Decreased Muscle Strength Research Articles

Blood Flow Restriction Training Improves Muscular Outcomes in Patients With Chronic Ankle Instability: A Critically Appraised Topic

Clinical Scenario: The high recurrence of lateral ankle sprains progresses to chronic ankle instability (CAI) and can affect many athletes in all sports. CAI is often associated with a decrease in muscle strength, an increase in pain, a decrease in the range of motion, and a decrease in balance or neuromuscular control. The use of blood flow restriction (BFR) with CAI can increase muscular outcomes and be used as a rehabilitation tool. Clinical Question: Is there evidence to suggest that BFR improves strength, muscle activation, and/or cross-sectional area of the lower leg musculature in those with CAI? Clinical Bottom Line: There is moderate evidence to support therapeutic exercise with low-intensity BFR in patients with CAI. The evidence concluded a significant improvement in BFR to increase muscle activation of the fibularis longus, anterior tibialis, vastus lateralis, and soleus. There is moderate evidence suggesting BFR can induce strength gains in the muscles of the lower extremity in patients with CAI. Strength of Recommendation: The comprehensive evidence is a Strength of Recommendation Taxonomy (SORT) Grade B, with a level of evidence of 2, according to the Centre for Evidence-Based Medicine (CEBM) for the studies included.

Effect of Phase Angle on Change in Quadriceps Muscle Strength 1 Year After Total Knee Arthroplasty: The Screening for People Suffering Sarcopenia in Orthopedic Cohort of Kobe Study

BackgroundPhase angle (PhA) has been reported to be associated with quadriceps strength in patients who have knee osteoarthritis and were scheduled for total knee arthroplasty (TKA). The PhA can also be expected to predict the time course of quadriceps muscle strength loss and recovery. We aimed to investigate the relationship between the preoperative PhA and the time course of quadriceps muscle strength change in patients undergoing TKA. MethodsA prospective cohort study was conducted on patients scheduled for primary unilateral TKA. A total of 855 patents were included in the analysis. The PhA and quadriceps muscle strength of the operated knee were measured preoperatively and at 3, 6, and 12 months postoperatively. To analyze the effect of the preoperative PhA on the change in postoperative quadriceps muscle strength, a linear mixed model with the quadriceps muscle strength as a dependent variable with the preoperative PhA, evaluation period (dummy variable), and their product terms as independent variables was conducted after adjusting for preoperative covariates. ResultsA statistically significant negative effect was present for a higher PhA, resulting in a greater decrease in quadriceps muscle strength between preoperative and 3 months postoperative (P = 0.012). In contrast, the effect was not statistically significant between 3 and 6 months postoperatively (P = 0.17). However, a statistically significant positive effect for a higher PhA resulting in a greater increase in quadriceps muscle strength was present between 6 and 12 months postoperatively (P = 0.027). ConclusionsPreoperative PhA is a useful predictor of the quadriceps muscle strength change after TKA. These findings suggest that evaluating the preoperative PhA could aid in the development of targeted rehabilitation programs aimed at optimizing quadriceps muscle function in patients undergoing TKA.

Physiotherapeutic Assessment in Oncological Post-Mastectomy Patients

Introduction: Breast cancer is one of the most prevalent forms of cancer among women, and the medical treatment protocols are highly aggressive. In the case of mastectomy, a number of different sequelae are generated, including pain, functional limitation of the shoulder, dehiscence of the wound, decrease in joint range, decrease in muscle strength, lymphedema, and so forth. Such consequences directly impact the functionality and quality of life of the individual. Physiotherapy represents a potential avenue for addressing the sequelae resulting from the surgical procedure. Objective: The objective is to conduct a bibliographic research on the early physiotherapeutic treatment of post-mastectomy cancer patients. Methodology: A search for clinical trials from 2016 to 2023 was conducted in multiple languages, including English, Portuguese, and Spanish, across several databases: PEDro, PubMed, ScienceDirect, Cochrane, and Google Scholar. The inclusion and exclusion criteria facilitated an appropriate selection process for clinical trials, in conjunction with the PRISMA method. The selected clinical trials included a total sample of 644 individuals, in which various physiotherapeutic modalities were evaluated for the purpose of combating the various sequelae generated by mastectomy. Conclusions: Physiotherapy offers a range of beneficial therapeutic modalities, which, when applied early in post-mastectomy cancer patients, have a positive impact on these individuals. These include therapeutic exercise, hydrotherapy, and resistance aerobic exercise. Conversely, there are modalities such as manual lymphatic drainage and extracorporeal shock wave therapy that have uncertain benefits, given the lack of consensus on their evidence base.

Diagnostic Value of Whole-Body MRI in Pediatric Patients with Suspected Rheumatic Diseases.

Background and Objectives: The diagnosis of rheumatic diseases in children is challenging and requires the use of advanced imaging examinations such as whole-body magnetic resonance imaging (MRI). Whole-body MRI allows visualization of bone marrow edema (BME), muscle edema, joint effusion and changes in the soft tissues surrounding the joints. The aim of this study was to collect and compare whole-body MRI findings, laboratory results and clinical manifestations of pediatric patients with suspected rheumatic disease. Materials and methods: In this retrospective single-center study, 33 patients who underwent whole-body MRI were included. Their age ranged from 9 to 17 years, and 24 (72.73%) of the patients were female. Patients were diagnosed as follows: juvenile idiopathic arthritis (27.27%), juvenile idiopathic inflammatory myopathies (21.21%), chronic nonbacterial osteomyelitis (21.21%) and other medical conditions (30.30%), such as arthritis associated with infection, scleroderma, Takayasu arteritis, polyarteritis nodosa and joint damage. Results: The most common symptom reported by 26 (79.79%) patients was pain. On physical examination, the limitation of joint mobility was examined in 17 (51.51%), swelling of the joints was observed in 12 (36.36%) patients and decreased muscle strength was noticed in 11 (33.33%) patients. An increase in the C-reactive protein (12%), erythrocyte sedimentation rate (9%), leukocyte count (9%) and creatine kinase (CK) (18%) was observed. Whole-body MRI revealed myositis (30%), joint effusion (27%) and BME (24%). The statistical analysis showed a significant relationship between myositis and the elevated CK level (p < 0.05). Conclusions: The most common symptom in the studied population was pain, while the limitation of joint mobility was found in more than half of patients. Myositis was the most commonly imaged lesion on the whole-body MRI and it was related to an increase in the CK level.

Profile of Sarcopenia in Elderly Patients at The Medical Rehabilitation Outpatient Department Dr. Soetomo General Academic Hospital

The elderly group is the age group that is most susceptible to geriatric syndromes, one of which is sarcopenia. Sarcopenia is a syndrome characterized by a progressive and overall decrease in muscle mass and skeletal muscle strength with an increased risk of disability, decreased quality of life, and death. Currently, research on sarcopenia profiles, particularly in Indonesia, is still limited. This research data is expected to help determine policies to improve the quality of services in the health sector. This study used the SARC-F questionnaire and the risk factor questionnaire for sarcopenia in elderly patients at the Medical Rehabilitation Outpatient Department RSUD Dr. Soetomo and has been permitted by the Penelitian dan Pengembangan (LitBang) section RSUD Dr. Soetomo, Surabaya. Several variables used in this study were gender, age, weight, height, body mass index (BMI), other diseases, physical activity, mood, and sarcopenia. There were 25 elderly patients at the Medical Rehabilitation Outpatient Department at RSUD Dr. Soetomo, Surabaya in November 2022”January 2023 which met the research inclusion criteria. The age of elderly patients at the Medical Rehabilitation Outpatient Department at RSUD Dr. Soetomo ranged from 60”81 years old, with an average of 60.48 years old. Female is the most common gender among the elderly patients at the Medical Rehabilitation Outpatient Department RSUD Dr. Soetomo, there are 17 (68%) female elderly patients. 80% of the elderly patients were in the young elderly group (60”69 years old), 16% in the middle elderly group (70”79 years old), and 4% in the old elderly group (≥80 years old). Age, gender, other diseases, and physical activity are risk factors that have a significant correlation with sarcopenia among elderly patients at the Medical Rehabilitation Outpatient Department RSUD Dr. Soetomo.

Nutrition Education and Nutritional Status of Chronic Lack of Energy Pregnant Women in PUSKESMAS Work Areas Throughout Kupang City

One of the indirect causes of preventable maternal and child mortality is the health status of pregnant women. Pregnant women with SEZ conditions are at risk of experiencing decreased muscle strength, which is needed in the process of labor so that it can result in fetal death, premature birth, birth defects, low birth weight babies, short birth babies and even infant death. The design used is quantitative with a cross sectional approach with univariate and bivariate analysis using the Chi-Square test. The population of this study were all pregnant women who did pregnancy checks at the Puskesmas in Kupang City in 2022. Sample technique using purposive sampling technique. This study was conducted from January to December 2022. The results showed that of all pregnant women who were given nutrition education in the form of counseling and provision of additional food, most experienced weight gain. In contrast to the increase in LiLA, although there is a change in the size of LiLA after being given education, there are still pregnant women who do not experience changes in LiLA. The statistical test results obtained a p-value &lt;0.005, which means that there is a relationship between the provision of nutrition education and the improvement of the nutritional status of pregnant women with SEZ. It is expected for health workers to carry out special monitoring of pregnant women at risk of SEZ in conducting health checks and consuming additional nutritionally balanced foods.

EHLERS–DANLOS SYNDROME — A CASE OF MULTIDIRECTIONAL SHOULDER INSTABILITY REHABILITATION

Introduction: Ehlers–Danlos Syndrome (EDS) is a hereditary and heterogeneous syndrome that affects conjunctive tissue, due to collagen production compromise. Hypermobile EDS (hEDS) is the most common subtype of this syndrome and can cause shoulder joint instability, which can lead to chronic pain and significant functional impairment. Methods: A case report of a patient with hEDS followed in our local health unit was made. The authors describe their clinical insight regarding the case, as well as the rehabilitation program the patient was submitted to. Results: Female patient, 32 years old. Functionally autonomous in every daily living activity. Clinically diagnosed with hEDS in 2013, after reporting bilateral shoulder instability. The patient presented herself in a Physical and Rehabilitation Medicine consultation, 6 months after being submitted to the third surgical intervention of the right shoulder. She presented an overall limited range of motion, decreased muscle strength and positive apprehension and drawer tests. An extensive rehabilitation program was prescribed, focusing on joint mobilization, dynamic stabilizers strengthening and proprioceptive training. After 12 weeks, the patient presented reduced shoulder pain and a better functional status. Conclusion: hEDS compromises the integrity of the static and dynamic stabilizers of the shoulder. Clinical management of these cases involves a multidisciplinary approach with early and adequate rehabilitation care treatments.

Adapting cytoskeleton-mitochondria patterning with myocyte differentiation by promyogenic PRR33.

Coordinated cytoskeleton-mitochondria organization during myogenesis is crucial for muscle development and function. Our understanding of the underlying regulatory mechanisms remains inadequate. Here, we identified a novel muscle-enriched protein, PRR33, which is upregulated during myogenesis and acts as a promyogenic factor. Depletion of Prr33 in C2C12 represses myoblast differentiation. Genetic deletion of Prr33 in mice reduces myofiber size and decreases muscle strength. The Prr33 mutant mice also exhibit impaired myogenesis and defects in muscle regeneration in response to injury. Interactome and transcriptome analyses reveal that PRR33 regulates cytoskeleton and mitochondrial function. Remarkably, PRR33 interacts with DESMIN, a key regulator of cytoskeleton-mitochondria organization in muscle cells. Abrogation of PRR33 in myocytes substantially abolishes the interaction of DESMIN filaments with mitochondria, leading to abnormal intracellular accumulation of DESMIN and mitochondrial disorganization/dysfunction in myofibers. Together, our findings demonstrate that PRR33 and DESMIN constitute an important regulatory module coordinating mitochondrial organization with muscle differentiation.

Dietary Protein and Physical Exercise for the Treatment of Sarcopenia.

Sarcopenia is a multifactorial age-related disorder that causes a decrease in muscle mass, strength, and function, leading to alteration of movement, risk of falls, and hospitalization. This article aims to review recent findings on the factors underlying sarcopenia and the strategies required to delay and counteract its symptoms. We focus on molecular factors linked to ageing, on the role of low-grade chronic and acute inflammatory conditions such as cancer, which contributes to the onset of sarcopenia, and on the clinical criteria for its diagnosis. The use of drugs against sarcopenia is still subject to debate, and the suggested approaches to restore muscle health are based on adequate dietary protein intake and physical exercise. We also highlight the difference in the amount and quality of amino acids within animal- and plant-based diets, as studies have often shown varying results regarding their effect on sarcopenia in elderly people. In addition, many studies have reported that non-pharmacological approaches, such as an optimization of dietary protein intake and training programs based on resistance exercise, can be effective in preventing and delaying sarcopenia. These approaches not only improve the maintenance of skeletal muscle function, but also reduce health care costs and improve life expectancy and quality in elderly people.

The Influence of Hip-Strengthening Program on Patients with Chronic Ankle Instability.

Background and Objectives: Repetitive ankle sprains lead to mechanical instability of the ankle. Patients with chronic ankle instability may experience decreased muscle strength and limited postural control. This study investigated the effects of a hip-strengthening exercise program on muscle strength, balance, and function in patients with chronic ankle instability. Materials and Methods: A total of 30 patients participated in the study and were randomly assigned to the two groups. Among the 30 participants, 14 were assigned to the hip joint-strengthening exercise group and 16 to the control group. The experimental group underwent a hip-strengthening exercise program and received training for 40 min per session twice a week for four weeks. The control group received the same frequency, duration, and number of sessions. Measurements were performed before and after the training period to assess changes in hip strength, balance, and function. Results: In the within-group and between-group comparisons, both groups showed significant differences in hip joint strength, static balance, dynamic balance, and function (FAAM; foot and ankle ability measures) (p < 0.05). Statistically significant differences were observed in the time × group interaction effects among the hip abductors and external rotation in hip joint strength, path length in static balance, posterolateral and posteromedial in dynamic balance, and FAAM-ADL and FAAM-SPORT functions (p < 0.05). Conclusions: Accordingly, this study confirmed that hip joint-strengthening exercises have a positive effect on the strength, balance, and function of patients with chronic ankle instability, and we believe that hip joint-strengthening exercises will be recommended as an effective intervention method for patients suffering from chronic ankle instability.

Skeletal muscle involvement in systemic amyloidosis is often overlooked.

Systemic amyloidosis is a condition in which misfolded amyloid fibrils are deposited within tissues. Amyloid myopathy is a rare manifestation of systemic amyloidosis. However, whether skeletal muscle involvement is underestimated and whether such deposition guarantees clinical and pathological myopathic features remain to be investigated. We retrospectively reviewed patients with systemic amyloidosis, in whom skeletal muscle biopsies were performed at our centre between January 2018 and June 2023. In total, 28 patients with suspected systemic amyloidosis were included. Among these, 21 presented with cardiomyopathy but lacked myopathic symptoms. The clinical and pathological data of these patients were further analysed. The amyloid type was confirmed by immunohistochemistry. Twenty-eight patients with suspected systemic amyloidosis underwent muscle biopsy. Amyloid deposition in the skeletal muscle was confirmed in 24 patients, including 22 with light-chain amyloidosis (AL) and two with transthyretin amyloidosis (ATTR). Among the 24 patients, seven presented with muscle weakness and decreased muscle strength (Group 1, symptomatic myopathy), whereas the remaining 17 exhibited normal muscle strength (Group 2, asymptomatic myopathy). Group 1 included four patients with AL-λ, one with AL-κ and two with ATTR. Group 2 included 15 patients with AL-λ and two patients with AL-κ. In Group 1, six patients exhibited neuropathy, whereas only one patient in Group 2 presented with subclinical neuropathy on nerve conduction studies. Amyloid deposition in the interstitium was the most obvious change, observed in all 24 patients. Neuropathic changes, including denervation atrophy and muscle fibre grouping, were also common. Except for type 2 fibre atrophy, the other myopathic changes were mild and nonspecific. No sarcolemmal disruption was observed. Immunohistochemical analysis revealed marked positivity for MAC and MHC1 expression in the regions with amyloid deposits. Clinicopathological analysis revealed no significant differences in the extent of muscular amyloid deposition between the two groups. Nevertheless, patients in Group 1 displayed more pronounced neurogenic atrophy on skeletal muscle biopsies. Our study indicates that amyloid deposition in skeletal muscle is commonly observed but rarely causes symptomatic myopathy in systemic amyloidosis.

KLF13 restrains Dll4-muscular Notch2 axis to improve the muscle atrophy.

Muscle atrophy can cause muscle dysfunction and weakness. Krüppel-like factor 13 (KLF13), a central regulator of cellular energy metabolism, is highly expressed in skeletal muscles and implicated in the pathogenesis of several diseases. This study investigated the role of KLF13 in muscle atrophy, which could be a novel therapeutic target. The effects of gene knockdown and pharmacological targeting of KLF13 on skeletal muscle atrophy were investigated using cell-based and animal models. Clofoctol, an antibiotic and KLF13 agonist, was also investigated as a candidate for repurposing. The mechanisms related to skeletal muscle atrophy were assessed by measuring the expression levels and activation statuses of key regulatory pathways and validated using gene knockdown and RNA sequencing. In a dexamethasone-induced muscle atrophy mouse model, the KLF13 knockout group had decreased muscle strength (N) (1.77±0.10 vs. 1.48±0.16, P<0.01), muscle weight (%) [gastrocnemius (Gas): 76.0±5.69 vs. 60.7±7.23, P<0.001; tibialis anterior (TA): 75.8±6.21 vs. 67.5±5.01, P<0.05], and exhaustive running distance (m) (495.5±64.8 vs. 315.5±60.9, P<0.05) compared with the control group. KLF13 overexpression preserved muscle mass (Gas: 100±6.38 vs. 120±14.4, P<0.01) and the exhaustive running distance (423.8±59.04 vs. 530.2±77.45, P<0.05) in an in vivo diabetes-induced skeletal muscle atrophy model. Clofoctol treatment protected against dexamethasone-induced muscle atrophy. Myotubes treated with dexamethasone, an atrophy-inducing glucocorticoid, were aggravated by KLF13 knockout, but anti-atrophic effects were achieved by inducing KLF13 overexpression. We performed a transcriptome analysis and luciferase reporter assays to further explore this mechanism, finding that delta-like 4 (Dll4) was a novel target gene of KLF13. The KLF13 transcript repressed Dll4, inhibiting the Dll4-Notch2 axis and preventing muscle atrophy. Dexamethasone inhibited KLF13 expression by inhibiting myogenic differentiation 1 (i.e., MYOD1)-mediated KLF13 transcriptional activation and promoting F-Box and WD repeat domain containing 7 (i.e., FBXW7)-mediated KLF13 ubiquitination. This study sheds new light on the mechanisms underlying skeletal muscle atrophy and potential drug targets. KLF13 regulates muscle atrophy and is a potential therapeutic target. Clofoctol is an attractive compound for repurposing studies to treat skeletal muscle atrophy.

KL-Biome (Postbiotic Formulation of Lactiplantibacillus plantarum KM2) Improves Dexamethasone-Induced Muscle Atrophy in Mice.

Sarcopenia refers to an age-related decrease in muscle mass and strength. The gut-muscle axis has been proposed as a promising target to alleviate muscle atrophy. The effect of KL-Biome-a postbiotic preparation comprising heat-killed Lactiplantibacillus plantarum KM-2, its metabolites, and an excipient (soybean powder)-on muscle atrophy was evaluated using dexamethasone (DEX)-induced atrophic C2C12 myoblasts and C57BL/6J mice. KL-Biome significantly downregulated the expression of genes (Atrogin-1 and MuRF1) associated with skeletal muscle degradation but increased the anabolic phosphorylation of FoxO3a, Akt, and mTOR in C2C12 cells. Oral administration of KL-Biome (900 mg/kg) for 8 weeks significantly improved muscle mass, muscle function, and serum lactate dehydrogenase levels in DEX-treated mice. KL-Biome administration increased gut microbiome diversity and reversed DEX-mediated gut microbiota alterations. Furthermore, it significantly increased the relative abundances of the genera Subdologranulum, Alistipes, and Faecalibacterium prausnitzii, which are substantially involved in short-chain fatty acid production. These findings suggest that KL-Biome exerts beneficial effects on muscle atrophy by regulating gut microbiota.

Bidirectional Relationships between Sarcopenia and Pelvic Floor Disorders.

Sarcopenia and pelvic floor disorders (PFDs) are prevalent and often cooccurring conditions in the aging population. However, their bidirectional relationship and underlying mechanisms remain underexplored. This narrative review aims to elucidate this relationship by exploring potential causative interplays, shared pathophysiological mechanisms, and common risk factors. A comprehensive literature search was conducted to identify relevant studies focusing on epidemiological associations, interaction mechanisms, and implications for patient care. While epidemiological studies demonstrate associations between sarcopenia and PFDs, our findings reveal a cyclical relationship where sarcopenia may exacerbate PFDs through mechanisms such as decreased muscle strength and mobility. Conversely, the presence of PFDs often leads to reduced physical activity due to discomfort and mobility issues, which in turn exacerbate the muscle atrophy associated with sarcopenia. Additionally, shared risk factors such as physical inactivity, nutritional deficiencies, metabolic syndrome, and menopausal hormonal changes likely contribute to the onset and progression of both conditions. These interactions underscore the importance of concurrently integrated care approaches that address both conditions. Effective management requires comprehensive screening, the recognition of contributing factors, and tailored exercise regimens supported by a multidisciplinary approach. Future research should focus on longitudinal studies tracking disease progression and evaluating the efficacy of multidisciplinary care models in optimizing patient outcomes.

Program Pengabdian Masyarakat Tentang Pentingnya Skrining Vitamin D Dalam Mencegah Sarkopenia Pada Lanjut Usia

Sarcopenia is a progressive degenerative condition characterized by a decrease in muscle mass, strength, and musculoskeletal function, affecting the quality of life of the elderly. This activity aims to screen for vitamin D and educate the elderly about sarcopenia. Community service activities were carried out in nursing homes, involving education and screening of vitamin D levels. The results showed that the majority of respondents were women (79.6%) with an average age of 74.05 years. Most respondents experienced vitamin D deficiency, with 87.1% deficient, 3.2% adequate, and only 9.7% having good levels, with it being found that more women experienced vitamin D deficiency than men. Education regarding the importance of vitamin D and preventing sarcopenia is provided through outreach sessions and poster media. This activity emphasizes the importance of early detection and comprehensive intervention including physical exercise, proper nutritional intake, and lifestyle modification to prevent sarcopenia and improve the quality of life of the elderly. Community-based interventions are needed to address vitamin D deficiency and promote musculoskeletal health in the aging population.

Pemeriksaan Gangguan Keseimbangan pada Usia Produktif dengan Menggunakan Fukuda Stepping di Dinas Lingkungan dan Kehutanan Yogyakarta

Balance limitations pose a significant concern for individuals of productive age. Productive age people who work in offices tend to have less physical activity. Lack of physical activity can affect the decrease in muscle strength, joints which results in a decrease in motion, steps tend to be short, feet cannot tread firmly and are easily unsteady. The decrease in motion function causes balance problems. If this continues to be allowed, it will cause the risk of falls and a decrease in the quality of life of workers in productive age. So it is important for office workers, especially workers at the Yogyakarta Environment and Forestry Service, to understand the importance of maintaining balance. One of the tests that can be used to assess balance is the Fukuda stepping test. This examination is carried out with the Fukuda test and vital sign checks to find out that this test is safe to be carried out by participants. The number of participants in this activity was 27 people consisting of men and women of productive age. This activity was held on Friday, October 13, 2023 at the Yogyakarta Environment and Forestry Service. After this test was carried out, it was found that 23 out of 27 office workers of productive age had balance disorders. After this test, the participants became more aware of the importance of maintaining balance and how to maintain it.

Risk Factors of Sarcopenia in COPD Patients: A Meta-Analysis.

Sarcopenia is a common complication of COPD associated with an age-related reduction in skeletal muscle mass associated with decreased muscle strength and / or reduced mobility. The incidence of sarcopenia in patients with COPD is twice that of non-COPD patients and is associated with poor prognosis, this study aimed to investigate the influencing factors of sarcopenia in COPD patients. Selected studies from PubMed, Embase, Web of Science, Cochrane Library, Wanfang, Wanfang, CNKI, CBM, and Wanfang databases as of November 12023. Patients aged 18 were selected; data were then independently extracted by two reviewers using a standard data collection form. In total, 17 articles reporting on 5408 patients were included. Age (OR = 1.083; 95% CI, 1.024-1.145), ALB (OR = 0.752; 95% CI, 0.724-0.780), BMI(OR = 0.701; 95% CI, 0.586-0.838), smoking (OR = 1.859; 95% CI, 1.037-3.334), diabetes (OR = 1.361; 95% CI, 1.095-1.692), qi deficiency (OR = 9.883; 95% CI, 2.052, 47.593), GOLD C (OR =2.232; 95% CI, 1.866, 2.670) and GOLD D (OR = 2.195; 95% CI, 1.826-2.637) were factors affecting muscle loss in COPD patients. Sarcopenia is more prevalent in patients with COPD. Age, body mass index, smoking, diabetes mellitus, qi deficiency, ALB, and GOLD grade were the contributing factors for sarcopenia in patients with chronic obstructive pulmonary disease. In the future, medical staff should not only pay attention to the early screening of sarcopenia in high-risk groups, but also provide relevant prevention information.

Impact of Hyperhomocysteinemia on Cytokine and Matrix Metalloproteinases Contents in Rat Skeletal Muscle

Abstract Background: High levels of homocysteine (Hcy) in the blood (hyperhomocysteinemia [HHcy]) are associated with many pathologies, including atherosclerosis, coronary heart disease, stroke, neurological disorders, and a decrease in muscle mass and strength. The present study aimed to evaluate the levels of pro- and anti-inflammatory cytokines and matrix metalloproteinases (MMPs) in skeletal muscle of rats with experimental HHcy. Methods: HHcy in rats of two age groups was induced by intragastric administration of D, L-thiolactone Hcy for 8 weeks. The criterion for the development of pathological conditions was a blood Hcy level above 15 mmol L−1. Cytokine and MMP levels in muscle homogenate were determined by enzyme-linked immunosorbent assay. Results: The findings of the study on the content of pro-inflammatory cytokines in skeletal muscles of rats with hyperhomocysteinemia indicated the following. For immature rats, the greatest reduction in tumor necrosis factor-α and interleukin-8 (IL-8) content was observed, whereas, for mature individuals, the most pronounced decline in IL-1b was evident in skeletal muscle tissue under the pathology state. The content of anti-inflammatory interferon-γ was also reduced in the muscles of both age groups by 30% compared to the control, besides a decrease in the content of collagenase MMP-1 was also observed. Conclusions: The presence of HHcy is associated with metabolic changes in skeletal muscles, which can result in a depletion of cytokines and a slowing down of proteolytic remodeling. This, in turn, can lead to the development of muscular abnormalities, including dysfunction, weakness, and muscle degeneration.

Associations between DEET, Organophosphorus Insecticides, and Handgrip Strength in Diabetes: An NHANES Analysis.

Sarcopenia and diabetes mellitus (DM) have been shown to be related. It has been demonstrated that pesticides/insecticides are linked to various health issues, including DM. This study investigated the relationships between exposure to pesticides/insecticides and muscle strength among community-dwelling DM patients in a national sample of the United States (US). Data from the 2011-2012 and 2013-2014 U.S. National Health and Nutrition Examination Survey (NHANES) on people aged 20 years with diabetes were retrieved. A digital dynamometer was used to quantify handgrip strength, and urine pesticide concentrations were determined through laboratory testing. Regression models were used to investigate the relationship between pesticide/insecticide exposure and handgrip strength. After weighting, the data from 412 NHANES participants represented 6,696,865 U.S. inhabitants. The mean age of the participants was 58.8 years. High para-nitrophenol levels (tertile 3 vs. tertile 1) were shown to be associated with lower handgrip strength in both males (aBeta = -7.25, 95% CI: -11.25, -3.25) and females (aBeta = -3.73, 95% CI: -6.89, -0.56). Further, females with elevated 2-isopropyl-4-methyl-pyrimidinol had decreased handgrip strength. Desethyl hydroxy N, N-diethyl-m-toluamide (DEET) was inversely related to handgrip strength in men aged ≥60 years. DEET acid and para-nitrophenol were inversely correlated to handgrip strength in women over 60 years. This study has linked certain pesticides/insecticides to decreased muscle strength in people with diabetes. Para-nitrophenol, in particular, is negatively related to muscular strength in both males and females, and 2-isopropyl-4-methyl-pyrimidinol is inversely related to muscle strength in females.

Diagnostic criteria, prevalence, and clinical outcomes of pediatric sarcopenia: A scoping review

Background & aimsSarcopenia, characterized by loss of muscle mass and decreased muscle strength, significantly affects adults but also influences pediatric health. However, definitions for low muscle mass, decreased strength, and sarcopenia in children are less established, impacting interventions for improving health outcomes. The objective of this scoping review is synthesize the existing literature on the diagnostic criteria, prevalence and clinical outcomes of sarcopenia. MethodsA scoping review, following the PRISMA extension for scoping reviews, examined pediatric sarcopenia literature until June 2023. The literature search was performed using MEDLINE and the Cochrane Central Register of Controlled Trials with the last search conducted on June 30, 2023. Criteria included studies on aged 0-20 years, covering healthy subjects, acutely ill patients, and chronic disease cases excluding specific conditions like neuromuscular diseases or prematurity. ResultsInitial search found 503 studies, finally, we included 56 studies. Most studies diagnosed sarcopenia using skeletal muscle mass indicators like total psoas muscle area from Computed Tomography or Magnetic Resonance Imaging. Around half of the longitudinal studies highlighted sarcopenia as a risk factor for various clinical outcomes, predominantly in hospitalized patients. However, cutoff values for sarcopenia indicators lacked consistency, with studies employing diverse percentile-based measurements or z-scores. ConclusionPediatric sarcopenia diagnosis primarily relies on skeletal muscle mass, with identified links to future clinical outcomes in specific conditions. The lack of standardized cutoffs for sarcopenia indicators underscores the necessity for age, gender, and race-specific cutoff values derived from studies establishing reference values for muscle mass and strength across diverse pediatric populations.