Kg For Males Research Articles

#5269 THE NUTRITIONAL ASSESSMENT TOOLS TO IDENTIFY PATIENTS AT INCREASED SARCOPENIA RISK

Abstract Background and Aims Protein-energy wasting (PEW), debilitating nutritional and metabolic disorder marked by a systemic reduction in protein and energy store, is prevalent among patients with end stage renal disease (ESRD). The magnitude of malnutrition among patients undergoing hemodialysis has been positively associated with, the risk of all-cause mortality, particularly due to cardiovascular disease and infections. Additionally, inadequate nutritional status has been implicated in the development of sarcopenia, characterized by decreased muscle mass, weakened muscle strength, and impaired physical function. As such, routine management of nutritional status may be crucial aspect of care for these patients. In addition to the nutritional risk index for Japanese hemodialysis patients (NRI-JH), developed for the diagnosis of PEW, the geriatric nutritional risk index (GNRI) and mini nutritional assessment short-form (MNA-SF) are frequently utilized as nutritional indices in patients on hemodialysis. However, few studies have compared the magnitude of associations between these nutritional measure and sarcopenia in patients undergoing hemodialysis. This study aimed to evaluate the degree of association between nutritional assessments and sarcopenia in this patient population. Method The current cross-sectional study recruited outpatients receiving maintenance hemodialysis between June 2019 and December 2021. The study collected patient information, including age, gender, body mass index, dialysis duration, primary kidney diseases, 11 comorbid conditions, and laboratory parameters (such as serum albumin, serum creatinine, and total cholesterol), from medical records. Physical therapists assessed muscle mass (skeletal muscle index [SMI]), muscle strength (handgrip strength), and physical performance (short physical performance battery [SPPB]), and sarcopenia was diagnosed when patients presented with low muscle mass (SMI <7.0 kg/m2 for males, <5.7 kg/m2 for females) and low muscle strength (handgrip strength <28.0kg for males, <18 kg for females) or low physical performance (SPPB ≤9) based on the Asian Working Group for Sarcopenia 2019 criteria. The study employed the NRI-JH, GNRI, and MNA-SF as markers of nutritional status. The NRI-JH was calculated based on body mass index, serum albumin, serum creatinine, and total cholesterol. Logistic regression analysis was performed to examine the associations of NRI-JH, GNRI, and MNA-SF with sarcopenia among patients on hemodialysis. Results Sixty-five patients undergoing hemodialysis were analyzed in this study. The mean age of the patients was 78.3 ± 10.7 years, with 36.9% being female. The average duration of dialysis was 6.4 ± 3.9 years. The most frequently observed underlying kidney disease was diabetes mellitus, followed by hypertension. The prevalence of sarcopenia was found to be 60.0%. After adjustment for the effects of age, gender, dialysis duration, and comorbidity index, patients with a lower score on the NRI-JH were significantly more prone to sarcopenia (odds ratio per 1-point increase, 1.33; 95% confidence interval, 1.04–1.69). The NRI-JH was demonstrated to have a stronger association with sarcopenia compared to the others (Table 1). Conclusion The NRI-JH and GNRI were significantly associated with risk of sarcopenia. The NRI-JH demonstrated a stronger association with the risk of sarcopenia compared to the GNRI.

#3246 THE ASSOCIATION OF THE CO-OCCURRENCE OF MALNUTRITION AND SARCOPENIA WITH MORTALITY IN HEMODIALYSIS PATIENTS: A MULTICENTER PROSPECTIVE COHORT STUDY

Abstract Background and Aims Frailty is widely acknowledged as an age-related fragile state characterized by physiological vulnerability to stress, and it is prevalent among patients undergoing maintenance hemodialysis therapy. Various factors are interconnected and can be theoretically consolidated into a cycle of frailty, with malnutrition and sarcopenia at the core. These can result in numerous negative health outcomes in patients on hemodialysis and prompt identification and treatment are necessary. However, limited research has investigated the impact of the overlap between malnutrition and sarcopenia on mortality in this patient population. In this study, we examined the association of the overlap between malnutrition and sarcopenia with all-cause mortality in patients undergoing maintenance hemodialysis. Method The present prospective cohort study recruited outpatients on hemodialysis from three facilities in Japan. At the study baseline, data on patients' characteristics including age, gender, body mass index, duration of dialysis, primary kidney diseases, 11 comorbid conditions, and laboratory parameters (including serum albumin level) were collected from medical records. In addition, muscle mass (skeletal muscle index [SMI]), muscle strength (handgrip strength), and physical performance (short physical performance battery [SPPB]) were measured by physical therapists. A comorbidity index was used to quantify the severity of comorbid illnesses, which was calculated based on primary kidney diseases and the 11 comorbidities. Malnutrition was identified based on geriatric nutritional risk index <98, which was calculated using the serum albumin level and body weight. Sarcopenia was diagnosed when patients had low muscle mass (SMI <7.0 kg/m2 for males and <5.7 kg/m2 for females) and low muscle strength (handgrip strength <28.0kg for males and <18 kg for females) or low physical performance (SPPB ≤9), in accordance with the Asian Working Group for Sarcopenia 2019 criteria. After classifying the study participants into four groups based on the absence or presence of malnutrition and sarcopenia, the mortality risk was evaluated using the Kaplan-Meier method and Cox proportional hazard analysis. This study was approved by the Research Ethics Committee and conducted in accordance with the principles of the Declaration of Helsinki. Results A total of 379 patients on hemodialysis were included in the analysis. The mean age of the patients was 69.5±12.6 years, and 40.2% of the cohort being female. The mean duration of dialysis was 7.9±4.5 years. The most prevalent underlying kidney disease was diabetes mellitus. At baseline, the prevalence rates of malnutrition and sarcopenia were 32.7% and 28.2%, respectively. Over a mean follow-up period of 4.3 years, 23 patients died. The Kaplan-Meier analysis demonstrated a lower cumulative survival rate in patients with malnutrition and/or sarcopenia. After adjustment for the effect of age, gender, duration of dialysis, and comorbidity index, the hazard ratio in patients with both malnutrition and sarcopenia was significantly higher than in patients without both (hazard ratio [HR] 5.78, 95% confidence interval [CI] 1.86-17.94). However, the hazard ratios in patients suffering from either malnutrition or sarcopenia alone were not significantly different (Table 1). Conclusion The present study has demonstrated the strong association of a state of co-occurrence between malnutrition and sarcopenia, which implies starvation and muscle wasting, with a poor prognosis in patients undergoing hemodialysis. The findings of this study have accentuated the significance of addressing both malnutrition and sarcopenia in routine clinical practice for patients undergoing maintenance hemodialysis.

#3657 ASSOCIATION BETWEEN AGE, SARCOPENIA, AND MORTALITY IN PATIENTS UNDERGOING HEMODIALYSIS: A PROSPECTIVE COHORT STUDY

Abstract Background and Aims The mean age of Japanese patients undergoing hemodialysis at the end of 2018 was 68.75 years, demonstrating a 15-year increase since 1985. The healthcare management of the geriatric patients presents significant challenges, encompassing both clinical and societal aspects, as they often experience overlapping comorbidities while undergoing hemodialysis. A systematic review and meta-analysis published in 2022 reported that sarcopenia was associated with heightened mortality rates in patients undergoing dialysis therapy. However, only a limited number of studies have investigated this association among Asian populations, whose differences in body composition, nutritional status, and socio-economic background distinguish them from those in the United States and Europe. Notably, no studies have targeted the older demographic, who constitute the majority of Asian patients on hemodialysis and possess numerous risk factors for death. This study categorized Japanese patients undergoing hemodialysis by age, <75 and 75≤, and examined the impact of sarcopenia on mortality according to age. Method This multicenter prospective cohort study enrolled 404 outpatients undergoing hemodialysis from three facilities in Japan and followed them up for three years. At baseline, information on age, sex, dialysis vintage, body mass index, primary kidney diseases, comorbid conditions, and laboratory parameters (serum albumin, serum hemoglobin, and hematocrit) were collected from medical records. The geriatric nutritional risk index (GNRI) was calculated based on the patient's serum albumin level and body weight. Sarcopenia was diagnosed in patients who had low muscle mass (skeletal muscle mass index <7.0 kg/m² for males and <5.7 kg/m² for females) and low muscle strength (handgrip strength <28.0kg for males and <18 kg for females) or low physical performance (short physical performance battery score ≤9), according to the Asian Working Group for Sarcopenia 2019 criteria. The Kaplan-Meier method and Cox proportional hazard analysis were used to evaluate the independent association between sarcopenia and mortality after adjusting for baseline characteristics in patients aged <75 and ≥75 years. Results A total of 404 patients participated in this study, with a mean follow-up period of 30 months, during which 50 (12.4%) patients died. Participants had a mean age of 68.4 ± 12.6 years and 62.6% of them were male and the mean GNRI was 91.1 ± 21.2. Diabetes mellitus was the most prevalent underlying kidney disease among the study cohort (38.1%). The prevalence of sarcopenia in all patients, those under 75 years of age, and those 75 years and older was 37.6%, 22.7%, and 63.1%, respectively. Kaplan-Meier analyses indicated a higher mortality rate among patients with sarcopenia compared to those without. In the subgroup analysis for patients aged <75 years, sarcopenia was significantly associated with increased mortality risk after full adjustment (hazard ratio [HR], 2.50; 95% confidence interval [CI], 1.05–5.95). Conversely, in the subgroup of patients 75 years and older, sarcopenia was not significantly associated with all-cause mortality (HR, 0.69; 95% CI, 0.28–1.68), and only a low GNRI was independently associated with poor survival (HR, 0.98; 95% CI, 0.96–1.00). Conclusion This present study determined that the impact of sarcopenia on mortality among patients undergoing hemodialysis may be altered by their age. Specifically, among those aged 75 years and above, malnutrition was found to be a strong predictor of poor survival, rather than sarcopenia.

Etiology of Chronic Kidney Disease and Comorbidities in Chronic Hemodialysis Patients

"Introduction: As general population tends to have increasing life expectancy, the risk associated with developing chronic kidney disease (CKD) with multiple incapacitating concequences, also increases. Method: For the present study, we registered the data from the observation files of 37 patients diagnosed with CKD undergoing treatment by chronic hemodialysis and noted the CKD associated diagnoses included in the notion of comorbidities. We monitored their statistical incidence both in the whole group and separately, in women and men using TTEST and CORREL. Results: The median age of the subjects was 55.86 (± 12.00) years. The study population mean weight was 74.90 (± 14.44) kg, with a mean weight of 69.33 kg for female subjects, and 77.92 kg for males, respectively. Diabetes was identified in 35.13% of patients, whilst heart failure was present in 16.21% of patients. Conclusions: Following the analysis of the information about the patients with CKD in the dialysis program, which we included in the study group, we observed the existence of variations that occur with age, significant correlations between age and weight and between albuminemia and weight. The most common comorbidity is high blood pressure followed by anemia. "

A Machine-Learning Approach to Target Clinical and Biological Features Associated with Sarcopenia: Findings from Northern and Southern Italian Aging Populations.

Epidemiological and public health resonance of sarcopenia in late life requires further research to identify better clinical markers useful for seeking proper care strategies in preventive medicine settings. Using a machine-learning approach, a search for clinical and fluid markers most associated with sarcopenia was carried out across older populations from northern and southern Italy. A dataset of adults >65 years of age (n = 1971) made up of clinical records and fluid markers from either a clinical-based subset from northern Italy (Pavia) and a population-based subset from southern Italy (Apulia) was employed (n = 1312 and n = 659, respectively). Body composition data obtained by dual-energy X-ray absorptiometry (DXA) were used for the diagnosis of sarcopenia, given by the presence of either low muscle mass (i.e., an SMI < 7.0 kg/m2 for males or <5.5 kg/m2 for females) and of low muscle strength (i.e., an HGS < 27 kg for males or <16 kg for females) or low physical performance (i.e., an SPPB ≤ 8), according to the EWGSOP2 panel guidelines. A machine-learning feature-selection approach, the random forest (RF), was used to identify the most predictive features of sarcopenia in the whole dataset, considering every possible interaction among variables and taking into account nonlinear relationships that classical models could not evaluate. Then, a logistic regression was performed for comparative purposes. Leading variables of association to sarcopenia overlapped in the two population subsets and included SMI, HGS, FFM of legs and arms, and sex. Using parametric and nonparametric whole-sample analysis to investigate the clinical variables and biological markers most associated with sarcopenia, we found that albumin, CRP, folate, and age ranked high according to RF selection, while sex, folate, and vitamin D were the most relevant according to logistics. Albumin, CRP, vitamin D, and serum folate should not be neglected in screening for sarcopenia in the aging population. Better preventive medicine settings in geriatrics are urgently needed to lessen the impact of sarcopenia on the general health, quality of life, and medical care delivery of the aging population.

Is Liver Frailty and functional capacity associated with severity of liver disease in patients awaiting Liver Transplantation? - A prospective Observational Study

Background: Liver is a major metabolic organ, interfering with the function of all organs and systems. So, the patients with severe liver disease may display wide manifestations of metabolic disorders, loss of muscle mass and function. Combination of these factors leads to decreased exercise tolerance and physical inactivity and it may be exaggerated with increasing severity of liver disease. The functional capacity could be severely affected due to multiple physiological derangements in these population. Hence, a liver transplant is the only cure for end stage liver disease. Currently only few literature are available that evaluated and described the status of frailty and functional capacity in these population. So we have tried to evaluate the same in Indian Population. Methodology: After ethical committee approval and written inform consent, 85 cirrhotic patients who fulfilled the Inclusion and Exclusion criteria were included in the study. Disease specific history, Severity of Liver disease, Physical evaluation of frailty via Hand grip strength, Balance and time taken to do 5 chair stands , subjective functional capacity evaluation was done through Duke activity status Index (DASI). Result: In 85 patients, the average Hand grip strength was 23.70 ± 10.60kg in males and 15.02± 5.08kg in females , average value of timed chair stands (TCS) was 18.18± 6.60 in males and 14.18± 8.65 in females , average balance score was 28.00 ±4.99 in males and 29.33± 2.58 in females and the average value of MELDNa was 22.2± 6.9. Conclusion: When compared with normal Indian standard Liver cirrhotic patient, form of frailty and reduced functional capacity non predominant. That stressed emphasis on rehabilitation and nutritional counselling during waiting period for Transplantation.

Low Grip Strength and Increased Mortality Hazard among Middle-Aged and Older Chinese Adults with Chronic Diseases

ObjectiveThis study aims to evaluate the association between lower grip strength and mortality hazard. MethodsWe selected 10,280 adults aged 45 to 96 years old from the China Health and Retirement Longitudinal Study and used multivariate Cox proportional hazard models to assess the association of grip strength with mortality hazard. In addition, we explored the possibility of a nonlinear relationship using a 4-knot restricted spline regression. ResultsWe found that elevated grip strength was associated with lower mortality up to a certain threshold. The baseline quartile values of grip strength were 30, 37, and 44 kg for males and 25, 30, and 35 kg for females. After adjusting for confounders, with category 1 as the reference group, the adjusted HRs were 0.58 (0.42–0.79) in males and 0.70 (0.48–0.99) in females (category 4). We also found a linear association between grip strength values and all-cause death risk (males, P = 0.274; females, P = 0.883) using restricted spline regression. For males with a grip strength < 37 kg and females with a grip strength < 30 kg, grip strength and death were negatively associated. ConclusionGrip strength below a sex-specific threshold is inversely associated with mortality hazard among middle-aged and older Chinese adults with chronic diseases.

On coho salmon &lt;i&gt;Oncorhynchus kisutch&lt;/i&gt; from Iturup Island

Results of biological analysis are presented for 162 specimens of coho salmon caught at the coast and in the rivers of Iturup Island (southern Kuril Islands) during their spawning migration in August-October, 2021. Almost all females and males close to puberty in the current year spent one year in the sea and were aged 1.1+ (66.7 %) and 2.1+ (30.0 %). The fish that spent two years in the sea were single – 1 specimen aged 1.2+ and 3 specimens aged 2.2+ (2.5 %). Taking into account the age of puberty and the body weight (2.63 kg for females and 2.44 kg for males, on average) the spawners reproduction in short streams is assumed. The high value of the gonad-somatic index (up to 20–22 % for some females) is other evidence that all these fish cannot run to other spawning areas but at least a part of them should spawn in the water bodies of Iturup Island. Indeed, some coho salmon were captured directly in the rivers. Beside the spawning fish, two actively feeding coho females aged 0.0+ (0.55 kg) and 1.0+ (1.11 kg) were caught with fixed nets.

Effect of frailty, physical performance, and chronic kidney disease on mortality in older patients with diabetes : a retrospective longitudinal cohort study

BackgroundDeclined renal function is associated with physical function impairment and frailty in a graded fashion. This study aimed to examine the relationship between renal function, frailty and physical performance with mortality in older patients with diabetes, while also determining their combined effects on patient outcome.MethodsA retrospective longitudinal study was conducted in elderly patients with diabetes. Kidney disease staging was based on clinical practice guidelines of the International Society of Nephrology, and chronic kiney disease (CKD) was defined as urinary albumin to creatinine ratio (UACR) > 30 mg/g, persistent reduction in estimated glomerular filtration rate (eGFR) below 60 mL/min per 1.73 m2 or both. The modified Rockwood frailty index (RFI) was composed of cumulative health deficits, and physical function was determined by handgrip strength (HGS). Additionally, a timed up and go (TUG) test was assessed at baseline. Kaplan-Meier survival and Cox proportional hazard analyses were used to analyze the association between CKD, frailty, physical function and mortality.ResultsFor the 921 enrolled patients, their mean age was 82.0 ± 6.7 years. After a median 2.92 (interquartile range [IQR] 1.06–4.43) year follow-up, the survival rate was 67.6% and 85.5% in patients with and without CKD, respectively. The mortality hazard ratio (crude HR) with CKD was 5.92 for those with an RFI higher than 0.313 (95% CI 3.44–10.18), 2.50 for a TUG time longer than 21 s (95% CI 1.22–5.13), and 2.67 for an HGS lower than 10.57 kg in females or 20.4 kg in males (95% CI 1.12–6.37). After multivariate adjustment, the mortality hazard ratio for an RFI ≥ 0.313 was 5.34 (95% CI 2.23–12.80) in CKD patients, but not in patients without CKD. In subgroup analysis, patients experiencing CKD and frailty, or physical function impairment, had the lowest survival proportion followed by only frailty/declined physical function, only CKD, without CKD, and non-frailty/non-physical impairment.ConclusionCKD, frailty and physical function impairment were all associated with an increased mortality risk in older patients with diabetes, while the combined effects of these 3 factors were seen on patient outcome.

Combined Effect of Dynapenia and Abdominal Obesity on the Prevalence of Peripheral Artery Disease in Older Adults Over 75 Years Old in China.

The objective is to examine the separate and joint effects of dynapenia and abdominal obesity on the prevalence of peripheral artery disease (PAD) in older adults of different ages (60-74 and over 75 years old). This study comprised 1293 community-dwelling Chinese participants recruited from Shanghai, China, who were aged at least 60 years (753 women; mean age: 72.0 ± 5.9 years). Dynapenia was defined as low-grip strength (<28.0 kg for males and <18.0 kg for females) but normal skeletal muscle index (≥7.0 kg/m2 for males and ≥5.7 kg/m2 for females). Abdominal obesity was determined according to waist circumference (≥90 cm for males and ≥85 cm for females), and PAD was diagnosed by an ankle-brachial index ≤ 0.9. Binary logistic regression models were performed to determine associations between dynapenia, abdominal obesity, and the combination of dynapenia and abdominal obesity and PAD. According to dynapenia and abdominal obesity status stratified by age (60-74 or over 75), the patients were divided into 4 groups: normal, dynapenia alone, abdominal obesity alone, and co-occurring groups. A logistic regression showed that the co-occurring groups (odds ratio = 4.63, 95% confidence interval = 1.41-15.21) had a higher prevalence of PAD than the normal group after adjusting for the covariates in older adults over 75 years of age. The combination of dynapenia and abdominal obesity increase the prevalence of PAD in older adults over 75 years. The present findings have important implications for the early identification of older adults with PAD and appropriate interventions should be implemented.

Handgrip strength and risk of malnutrition are associated with an increased risk of hospitalizations in inflammatory bowel disease patients.

In patients with inflammatory bowel disease (IBD), frailty is independently associated with mortality and morbidity. This study aimed to extend this work to determine the association between the clinical frailty scale (CFS), handgrip strength (HGS), and malnutrition with IBD-related hospitalizations and surgeries. IBD patients ⩾18 years of age were prospectively enrolled from two ambulatory care clinics in Alberta, Canada. Frailty was defined as a CFS score ⩾4, dynapenia as HGS < 16 kg for females and <27 kg for males, malnutrition using the subjective global assessment (SGA), and the risk of malnutrition using either the abridged patient-generated SGA (abPG-SGA), or the Saskatchewan Inflammatory Bowel Disease Nutrition Risk Tool (SaskIBD-NRT). Logarithm relative hazard graphs and multivariable logistic regression models adjusting for relevant confounders were constructed. One hundred sixty-one patients (35% ulcerative colitis, 65% Crohn's disease) with a mean age of 42.2 (±15.9) years were followed over a mean period of 43.9 (±10.1) months. Twenty-seven patients were hospitalized, and 13 patients underwent IBD-related surgeries following baseline. While the CFS (aHR 1.34; p = 0.61) and SGA (aHR 0.81; p = 0.69) did not independently predict IBD-related hospitalizations, decreased HGS (aHR 3.96; p = 0.03), increased abPG-SGA score (aHR 1.07; p = 0.03) and a SaskIBD-NRT ⩾ 5 (aHR 4.49; p = 0.02) did. No variable was independently associated with IBD-related surgeries. HGS, the abPG-SGA, and the SaskIBD-NRT were independently associated with an increased risk of IBD-related hospitalizations. Future studies should aim to validate other frailty assessments in the IBD population in order to better tailor care for all IBD patients.

Body composition and nutrition in skiing

Special requirements, such as super-maximally filled glycogen stores, short regeneration times, correct meal timing or appropriate weight specifications for ski jumping are particularly useful for endurance athletes such as cross-country skiers. A deficiency could have a fatal effect on performance and possibly a negative influence on health.&#x0D; While cross-country skiing is clearly one of endurance sports, ski jumping and alpine skiing are considered to be fast-strength sports or technical (acrobatic) sports.&#x0D; The proven advantages of carbohydrate loading (supercompensation), a nutritional technique for classic endurance loads, also apply to cross-country skiing.&#x0D; A drop in performance, concentration and coordination disorders as well as overheating threaten if fluid loss exceeds 2% of the total body water. Vitamin additives or sweeteners in sports drinks are inefficient. Since the higher need is actually compensated by the increased food intake with a balanced mixed diet, there is, in principle, no over-proportional need for individual vitamins in athletes.&#x0D; As the maximum oxygen uptake is already 15% lower from 3000 m altitude, a drop in performance is clearly noticeable there.&#x0D; When skiing (snowshoeing, ski touring, etc.), it should be noted that an ascent of 100 meters in altitude alone requires an additional 100–150 kcal. At moderate activity, the additional energy requirement at high altitudes compared to the sea level is estimated to be 250–290 kcal per day for men and 180–200 kcal per day for women.&#x0D; Top athletes in cross-country skiing can liberate 170–210 kJ/min (40– 50 kcal/min) in a dominant anaerobic manner within 2–3 minutes. The respective energy consumption is modified by numerous personal as well as external factors (for cross-country skiing, for example, the outside temperature, the friction resistance of the snow, the technique, the height profile of the route and the headwind).&#x0D; In cross-country skiers, the average values of body fat range between 4.8 and 12.7% in males and from 10.6 to 22.7% in females, while the average values of lean body mass (LBM) vary between 58.2 and 68.8 kg in males and from 45.6 to 48.6 kg in females. In alpine skiers, the mean values of body fat are between 9.7 and 15.8% in males and from 16.2 to 26.7% in females, and the LBM values in males range between 59.9 and 74.7 kg, in females from 42.1 to 52.8 kg. The span of body fat in male ski jumpers ranges from 8.6 to 16% with an LBM of 59.7 kg. Since 2012, a BMI of at least 21 kg/m² including suit and shoes has been a condition for ski jumpers to be able to use full-length skis (145% of body height). Otherwise, shorter skis have to be used, which reduces the wing area and is intended to reduce the jump distance as a penalty. The average values of body fat in male athletes of Nordic Combined range between 8.9 and 11.2%, and the corresponding LBM values are between 62.0 and 64.1 kg. When comparing these parameters of body composition, it must always be remembered that different methods of determining the body fat percentage have been used in corresponding studies and that possible differences do not represent a development of the skiing somatotypes over time but could also have methodological reasons.

Interactive effect of serum uric acid and handgrip strength on all-cause mortality among Japanese community-dwelling people

BackgroundUric acid is both a pro-oxidant and an antioxidant. This study examined whether serum uric acid (SUA) is associated with all-cause mortality and cardiovascular biomarkers in members of the general population who had varying levels of handgrip strength (HGS). MethodsThe analysis is based on 1736 participants, of whom 785 were male (69 ± 11 years old) and 951 were female (69 ± 9 years old). We obtained adjusted relative risk estimates for all-cause mortality from the Japanese Basic Resident Registry and used a Cox proportional hazards model (adjusted for possible confounders) to determine the hazard ratios (HR) and 95% confidence intervals (CI). ResultsThe results indicated a significant interaction between the effects of SUA levels and HGS on all-cause mortality risk. Among participants with low HGS (<30.0 kg in males, <20.0 kg in females), low SUA levels (<3.5 mg/dL in males, <3.0 mg/dL in females; HR: 2.40; 95% CI: 1.07–5.40) and high SUA levels (≥8.0 mg/dL in males, ≥7.0 mg/dL in females; HR: 3.05; 95% CI: 1.41–6.59) were associated with a significantly higher HR for all-cause mortality than medium SUA levels (3.5–7.9 mg/dL in males, 3.0–6.9 mg/dL in females). Among participants with high HGS (≥30.0 kg in males; ≥20.0 kg in females), there was no difference between the HR for all-cause mortality between the three SUA-category groups. ConclusionsThe association between SUA and the risk of all-cause mortality was U-shaped for this population of community-dwelling adults. This was primarily true for those with low HGS.

Prevalence and risk factors of sarcopenia without obesity and sarcopenic obesity among Chinese community older people in suburban area of Shanghai: A cross-sectional study.

The aim of the present study was to explore the prevalence and risk factors of sarcopenia without obesity (S) and sarcopenic obesity (SO) among community-dwelling older people in the Chongming District of Shanghai, China, according to the Asian Working Group for Sarcopenia (AWGS) 2019 Consensus as the diagnostic criteria of sarcopenia. In this cross-sectional study, a total of 1,407 subjects aged ≥65 years were included, where the mean age of the subjects was 71.91 ± 5.59 years and their mean body mass index (BMI) was 24.65 ± 3.32 kg/m2. According to the Asian Working Group for Sarcopenia (AWGS) 2019 Consensus, sarcopenia was defined as a low appendicular skeletal muscle mass index (≤7.0 kg/m2 in males and ≤5.7 kg/m2 in females), decreased handgrip strength (<28.0 kg in males and <18.0 kg in females), and/or low gait speed (<1.0 m/s) or poor 5-time chair stand test (5CST) (≥12s). The SO met both the diagnostic criteria for sarcopenia and obesity, meanwhile obesity was defined as an increased percentage of body fat (PBF) (≥25% in males and ≥35% in females). Univariate and multiple logistic regression analyses were performed to explore the risk factors of both S and SO. The prevalence of S and SO was 9.74% (M: 9.29%, F: 10.05%) and 9.95% (M: 13.94%, F: 7.14%). Lower BMI (OR = 0.136, 95% CI: 0.054-0.340, p < 0.001), lower hip circumference (OR = 0.858, 95% CI: 0.816-0.903, p < 0.001), farming (OR = 1.632, 95% CI: 1.053-2.530, p = 0.028), higher high-density lipoprotein cholesterol (HDL-C) level (OR = 2.235, 95% CI: 1.484-3.367, p < 0.001), and a sleep duration <7 h (OR = 0.561, 95% CI: 0.346-0.909, p = 0.019) were risk factors for S. While aging (70-74 y, OR = 1.923, 95% CI: 1.122-3.295, p = 0.017; 75-79 y, OR = 3.185, 95% CI: 1.816-5.585, p < 0.001; ≥80 y, OR = 7.192, 95% CI: 4.133-12.513, p < 0.001), male (OR = 1.981, 95% CI: 1.351-2.904, p < 0.001), higher BMI (OR = 4.865, 95% CI: 1.089-21.736, p = 0.038), higher monocyte level (OR = 4.203, 95% CI: 1.340-13.181, p = 0.014), and a sleep duration >9 h (OR = 1.881, 95% CI: 1.117-3.166, p = 0.017) were risk factors for SO. Our study showed the high prevalence of S and SO among community-dwelling older people in the Chongming District. The SO was more prevalent in males. Behavioral factors and lifestyle (such as farming and sleep duration) were associated more with the development of S, while age and male gender were associated more with the development of SO.

Impact of Preoperative Handgrip Strength on Postoperative Outcome after Radical Gastrectomy for Gastric Cancer Patients

In this study, we investigated whether preoperative low-handgrip strength (HGS) defined by the Asian working group for sarcopenia could be a predictor of postoperative outcomes in patients with gastric cancer. A total of 327 patients who underwent radical gastrectomy for c-stage I-III primary gastric cancer with pre-operative HGS records were included. The cut-off values of HGS were defined as 28 kg for males and 18 kg for females, with values below and above the cut-off defined as low-HGS and high-HGS, respectively. The primary outcome was infectious complications. We compared the postoperative outcomes of the groups after adjusting for the background using propensity score matching. Of the 327 patients, 246 (75.2%) and 81 (24.8%) were in the high and low-HGS groups, respectively. After adjusting for background, there were 57 patients in both groups. After matching, the low-HGS group had significantly more infectious complications (17.5% vs. 1.8%, p = 0.008). Multivariate analysis of infectious complications in the low-HGS group demonstrated chronic kidney disease and diabetes as independent risk factors (odds ratio 4.390, 95% confidence interval 1.120-17.20, p = 0.034). Preoperative low-HGS according to the Asian criteria was associated with infectious complications after gastrectomy. Chronic kidney disease and diabetes were independent risk factors for infectious complications among patients with low-HGS.

Characterizing Frailty in Adults with Sickle Cell Disease Using Frailty Phenotype

Background As individuals with sickle cell disease (SCD) age, they acquire both SCD and age-related complications early in life leading to premature functional decline. Chronologic age does not accurately represent health status. Frailty is a syndrome that frequently occurs with aging, characterized by decreased physiologic reserve and increased vulnerability to stressors. It leads to adverse outcomes such as loss of independence and death. Individuals with SCD experience stressors such as frequent hospitalizations for vaso-occlusive painful events and organ damage; however, frailty has not been defined in people with SCD. This study seeks to assess the feasibility of characterizing frailty in older adults with SCD using the Fried Frailty Phenotype (FP). Methods We enrolled younger (age 18-39) and older (age ≥ 40 years) adults with SCD in a single-center cross-sectional study. Frailty was defined as the presence of ≥ 3 of the following criteria: unintentional weight loss (≥ 10 pounds in the last year), exhaustion (by 2-item questionnaire), weakness (seated grip strength < 27 kg for males and < 16 kg for females), slowness (usual gait speed ≤ 0.8 m/s), and low physical activity by questionnaire (energy expenditure < 383 kcal/week for men and < 270 kcal/week for women). Individuals with 1 or 2 criteria present were categorized as 'prefrail' and individuals with none of the criteria were categorized as 'robust'. We summarized demographic, medical history, and scores for each FP criterion. Feasibility end points were the proportion of participants who completed all portions of the FP assessment, acceptability of the assessments, and adverse events. We described the characteristic of participants in each FP group. Results We assessed FP at steady state in 28 participants. 93% (n=26) of participants had complete data (1 did not complete all surveys and 1 did not complete grip strength assessment both due to limited time in clinic). There were no adverse events related to performing FP. No participants reported that FP measures were difficult to understand or upsetting. The mean age of all participants was 46.3 (range 19-77 years). The mean age was 28.8 (± 5.1) for younger adults and 54.6 (± 8.7) for older adults. Most (68%) were aged ≥ 40 years and female (71%). Most (57%) had HbSS, 32% had HbSC, 7% had HbSβ0-thalassemia, and 4% had HbSβ+-thalassemia. Out of the 26 participants with complete data, 1 participant met criteria for being frail, 58% (n=15) were prefrail, and 38% (n=10) were robust. The proportion of participants positive for each FP criterion is shown in Figure 1. Out of the 27 participants who completed survey data, 7% (n=4) met criteria for weight loss. Several (41%) participants met criteria for exhaustion with 11 participants reporting that they felt that "everything was an effort" and 3 participants reported that they also felt that they "could not get going" at least a moderate amount of the time. The median grip strength was 30 kg (IQR 25-37) with median of 26 kg (IQR 21-32) for women and 53 kg (IQR 42-51) for men. No participants met criteria for weakness. On usual gait speed assessment, the median gait speed was 1.17 m/s (IQR 1.02-1.22). No participants met criteria for slowness. When we compared characteristics between prefrail/frail versus robust participants (Table 1), prefrail/frail participants had a significantly shorter six-minute walk distance (6MWD) (414 vs 492 meters; p=0.03) and had more participants hospitalized in the last year that approached significance (38% vs 0%; p=0.053). There was no difference in age, income, employment status, hemoglobin, hydroxyurea use, opioid use, history of avascular necrosis, or history of stroke. Conclusion We demonstrated that measuring frailty using Fried Frailty Phenotype was feasible, acceptable, and safe in both younger and older adults with SCD. Most participants met criteria for being prefrail due to exhaustion. Prefrail/frail participants in our study had a shorter 6MWD and more participants hospitalized in the last year, which suggests there is clinical significance in identifying prefrail individuals with SCD. This may facilitate early initiation of interventions to prevent frailty. Regular exercise has been shown to reduce exhaustion and frailty in older adults in the general population. In future studies we will assess the prevalence of frailty in a large sample of adults with SCD and determine the appropriate cut points for each criterion. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Demographics Prediction and Heatmap Generation From OCT Images of Anterior Segment of the Eye: A Vision Transformer Model Study.

To predict demographic characteristics from anterior segment optical coherence tomography (AS-OCT) images of eyes using a Vision Transformer (ViT) model. A total of 2970 AS-OCT images were used to train, validate, and test a ViT to predict age and sex, and 2616 images were used for height, weight, and body mass index (BMI). The main outcome measure was the area under the receiver operating characteristic curve (AUC) of the ViT. The ViT achieved the largest AUC (0.910) for differentiating age ≤75 versus >75 years, followed by age ≤60 versus 60-75 versus >75 years (AUC, 0.844), and for discriminating sex (AUC, 0.665). The prediction abilities for the other demographic characteristics were lower: an AUC of 0.521 for classifying height ≤170 versus >170 cm in males and ≤155 versus >155 cm in females; 0.522 for weight <70 versus ≥70 kg in males and 0.503 for <55 versus ≥55 kg in females, and 0.517 for BMI <23 versus 23-25 versus ≥25 kg/m2. Heatmaps highlighted the area of the iridocorneal angle for its contribution to the prediction of age ≤75 versus >75 years. Although the ViT demonstrated a good ability to classify age from AS-OCT images, it performed poorly for sex, height, weight, and BMI. The heatmap obtained of the prediction will provide clues to understanding the age-related anterior segment changes in eyes. The ViT can determine age-related anterior segment structural changes using AS-OCT images, which will aid clinicians in the management of ocular diseases.

Assessment of phenotypic diversity within Goliath chickens population in Benin.

Goliath chickens are a new strain of poultry that originated in the department of Zou, commune of Agbangnizoun in the Republic of Benin. The characteristics of this chicken strain have not been well studied. The purpose of this study was to characterize the phenotypic diversity of Goliath chickens in departments of Zou and Couffo. A total of 140 birds made up of 92 females and 48 males were sampled using 18 morphological descriptors. The results showed a wide variation in plumage colour within overall population with the most dominant being black (18.57%), white (17.14%) and red (16.43%). Black (21.74%) and white (20.65%) plumage dominated in females and red in males (35.42%). Coloured beaks and shanks were common in both chicken sexes. Yellow eyes were more common in females (63.04%), while red eyes were the most prevalent in males (43.75%). Comb and wattle colours were red in both sexes. Morphometrically, sexual dimorphism is very marked most of the body measurements with male birds being significantly superior. The average body weight was 3.26kg in males and 2.78kg in females. The population was clustered in three morphotypes according to the gradient size. Chickens from Bohicon and Agbangnizoun on the one hand, and those from Zagnanado and Toviklin on the other, formed groups 1 and 2, respectively, while group 3 included individuals from Djidja. 77.96% of observed diversity was due to variation between individuals. Molecular characterization is recommended for a thorough knowledge of the Goliath chicken strain of Benin.

Prognostic value of liver damage assessed by direct bilirubin and skeletal muscle weakness in patients with heart failure

Abstract Background Patients with heart failure (HF) have a high prevalence of liver function abnormalities such as bilirubin abnormalities. However, the relationship between abnormalities of direct bilirubin (DB), a fraction of total bilirubin, and dynapenia are unclear, and the effect of the coexistence of both on the prognosis of patients with HF remains unclear. Purpose This study investigated the association between total/direct bilirubin and dynapenia, a muscle weakness syndrome. Moreover, we considered the effect of the combination of high DB and dynapenia on increased mortality. Methods In this retrospective cohort study, we reviewed patients with HF for whom we assessed total bilirubin, DB, handgrip strength, and leg strength at discharge, which were further evaluated to determine the presence of dynapenia. Dynapenia was defined by the lower handgrip strength and leg strength. Low handgrip strength was defined as &amp;lt;26 kg for males and &amp;lt;18 kg for females, and low leg strength assessed by the maximal quadriceps isometric strength was defined as &amp;lt;45% body mass (%BM) for males and &amp;lt;35% BM for females. Multiple linear and multivariate logistic regression analyses were used to examine the association between DB with muscle weakness and dynapenia. In addition, we examined the prognostic value of comorbid DB abnormalities (≥0.5) and dynapenia. The endpoint was all-cause mortality. Results Among 853 inpatients enrolled, high DB was identified in 147 and dynapenia in 377 (44.2%) patients. Multiple regression analysis showed that high DB was independently associated with decreased grip and leg strengths (grip strength, P=0.027; leg strength, P=0.002). Furthermore, after adjusting for covariates, the high DB group (odds ratio: 1.800, 95% confidence interval [CI]: 1.203–2.695, P=0.004) was significantly associated with dynapenia compared to the low DB group. During the follow-up period, 189 patients died (median, 1.77 years; interquartile range, 0.64–3.81 years). The risk of death was significantly higher in the high DB/dynapenia group than in the low DB group, even after adjusting for the severity of HF (hazard ratio: 2.610, 95% CI: 1.680–4.051, P&amp;lt;0.001). Conclusions High DB is associated with muscle weakness in patients with HF and affects patient prognosis. Funding Acknowledgement Type of funding sources: Foundation. Main funding source(s): This work was partially supported by JSPS KAKENHI.

Coexistence of sarcopenia and osteoporosis in patients with heart failure: prevalence and association with functional status

Abstract Background Sarcopenia, the loss of muscle mass and function, and osteoporosis, a condition of low bone mass and micro-architectural deterioration of bone, frequently coexist and are associated with low functional status in heart failure (HF) patients. Aims We aimed to investigate the impact of coexistence of sarcopenia and osteoporosis on functional status in HF patients. Methods This cross-sectional study was conducted using data from patients who admitted to our institute for the diagnosis and management of HF from 1 November 2015 to 30 April 2021. All patients received the dual-energy X-ray absorptiometry (DEXA) method before discharge. The diagnosis of sarcopenia was made according to the criteria of Asia Working Group for Sarcopenia 2019 recommendation as follows: reduced skeletal muscle mass [appendicular skeletal muscle mass index (ASMI) by DEXA, &amp;lt;7.00 kg/m2 in males and &amp;lt;5.40 kg/m2 in females] plus lower muscle strength (handgrip strength, &amp;lt;28 kg in males and &amp;lt;18 kg in females) and/or poor physical performance (gait speed, &amp;lt;1.0 m/s; chair stand test time. ≥12 s; short physical performance battery ≤9 points). In addition, bone mineral densities (BMDs) at the lumbar spine, femoral neck, and total femur were measured by DEXA, and osteoporosis was diagnosed when BMDs at any of the three sites were less than 70% of Young Adult Mean (YAM). Functional status was assessed by the Barthel Index (BI) within three days before discharge, and patients with a BI score of &amp;lt;85 points was defined as having functional dependence (FD). The missing data were imputed using multiple imputation by chained -equations algorithm. Results Four hundred-thirty eight patients [median age of 74 years (interquartile range, 65–82 years), 37% females] were included in the analyses. Of these, percentage of HF patients with sarcopenia, osteoporosis, and sarcopenia and osteoporosis was 45%, 34%, and 20%, respectively (Figure 1A). The analysis of covariance showed a lower %YAM at any sites in patients with sarcopenia than those without sarcopenia (Figure 1B). When patients were divided into subgroups according to the presence or absence of sarcopenia and osteoporosis, the prevalence of FD was 32%, 34%, and 48% in patients with osteoporosis alone, sarcopenia alone, and sarcopenia and osteoporosis, respectively. Multivariate logistic regression analysis indicated that an increase in adjusted odds ratio (OR) for predicting FD was observed across subgroups in the following order: patients with osteoporosis alone [OR, 1.64; 95% confidence interval (CI), 0.63–4.24; p=0.31], those with sarcopenia alone (OR, 2.44; 95% CI, 1.13–5.25; p=0.02) and those with both conditions (OR, 3.34; 95% CI, 1.52–7.38; p&amp;lt;0.01) (Figure 2). Conclusion There was considerable overlap between sarcopenia and osteoporosis in HF patients, which appeared to be a risk factor for FD. Funding Acknowledgement Type of funding sources: None.