Manual Grip Strength Research Articles

Gait speed in older adults: exploring the impact of functional, physical and social factors

Purpose: With age there is a neuromuscular and cognitive decline that impacts on functional ability. One of the most characteristic and easily recognisable signs of this decline is a decrease in usual gait speed. For older adults, gait speed is a non-invasive indicator of health and functional status and is regarded as a vital sign. As it predicts various conditions later in life, measuring usual walking speed is crucial in the clinical setting. Therefore, analysing and determining the association between walking speed and the impact of functional and socio-economic variables may facilitate the prevention of associated health problems and the maintenance of physical function in older adults. This study aims to identify the key factors that influence walking speed in older adults, as well as to examine the influence of socio-economic status on walking speed. Methods: A total of 1253 older adults (89.5% women) with a mean age of 78.1 ± 5.8 voluntarily participated in this descriptive cross-sectional study, which examines the results of functional capacity tests and socioeconomic data in older adults. To assess physical function, SPPB tests (chair stand test, balance tests, gait speed test), manual grip strength, muscle quality index, and power were conducted, in addition to measuring body composition and socioeconomic status. Results: The final regression model showed that gait speed was significantly partially explained (R2=0.35; p<0.01) by the socioeconomic environment, age, balance, and relative power. At the same time, belonging to a higher socio-economic environment is linked to lower relative power (p<0.01; η2=0.07). Conclusions: Exploring the factors that affect walking speed in older adults, this study highlights that age, relative power and balance are significant determinants. These clinical markers provide crucial information for designing personalized and effective interventions to promote healthy aging. Keywords: Frailty, gait speed, elderly, relative power, socioeconomic status.

Effects on older adult Women's precision, strength and flexibility from resistance training and handicrafts practice

IntroductionAs individuals age, they experience a gradual decline in strength, flexibility, and precision control. While resistance training has shown positive effects on aging, little is known about how beneficial handicrafts could be in effectively promoting motor improvements in aging. This study aimed to compare manual precision, manual grip strength, and upper limb flexibility among three groups of older adult women: (a) regular practitioners of resistance training, (b) regular practitioners of handicrafts, and (c) insufficiently active participants who did not engage in either regular resistance training or handicraft practice. MethodsA total of 30 women (mean age = 67.86, SD = 7.01) were divided equally into the three groups (n = 10 per group). The participants were asked to perform a manual manipulative precision test, a manual grip strength test, and an upper limb flexibility test. ResultsThe participants in the resistance training group exhibited superior precision and strength compared to those in the handicraft group, as well as better precision, strength, and flexibility compared to the control group participants. The handicraft group demonstrated better precision and upper limb flexibility compared to the control group. ConclusionTherefore, while resistance training was particularly beneficial for improving these motor skills, engaging in handicrafts also proved to be an effective means of maintaining and/or enhancing certain important motor abilities.

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

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

Valores normativos para la fuerza prensil manual en adultos mayores colombianos estimados mediante regresión cuantílica

IntroductionHandgrip strength is a robust indicator of the biological health of elderly. ObjectiveThe purpose of this study is twofold: 1) estimate the normative values of absolute and relative handgrip strength, specific to adults over 60 years of age in Colombia, using quantile regression models: 2) compare the normative values of absolute and relative handgrip strength in Colombian older adults with those from different countries. MethodsA cross-sectional analysis of a sample of 5377 older adults. Handgrip strength was evaluated with a TKK 5101 digital dynamometer (Takei Scientific Instruments Co., Ltd., Tokyo, Japan). Relative handgrip strength was estimated by dividing by weight in kilograms. The absolute and relative handgrip strength normative values were estimated through quantile regression models for the percentiles P5, P10, P25, P50, P75, P90 and P95, they were developed independently for each sex; all analyzes were adjusted for the expansion factor. ResultsAbsolute handgrip strength values were considerably higher in men (P50 60–64 years = 32.0 kg, P50 >85 years = 18.0 kg) compared to women (P50 60–65 years = 19.0 kg; P50 >85 years = 12.0 kg), in all age groups. Additionally, as age increases in both sexes, there is a decrease in the values of absolute and relative manual grip strength. ConclusionsThe estimated normative values in the Colombian population were generally lower than those reported in other studies around the world. These results could be related with methodologies used variability to evaluate handgrip strength and the estimation methods, which could influence the discrepancies between the different reports.

Differences between handgrip strength and anthropometric measurements with respect to the index of biological maturation in schoolchildren

The aim of this study was to identify the differences in handgrip strength values and anthropometric measurements with respect to the index of biological maturation (IBM) in schoolchildren. A descriptive study was conducted with a total of 256 schoolchildren (78 boys and 178 girls) aged 10 to 14 years. Body weight, height and sitting height (trunk and leg length) were measured using the ISAK protocol; also, manual grip strength was evaluated with a digital dynamometer and a formula of Mirwald et al. (2002) was used to determine the peak growth velocity (PGV) through the IMB. Subsequently, the sample was categorized into 7 groups according to their BMI (-1.5, -1.0, -0.5, 0, 0.5, 0.5, 1.0 and 1.5 years). Significant differences were found in schoolchildren in the 0.5, 1.0- and 1.5-years group with respect to the -0.5, -1.0- and -1.5-years groups in body weight, height, trunk and leg length, and grip strength (p ≤ 0.05). We conclude that the higher the biological maturation index there is a tendency for the anthropometry and grip strength values in schoolchildren to be higher with respect to those with a lower IMB.

How we get a grip: Microstructural neural correlates of manual grip strength in children

Maximal grip strength is associated with a variety of health-related outcome measures and thus may be reflective of the efficiency of foundational brain-body communication. Non-human primate models of grip strength strongly implicate the cortical lateral grasping network, but little is known about the translatability of these models to human children. Further, it is unclear how supplementary networks that provide proprioceptive information and cerebellar-based motor command modification are associated with maximal grip strength. Therefore, this study employed high resolution, multi-shell diffusion and quantitative T1 imaging to examine how variations in lateral grasping, proprioception input, and cortico-cerebellar modification network white matter microstructure are associated with variations in grip strength across 70 children. Results indicated that stronger grip strength was associated with higher lateral grasping and proprioception input network fractional anisotropy and R1, indirect measures consistent with stronger microstructural coherence and increased myelination. No relationships were found in the cerebellar modification network. These results provide a neurobiological mechanism of grip behavior in children which suggests that increased myelination of cortical sensory and motor pathways is associated with stronger grip. This neurobiological mechanism may be a signature of pediatric neuro-motor behavior more broadly as evidenced by the previously demonstrated relationships between grip strength and behavioral outcome measures across a variety of clinical and non-clinical populations.

Health-Related Physical Fitness in Adolescents from Spain, Estonia and Iceland: A Cross-Sectional, Quantitative Study.

The benefits of physical fitness (PF) for health are well-known. Low PF significantly contributes to the prevalence of obesity in adolescents, with an increased risk of developing chronic diseases. The objectives of the present study were to explore the health-related PF components and body composition levels in adolescents in three European cities, and their differences. The present study is a cross-sectional, descriptive, and quantitative research effort with 1717 participants aged between 13−16 years (48% girls), enrolled in public and private secondary schools in Seville (Spain), Reykjavik (Iceland) and Tartu (Estonia). The ALPHA fitness battery test was used with the following tests: handgrip strength, standing broad jump, 4 × 10 m speed-agility, 20 m shuttle run, and anthropometric variables. Regarding body composition, differences were detected for city and gender in height (p < 0.001), weight (p < 0.001), body fat percentage (p < 0.001), and waist circumference (p < 0.001); but no differences were reported for BMI for both city (p = 0.150) and gender (p = 0.738). Similarly, concerning PF, it was detected statistically significant differences between cities and gender in handgrip strength (p < 0.001), jump test (p < 0.001), speed-agility test (p < 0.001), and cardiovascular endurance in both variables (p < 0.001). In total, 26.8% of the boys and 27.3% of the girls were categorized as overweight; 18.1% of the boys and 31.2% of the girls had an excessive percentage of fat mass; and 22.7% of the boys and 22.2% of the girls showed an excessive waist circumference. The participants from Seville presented the lowest results in PF tests. In contrast, Reykjavik, with the highest results in the endurance and speed-agility tests, and Tartu, with higher results in the manual grip strength and long jump tests, shared the highest results.

Physical Fitness and Upper Limb Asymmetry in Young Padel Players: Differences between Genders and Categories.

This study aimed to assess the physical fitness and upper body asymmetries of young padel players aged between 13 and 16 years and to determine the possible differences between genders and categories. A total of 60 padel players were divided into four groups: under-14 male (n = 15; age: 13.75 ± 0.45 years; height: 1.64 ± 0.07 m; weight: 54.7 ± 8.3 kg), under-14 female (n = 15; age: 13.75 ± 0.44 years; height: 1.60 ± 0.05 m; weight: 51.5 ± 6.0 kg), under-16 male (n = 15; age: 15.44 ± 0.51 years; height:1.71 ± 0.04 m; weight: 63.88 ± 6.2 kg) and under-16 female (n = 15; age:15.46 ± 0.52 years; height:1.63 ± 0.05 m; weight: 55.08 ± 3.6 kg). Handgrip strength, ischiosural flexibility, gestural speed of the dominant arm, vertical jump, cardiorespiratory capacity, lateral movement, lateral acceleration and reaction time were measured. Male players showed better results in manual grip strength, vertical jump power, cardiorespiratory capacity and lateral movement (p < 0.05). Moreover, males presented a higher percentage of asymmetry in upper limb strength. Female players showed better reaction time and greater flexibility (p < 0.05). Regarding the differences between categories, the under-16 players showed greater flexibility, gestural speed, vertical jump power, cardiorespiratory capacity and lateral movement compared to the under-14 players. These results can be used as reference values for coaches/physical trainers of younger categories to improve health control and physical performance planning.

Strength training with and without arteriovenous blood flow restriction improves performance, regardless of changes in muscle hypertrophy, in Wistar rats.

Strength training (ST) with blood flow restriction (BFR) is known to promote increases in hypertrophy and strength sometimes similar to traditional ST despite the effects of the arterial BFR on muscle adaptations and safety are not well established. The aim of this study was to assess whether ST with arterial BFR is able to improve muscular adaptations, performance and its safety in Wistar rats. Animals aging 8 weeks were divided in four groups: sedentary sham (S/S), sedentary with arterial BFR (S/BFR), trained sham (T/S), and trained with arterial BFR (T/BFR). Training protocol consisted of four weeks of ST composed by six sets of 10 ladder climbing with 50% of 1 maximal voluntary contraction. Body weight, epididymal fat, maximum loaded weight, manual grip strength, muscular hypertrophy index, systolic blood pressure, enzyme activity of superoxide dismutase, nitrite/nitrate concentration and tumor necrosis factor alpha were analyzed. The BFR rate was between 36% and 38%. T/BRF was effective to promote strength and hypertrophy. T/S is an alternative to improve strength, but it did not promote hypertrophy. Furthermore, we found no significant cardiac and metabolic changes. Thus, T/BFR is able to improve muscle adaptations and performance in rats, without causing cardiovascular and metabolic damage.

Anthropometric Characterization and Physical Performance by Age and Biological Maturation in Young Tennis Players

The objective was to analyze anthropometric and physical performance variables as a function of chronological age and biological maturity in young Chilean tennis players. The study was observational, cross-sectional, with descriptive and analytical characteristics. Eighty-seven tennis players were evaluated (58 men 15.1 ± 0.8 years and 29 women, 15.3 ± 0.8 years). The measured anthropometric variables were a sprint test of 20m; a modified agility test; a sit-and-reach test and shoulder flexibility; manual grip strength; horizontal jump in feet; a medicine ball throw; a countermovement vertical jump; an abalakov vertical jump and a 20-m shuttle-run test. The growth velocity acceleration peak (APHV), skeletal muscle mass and fat mass were calculated, R2 and standard error of estimate (SEE) were examined. The results show that chronological age explained the anthropometric variables between 1 and 23% in men and 1 and 29% in women; by biological age, variables were explained between 3 and 53% in men and 2 and 42% in women. Of the physical performance variables, chronological age described between 2 and 24% of them in men and 1 and 29% in women; the same were explained by biological age between 1 and 19% in men and 1 and 26% in women. We conclude that anthropometric variables showed a better relationship with biological age, except for volume of fat tissue, while physical performance variables showed low association with both biological and chronological age.

Prevalence of sarcopenia in elderly users of the primary health care system.

Objective: to identify the prevalence of sarcopenia in elderly primary care users, and the relationship of nutritional status with sarcopenia. Material and methods: the study was a cross-sectional study with elderly users of the primary health care network. The participants were evaluated for the diagnosis of sarcopenia, which involved calculation of muscle mass, grip strength, and walking speed, as well as sociodemographic, anthropometric and nutritional variables. Nutritional status was evaluated through the body mass index (BMI) and the Mini Nutritional Assessment (MNA) instrument. The study was conduted at eleven family health centers in Marau, Rio Grande do Sul, and included elderly subjects aged 65 years and over (n = 148). Results: of the elderly subjects evaluated, 72.3% were female; mean age was 73.6 years (SD: 5.5), ranging from 65 to 89 years. The prevalence of sarcopenia was 14.2%, 47.3% of the sample had low manual grip strength, and 53.7% had inadequate walking speed. Regarding BMI, 10.8% of participants were classified as underweight, and 75% of these were diagnosed with sarcopenia. Sarcopenia was significantly associated with the oldest age group (p = 0.046) and with higher BMI (p < 0.001). Conclusions: results show the importance of assessing nutritional status and a potential diagnosis of sarcopenia, mainly since this syndrome is highly associated with inappropriate food intake, which is often impaired among the elderly because of economical and/or physiological reasons.

Sarcopenia in children and adolescents with chronic liver disease

ObjectiveTo investigate the occurrence of sarcopenia in children and adolescents with chronic liver disease. MethodsA series of cases, with patients aged 6‐19 years of both genders, who were treated in Liver Outpatient Clinics. Weight, height, muscle strength (assessed by manual grip strength), and muscle mass (estimated through dual‐energy X‐ray absorptiometry) were measured. Sarcopenia was diagnosed based on the simultaneous presence of muscle mass and muscle strength déficits, defined as the values below the mean for muscle mass and strength of the studied population, according to gender. A descriptive analysis (mean and standard deviation) was performed, and the difference of means was calculated by Student's t‐test. ResultsA total of 85 patients were studied, mostly females (64.7%), with a mean age of 11.7 (SD=3.4) years. Sarcopenia was identified in 40% of the patients. Muscle strength déficit was found in 54.1% of the subjects, and 50.6% showed muscle mass déficit. The mean muscle mass for males was higher than that for females (6.07; SD=1.22kg/m2vs. 5.42; SD=1.10kg/m2; p=0.016). However, there was no significant difference in sex‐related muscle strength (male=0.85; SD=0.52 kgf/kgm2 and female=0.68; SD=0.30 kgf/kgm2; p=0.113). ConclusionThe research findings identified that sarcopenia is a condition found in pediatric patients treated at a public referral institution for chronic liver disease.

Força de preensão manual e funcionalidade em idosos longevos: um estudo transversal

Objetivo: analisar a relação entre a força de preensão manual e a medida de independência funcional de idosos longevos. Método: estudo quantitativo transversal desenvolvido com 72 longevos da atenção primária, de Curitiba/PR (Brasil). O levantamento de dados ocorreu entre agosto e dezembro de 2015. Realizaram-se análises descritivas e de associação entre variáveis. Resultados: vinte e dois (30,6%) longevos apresentaram redução da força de preensão manual; e quanto à medida de independência funcional, 51 (70,8%) eram independentes e 21 (29,2%) moderadamente dependentes. Houve associação significativa entre a força de preensão manual e a medida de independência funcional cognitiva (p=0,021). Discussão: são fundamentais os cuidados gerontológicos relacionados à prática de atividade física e participação em oficinas de estimulação cognitiva, adaptados à escolaridade dos longevos. Conclusão: Diante da associação entre a funcionalidade e a força de preensão manual, recomenda-se a avaliação desses aspectos nas consultas de enfermagem aos longevos, em diferentes contextos de atendimento.

Effect of Autonomic Responses After Isometric Training at Different Intensities on Obese People.

Arterial hypertension is among the leading causes of mortality worldwide. The primary non-pharmacological management of arterial hypertension is isometric grip training, which has shown better results than pharmacological methods; however, it has not been thoroughly studied in large muscle groups. This study compared the pressor response of isometric exercise training at different intensities, in large groups versus small muscle groups, in sedentary eutrophic and overweight people aged 20-29 years. A sample of 93 people (57 people with excess weight and 36 people of normal weight) participated in isometric training for 5 days, subdivided into leg press vs. handgrip strength, with different intensities for each subgroup (30 and 50%, 1 RM). Before and after the 5 training days, Heart Rate Variability (HRV) and systolic and diastolic blood pressure, BSBP-BDBP and PSBP-PDBP, were measured to evaluate the state of sympathetic activation at rest and pressor response. Changes with significant differences (p <0.05) in terms of pre-post training measurements in the eutrophic group were the BSBP-PSBP variables at 30% and 50% 1 RM for manual isometric grip strength. In the excess weight group, the only significant change was the PSBP variable in handgrip strength at 30% 1 RM. It should be noted that in all cases, blood pressure values reduced. Isometric strength exercises in large and small muscle groups show a tendency to reduce blood pressure values; however, the isometric handgrip force at 30% 1 RM shows statistically significant reductions in blood pressure values.

Strength and multimorbidity among community-dwelling elderly from southern Brazil.

The number of chronic diseases is associated with the reduction in muscle mass and strength in older people (≥60 y of age). The purpose of this study was to asses the association between multimorbidities and handgrip strength in older community-dwelling individuals from a city in southern Brazil, identifying potential differences according to sex and loss of muscle mass. This was a cross-sectional population-based study among older individuals living in the urban area of Pelotas, Rio Grande do Sul, Brazil. Grip strength was assessed with digital dynamometers according to the criteria of the European Working Group on Sarcopenia in Older People (EWGSOP) to define dynapenia. Multimorbidity was defined by self-report as the presence of at least 5 diseases diagnosed by a physician. Covariates of the study were age, sex, socioeconomic status, schooling, marital status, nutritional status, alcohol consumption, and smoking habits. Statistical analyses were stratified according to the presence of myopenia (low muscle mass). We received completed information from 1336 individuals ≥60 y of age. Multimorbidity was 50% and 16% more prevalent, respectively, among men and women classified in the lower quartile of manual grip strength (prevalence ratio [PR], 1.50; 95% confidence interval [CI], 1.15-1.95 for men and PR, 1.16; 95% CI, 1.03-1.32 for women) compared with those from the upper quartile. Among men without myopenia, the presence of dynapenia increased the odds of having multimorbidity (PR, 1.42; 95% CI, 1.18-1.71). Among those with myopenia, there was a 10% increase in the prevalence of multimorbidity only for women with dynapenia (PR, 1.10; 95% CI, 1.00-1.21). Results from the present study indicated an association between manual grip strength and multimorbidity among this population, and the effect measures were greater in men. Manual grip strength proved to be a good marker of health in this population, especially in those who did not present with myopenia.

Analysis of the health profiles and prevalence of falls for patients over 65years of age in a thermal environment.

A falls prevention programme has been initiated in balneotherapy at Balaruc-les-Bains. To determine the health profiles of subjects who are at risk of falls, over 65years of age and attending balneotherapy. Questionnaires were used to evaluate people on their fear of falling. Fatigue was assessed by visual analog scale as well as by functional status over the past 12months. EQ-5D-3L, the IPAQ questionnaire and Fried's frailty scale were all used. Patients' functional capabilities were tested using the Unipedal stance test, the TUG test, the SPPB, the Tandem walking test and the isometric manual grip strength test. Out of the 1471 patients (72.45years ± 5.10), the women (67%) were tested. In the last 12months, 485 of these 1471 patients fell (33%) and 37% of them suffered a severe injury. 45-50% of these subjects are now in good health. Women had a significantly higher impaired perception of their health than men (0.02 < p < 0.0001). According to Fried's criteria, 10.2% of the population is considered frail, with a significantly greater number of women (p < 0.0001). Static equilibrium was subnormal (less than 12s during the TUG). The number of steps in tandem position discriminates individuals and gender as does the speed of moving from A to B and muscular strength. More than one-third of the subjects (more women than men) aged 65 or older visiting the Balaruc-les-Bains health resort are pre-frail or frail. They all have a recent history of falls, suffer from impaired muscle strength, and have balance and gait disorders.

Associação entre função física e incapacidade autorrelatada em idosos comunitários: uma abordagem de acordo com o Modelo de Funcionalidade, Incapacidade e Saúde

Introdução: Deficiências como fraqueza muscular tendem a aumentar com o envelhecimento e a incapacidade pode ameaçar a qualidade de vida dos idosos. Objetivo: investigar se há correlação entre preensão manual e incapacidade em idosos comunitários. Métodos: Participaram 62 idosos (70,14 ± 6,29 anos). Foram investigados: idade, sexo, nível de escolaridade, estado civil, classe econômica, função física (força de preensão manual) e incapacidade pelo instrumento WHODAS 2.0. Estatística: descritiva e Coeficiente de Correlação de Spearman. Resultados: Os idosos apresentaram média de idade de 70,14 anos e, em sua maioria, eram do sexo feminino, casados, baixo grau de escolaridade e renda média-baixa. Observou-se correlação negativa estatisticamente significativa entre a incapacidade e força de pensão manual, assim como entre preensão manual e cognição e mobilidade no WHODAS. Os demais domínios do WHODAS não apresentaram correlação significativa com a preensão manual. Conclusão: A função física avaliada foi correlacionada com níveis de incapacidades nos idosos.

Association between frailty and the combination of physical activity level and sedentary behavior in older adults

BackgroundThe combined association of physical activity and sedentary behavior with adverse health factors is not yet clear in the literature. A combined analysis of physical activity level and sedentary behavior may provide evidence of the interrelation between these behavioral variables and the frailty syndrome. Thus, the aim of this study was to examine the relationship between physical activity level, sedentary behavior and frailty in older adults.MethodsIn this study, we evaluated 457 older adults (age range = 60 to 96 years old) from the Longitudinal Study of the Elderly Health of Alcobaça, Bahia. The frailty condition was defined by the presence of three or more of the following criteria: unintentional weight loss, slow walking speed measured over a 4.57 m test, a reduction of manual grip strength and exhaustion. Based upon these criteria, participants were classified as non-frail or frail. Physical activity level and time spent in sedentary behavior were assessed with the International Questionnaire of Physical Activity. Descriptive statistics were used to characterize the sample. To examine the combined association of physical activity and sedentary behavior with frailty, chi-square and Poisson regression tests were used. Statistical significance was defined as p ≤ 0.05.ResultsThe prevalence of frailty was 8.8% (n = 40), with higher prevalence observed with increasing age. Low physical activity level combined with excessive time spent in sedentary behavior (physical activity level < 150 min/wk. and sedentary behavior ≥540 min/day) was associated with frailty, resulting in a prevalence ratio of 2.83 (95% CI, 1.23 to 6.52).ConclusionFrailty is more prevalent among older adults who exhibit insufficient levels of physical activity combined with a great amount of time spent in sedentary behavior, even when adjusted for sociodemographic factors.

Prevalence of Sarcopenia and Association with Lifestyle Patterns in Patients with Type 2 Diabetes Mellitus (P01-025-19)

ObjectivesThe aim of the study was to establish the prevalence of sarcopenia and associated factors in elderly with type 2 diabetes (DM) in southern Brazil. MethodsA cross-sectional study was performed in 240 patients with type 2 DM. The diagnosis of sarcopenia was performed according to EWGSOP criteria. Muscle mass was calculated by skeletal muscle mass index (appendicular skeletal muscle mass/height2 - Inbody® bioimpendance). Muscle strength was assessed by manual grip strength (Jamar® dynamometer) and physical performance was assessed by the sit and lift test. Patients with type 2 DM with age ≥60 years and with the ability to ambulate were selected. Patients with recent cardiovascular events, serum creatinine >2.0 mg/dl, use of corticosteroids and BMI >40 kg/m2 were excluded. The sample size was 240 patients based on meta-analysis who found 17% sarcopenia in elderly patients without DM. ResultsWe included 240 patients aged 68.4 ± 5.5 years, 53.2% were women and the duration of DM was 15 (8–22) years, the BMI was 29.4 ± 4.4 kg/m2. The prevalence of sarcopenia was 21% and men had more sarcopenia (75%). Patients with sarcopenia walk less [3541 (2227–4574) vs. 4521 (3037–5678) steps, P = 0.013], drink more alcohol [21 (56.8%) vs. 71 (31.8%); P < 0.034] and have lower total cholesterol levels [146 ± 41 Vs. 168 ± 43; P = 0.007] than the group without sarcopenia. In multivariate logistic regression models, walking < 3760 steps [OR = 2868; CI 95% 1.331–6.181] and male [OR = 5285; CI 95% 2261–12,350], were associated with sarcopenia. ConclusionsThe prevalence of sarcopenia was 21%, higher than in patients without diabetes (17%). In this group of patients, lower physical activity, and male sex were associated with sarcopenia. Funding SourcesFIPE n. 160467; CAPES.

Sarcopenia in children and adolescents with chronic liver disease

ObjectiveTo investigate the occurrence of sarcopenia in children and adolescents with chronic liver disease. MethodsA series of cases, with patients aged 6–19 years of both genders, who were treated in Liver Outpatient Clinics. Weight, height, muscle strength (assessed by manual grip strength), and muscle mass (estimated through dual-energy X-ray absorptiometry) were measured. Sarcopenia was diagnosed based on the simultaneous presence of muscle mass and muscle strength déficits, defined as the values below the mean for muscle mass and strength of the studied population, according to gender. A descriptive analysis (mean and standard deviation) was performed, and the difference of means was calculated by Student's t-test. ResultsA total of 85 patients were studied, mostly females (64.7%), with a mean age of 11.7 (SD=3.4) years. Sarcopenia was identified in 40% of the patients. Muscle strength déficit was found in 54.1% of the subjects, and 50.6% showed muscle mass déficit. The mean muscle mass for males was higher than that for females (6.07; SD=1.22kg/m2vs. 5.42; SD=1.10kg/m2; p=0.016). However, there was no significant difference in sex-related muscle strength (male=0.85; SD=0.52kgf/kgm2 and female=0.68; SD=0.30kgf/kgm2; p=0.113). ConclusionThe research findings identified that sarcopenia is a condition found in pediatric patients treated at a public referral institution for chronic liver disease.