset AF over a median follow-up of 12.56 years. The groups of non-sarcopenia, probable sarcopenia, and confirmed sarcopenia accounted for 22,290 (6.1%), 1665 (9.2%), and 52 (11.9%) cases, respectively. Compared with the non-sarcopenia group, participants with probable sarcopenia or confirmed sarcopenia had an 8% (95% CI, 1.03-1.14) or 61% (95% CI, 1.23-2.12) higher risk of AF incidence. The findings remained robust in multiple sensitivity analyses, such as subgroup analysis and further adjustment of genetic predisposition. Notably, the association between sarcopenia and a high AF risk was more pronounced in younger participants, women, and those with valvular heart disease. In conclusion, sarcopenia was associated with a high long-term risk of AF in Caucasians, supporting sarcopenia as a new independent risk factor of AF.

Association of body composition and survival in patients with locally advanced breast cancer: a historical cohort study.

Altered body composition has been attributed to major health problems globally, particularly in patients with cancer. To date, there have not been sufficient indices for body compositions in predicting the survival of locally advanced breast cancer (LABC). To assess the association between body composition and overall survival (OS) as well as disease-free survival (DFS) in patients with LABC. A retrospective study was conducted of patients with LABC diagnosed between 2010 and 2018. Body composition parameters, including skeletal muscle and adiposity parameters, were measured using computed tomography at the L3 vertebra using in-house software developed by MATLAB and freeware Python 3.6.13. The association between body composition and OS and DFS were analyzed using a log-rank test and multivariate Cox-proportional hazard regression. Of 199 patients, 72 (36%) died during the follow-up period (range = 3.8-150.7 months). Median survival was 101 months. Low visceral-to-subcutaneous ratio ≤0.3 (adjusted hazard ratio [aHR] = 2.57, 95% confidence interval [CI] = 1.51-4.37; aHR = 2.46, 95% CI = 1.33-4.56), and high composite fat (aHR = 3.26, 95% CI = 1.69-6.29; aHR = 2.19, 95% CI = 1.11-4.3) were associated with lower OS and DFS. Positive lymph nodes ≥3, progesterone receptor negative, and total radiation dose >5000 cGy significantly decreased both OS and DFS. A history of previous treatment before body composition assessment and surgery had a protective effect on OS and DFS. No association of sarcopenia, body mass index, and adiposity areas with survival outcomes was observed. Low visceral-to-subcutaneous ratio and high composite fat were independent prognostic factors for OS and DFS in patients with LABC. However, other body composition parameters showed no effect on survival.

Unlocking Cognitive Potential: Association of Sarcopenia and Mediterranean Diet on Cognitive Function in Community-Dwelling Elderly of the Dalmatian Region.

The aim of this study was to determine the association between muscle strength, adherence to the Mediterranean diet (MeDi) and cognitive function in community-dwelling elderly. General data, data of body composition and anthropometric parameters, clinical and laboratory findings, cognitive test questionnaires (Mini-Mental State Examination-MMSE, Trail Making Test-TMT, Symbol Digit Modalities Test-SDMT), and nutritional assessments (Mini Nutritional Assessment-MNA, Mediterranean Diet Serving Score-MDSS) were obtained for each study participant. Handgrip strength (HS) was used as one of the key parameters for defining probable sarcopenia, among the Short Physical Performance Battery test (SPPB) (for defining physical activity) and the strength, assistance with walking, rising from a chair, climbing stairs, and falls questionnaire (SARC-F). Our cross-sectional study involved 114 participants aged ≥ 60 years, and two-thirds of the participants were female (76.3% vs. 23.7%). Probable sarcopenia was found in 34.7% of them. Using bivariate regression analysis, cognitive deficit among the sarcopenic population was associated with the following groups of collected data: (a) sociodemographic-associated factors-advanced age (OR: 1.07; p = 0.004), single marital status (OR: 3.25; p = 0.03), and low level of education (OR: 0.22; p < 0.003); (b) behavioral-associated factors-duration of institutionalization (OR: 1.05; p = 0.007), performance of heavy physical work (OR: 6.26; p = 0.001), low physical activity (OR: 0.08; p = 0.002), and risk of malnutrition (OR: 3.87; p = 0.005); (c) disease-related factors-loss of appetite (OR: 2.24; p = 0.04), information processing speed (OR: 0.88; p < 0.001), blood pressure systolic/diastolic variables (OR: 0.96/0.96; p = 0.002/0.02), medications (OR: 1.19; p = 0.005), predictive sarcopenia score ≥ 4 (OR: 3.1; p = 0.003), and low muscle strength (OR: 0.92; p = 0.002). Cognitive preservation among the sarcopenic population was associated with married status (OR: 0.23; p = 0.20), a high level of education (OR: 0.18; p = 0.002), smoking (OR: 0.33; p = 0.02), high physical activity (OR: 0.07; p < 0.001), and dietary habits using poultry (OR: 0.12; p = 0.004). The results suggest a significant association between sarcopenia and cognitive function in community-dwelling elderly, highlighting the need for regular nutritional interventions in this special population.

Sarcopenia prevalence between obese and morbid obese patients in an obesity center

Background/Aim: Sarcopenia and obesity are independent diseases that result in decreased muscle strength and function. Few studies have been conducted on the association of sarcopenia and obesity, especially in women. This study aims to measure the possibility of sarcopenic obesity in women with obesity. Methods: Our study was organized using a prospective cross-sectional study in Turkey. A total of 135 volunteer were included in the study. Inclusion criteria required the patients to have a BMI &gt;35 kg/m2 or BMI &gt;40 kg/m2 and no current comorbid disease. The exclusion criteria included: age (&lt;18 and &gt;70 years were excluded), history of muscle disease, malignancy, psychiatric disorders such as bipolar disease and psychosis, malnutrition, and recent corticosteroid (CS) use (within the last three months). Probable sarcopenia is determined by low skeletal muscle strength, and confirmed sarcopenia is defined if there is both low skeletal muscle mass and low skeletal muscle quality. Muscle strength was measured with isometric dynamometry using the handgrip method. A six-minute walk test (6MWT), in which we measured walking speed, was performed to determine the physical performance of the patients. We adjusted appendicular skeletal muscle (ASM) using height squared (ASM/height2) bioelectrical impedance analysis (BIA) to measure the muscle mass. Results: Patients’ mean age was 43 (11.4) (20-69) years. Of the total participants, 64.6% were in the age range of 40-59; 19.2% of patients were defined as possible sarcopenia; and 2.2% had confirmed sarcopenia. A total of 78.5% of patients did not meet any of the sarcopenia criteria. We determined that there was no difference in anthropometric measurements between sarcopenic and non-sarcopenic patients (P&gt;0.05), except for waist and hip circumferences. However, we did observe a noteworthy distinction in waist and hip circumference measurements between the two groups, with sarcopenic patients exhibiting larger circumferences (P=0.05 and P=0.032, respectively). Our study revealed a significant disparity in the results of the six-minute walk test and handgrip strength values between sarcopenic and non-sarcopenic patients (P&lt;0.001). Specifically, non-sarcopenic patients demonstrated higher values in both tests.. Conclusion: Obesity and sarcopenic obesity will continue to be a public health problem in the future among middle-aged women. It should be considered that the prevalence of decreased muscle strength was high in our study group, and physical performance decreased due to muscle strength. We concluded that as success in the six-minute walk test and handgrip values increased, the diagnosis of sarcopenia decreased, and each increase in platelet count increased the risk of sarcopenia in obese female patients.

Sarcopenia and Sarcopenic Obesity and Mortality Among Older People

Sarcopenia and obesity are 2 global concerns associated with adverse health outcomes in older people. Evidence on the population-based prevalence of the combination of sarcopenia with obesity (sarcopenic obesity [SO]) and its association with mortality are still limited. To investigate the prevalence of sarcopenia and SO and their association with all-cause mortality. This large-scale, population-based cohort study assessed participants from the Rotterdam Study from March 1, 2009, to June 1, 2014. Associations of sarcopenia and SO with all-cause mortality were studied using Kaplan-Meier curves, Cox proportional hazards regression, and accelerated failure time models fitted for sex, age, and body mass index (BMI). Data analysis was performed from January 1 to April 1, 2023. The prevalence of sarcopenia and SO, measured based on handgrip strength and body composition (BC) (dual-energy x-ray absorptiometry) as recommended by current consensus criteria, with probable sarcopenia defined as having low handgrip strength and confirmed sarcopenia and SO defined as altered BC (high fat percentage and/or low appendicular skeletal muscle index) in addition to low handgrip strength. The primary outcome was all-cause mortality, collected using linked mortality data from general practitioners and the central municipal records, until October 2022. In the total population of 5888 participants (mean [SD] age, 69.5 [9.1] years; mean [SD] BMI, 27.5 [4.3]; 3343 [56.8%] female), 653 (11.1%; 95% CI, 10.3%-11.9%) had probable sarcopenia and 127 (2.2%; 95% CI, 1.8%-2.6%) had confirmed sarcopenia. Sarcopenic obesity with 1 altered component of BC was present in 295 participants (5.0%; 95% CI, 4.4%-5.6%) and with 2 altered components in 44 participants (0.8%; 95% CI, 0.6%-1.0%). An increased risk of all-cause mortality was observed in participants with probable sarcopenia (hazard ratio [HR], 1.29; 95% CI, 1.14-1.47) and confirmed sarcopenia (HR, 1.93; 95% CI, 1.53-2.43). Participants with SO plus 1 altered component of BC (HR, 1.94; 95% CI, 1.60-2.33]) or 2 altered components of BC (HR, 2.84; 95% CI, 1.97-4.11) had a higher risk of mortality than those without SO. Similar results for SO were obtained for participants with a BMI of 27 or greater. In this study, sarcopenia and SO were found to be prevalent phenotypes in older people and were associated with all-cause mortality. Additional alterations of BC amplified this risk independently of age, sex, and BMI. The use of low muscle strength as a first step of both diagnoses may allow for early identification of individuals at risk for premature mortality.

Association of sarcopenia with osteoporosis in Chinese patients with type 2 diabetes

BackgroundPeople with type 2 diabetes mellitus (T2DM) present a higher tendency to develop sarcopenia and osteoporosis compared with the normal population. Currently, osteoporosis screening has been frequently performed among T2DM patients, but sarcopenia screening is relatively less, and the association between the two diseases remains unclear. Herein, this study aims to determine the association between sarcopenia and osteoporosis in Chinese T2DM patients.MethodsThis was a retrospective study of 678 patients with T2DM in the First Affiliated Hospital of Wenzhou Medical University. The bone mineral density (BMD) and muscle mass were measured by using dual-energy X-ray absorptiometry scanning. The diagnostic criteria of sarcopenia referred to the consensus by the Asia Working Group for Sarcopenia (AWGS).ResultAmong T2DM patients, the proportion of the sarcopenia population complicated with osteoporosis was higher than that of the non-sarcopenia (30.9% vs. 8.6% in men and 46.9% vs. 33.9% in women), but only significantly in men. The BMD of the hip and femoral neck was positively correlated with skeletal muscle mass index (SMI), grip strength, and gait speed (P < 0.01). After adjusting all covariates, the association between sarcopenia and BMD showed odds ratios of 0.43 (95% CI:0.28–0.66) for the femoral neck and 0.49 (95% CI:0.32–0.73) for the hip.ConclusionsThe BMD of the hip and femoral neck in T2DM patients is related to sarcopenia-related indicators and represents an independent protective factor for sarcopenia. To reduce the risk of falls, fractures, and weakness, it is necessary to take sarcopenia assessment in people with T2DM and osteopenia/osteoporosis.

Association of Sarcopenia, as Defined Based on the Skeletal Muscle Index, With Mortality and Morbidity After Cardiac Surgery: A Retrospective Cohort Study

To investigate whether "sarcopenia," defined based on the preoperative skeletal muscle index (SMI), can predict major postoperative morbidity and all-cause mortality. A retrospective observational cohort study. At the authors' Department of Critical Care Medicine. A total of 986 adult Chinese patients underwent cardiac surgery (coronary artery bypass graft, valve surgery, combined surgery, or aortic surgery) between January 2019 and August 2022. The skeletal muscle area at the third lumbar level (L3) was measured via preoperative computed tomography (up to 3 months from the date of imaging to the date of surgery) and normalized to patient height (skeletal muscle index). Sarcopenia was determined based on the skeletal muscle index being in the lowest sex-specific quartile. The primary outcome was all-cause mortality. The secondary outcome was major morbidity. A total of 968 patients were followed for a median of 2.00 years, ranging from 1.06 to 2.90 years. After the follow-up, 76 patients died during the follow-up period. Multivariate Cox proportional analysis showed a relationship between sarcopenia (adjusted hazard ratio 1.80, 95% CI 1.04-3.11; p = 0.034) and all-cause mortality. Kaplan-Meier curves revealed a significantly lower survival rate in the sarcopenia group than in the nonsarcopenia group. Overall, 199 (20.6%) patients had major morbidity. Multivariate analysis showed a significant relationship between sarcopenia (adjusted odds ratio = 2.21, 95% CI 1.52∼3.22, p < 0.001) and major morbidity. Sarcopenia, defined by the skeletal muscle index, is associated with all-cause mortality and major morbidity after cardiac surgery, thereby suggesting the need for perioperative sarcopenia risk assessment for patients undergoing cardiac surgery to guide the prevention and management of adverse outcomes.

PERCENT TIME SPENT IN AN IMPAIRED GLUCOSE STATE AND ADVERSE MUSCLE OUTCOMES: THE SWAN STUDY

Abstract Sarcopenia is common among older adults, but associations of sarcopenia and diabetes are mixed. Beyond sarcopenia, relationships between glucose levels and muscle quality and power are understudied. We examined the association of time spent in an impaired glucose state and muscle outcomes. Muscle quality and power were assessed in 2015-2016 in 1,614 women (aged 66 + 2.7 years) without diabetes at baseline. Muscle quality was the average grip strength (measured in three trials using a Jamar dynamometer) per kilogram whole-body skeletal muscle mass (measured using bioelectrical-impedance analysis). Muscle power (Watts/kilogram body weight) was assessed using a 3-cycle timed stair climb: [(body weight (N)*stair height (m))/average ascent time (sec)]/body weight (kg). Fasting blood was collected at 11 visits; glucose ≥100mg/dL was considered impaired, with percent time spent in an impaired glucose state (%IGS) calculated as:(number visits with impaired glucose)/(number visits with glucose)*100 and categorized as ≤24%(n=1,203), 25-49%(n=184), 50-74%(n=136), ≥75%(n=91). Cross-sectional multivariable linear regression models were constructed for muscle outcomes with the independent predictor %IGS, adjusting for age, menopausal status, race/ethnicity, hormone use, and height. Compared to the lowest %IGS, all other groups had significantly lower mean muscle quality (β range: -0.091, -0.110 and -0.135, respectively) with the largest difference vs. highest %IGS (β= -0.135, 95%CI:-0.192,-0.077). Similar results were observed for muscle power (β range: -0.022, -0.024 and -0.020, respectively), though the highest %IGS was not significantly different. Results suggest that a longer time in an impaired glucose state from middle to older age may be associated with lower muscle function in older women.