Muscle Mass Index Research Articles

Influence of sarcopenia as determined by bioelectrical impedance analysis in acute pancreatitis.

Sarcopenia can be defined as the loss of muscle mass and strength. It is a poor prognostic factor for many diseases. Our study aims to assess the prevalence of sarcopenia in patients with acute pancreatitis using bioelectrical impedance analysis (BIA) and hand dynamometry while also investigating its impact on acute pancreatitis. Sixty patients admitted with a diagnosis of acute pancreatitis were included in this prospective study. Following their admissions, prognostic markers were calculated, muscle strengths were measured using a hand dynamometer, and body compositions were determined using a BIA device. Accordingly, acute pancreatitis patients were divided into 2 groups: sarcopenic and nonsarcopenic. The demographic characteristics, anthropometric measurements, Ranson score, Glasgow-Imrie score, Balthazar score, APACHE-II score, disease severity according to the Atlanta classification, length of hospital stay, and laboratory findings of the 2 groups were compared. Sarcopenia was identified in 11 cases among those with acute pancreatitis included in the study. In the sarcopenic group, the mean age, Glasgow-Imrie score and number of cases with severe acute pancreatitis according to the Atlanta classification were significantly higher; body mass index, upper arm circumference, skeletal muscle mass index, and grip strength were significantly lower (P < .05). This study is the first to evaluate sarcopenia in acute pancreatitis cases using BIA and hand dynamometry. Sarcopenia may play a significant role in predicting the prognosis of acute pancreatitis.

The finger-ring test as an indicator of muscle mass estimated by dual-energy X-ray absorptiometry in an adult community-dwelling population.

The finger-ring test (FRT) offers a simple method to screen older adults at increased risk of sarcopenia. To investigate the association between the FRT and lean soft tissue mass estimated by dual-energy X-ray absorptiometry (DXA), and to further elucidate the FRT as an indicator of muscle mass, while accounting for potential confounders, in a community-dwelling population. Within this cross-sectional study 430 community-dwelling individuals aged 18 to 79 (286 women (66.5%) and 144 men (33.5%)) were enrolled. Data regarding FRT and anthropometric measurements were collected. Whole-body composition was estimated using DXA. Binary and ordinal logistic regressions were performed. The frequency of smaller calf, just fits, and bigger calf was 17.7%, 33.7%, and 48.6%, respectively. Regardless of sex, higher appendicular lean soft tissue mass adjusted for height squared was observed for higher FRT categories (p < 0.001). For the ordinal logistic regression model, each unity of increment in appendicular lean soft tissue mass adjusted for height squared (kg/m2) was associated with a higher probability of being allocated to higher finger-ring test categories, in both genders. A higher cumulative adjusted odds ratio was found for women (7.53; 95% confidence interval: 4.58-12.38) than for men (2.99; 2.00-4.48). By demonstrating an association between the appendicular lean soft tissue mass estimated by DXA and the FRT, these results strengthen the utility of this simple self-test as an indicator of muscle mass, which can be used in the primary prevention of muscle mass decline and its recovery.

Sex differences in the association between sarcopenia index and sarcopenia: a cross-sectional study from a Chinese community-based population

Abstract Purpose The sarcopenia index (SI) is a convenient method to screen for sarcopenia, but few studies have analysed whether there are sex differences. The aim of this study was to analyse sex differences in the relationship between SI and sarcopenia in a Chinese community-based population. Methods This cross-sectional study included participants from 2011 China Health and Retirement Longitudinal Study. The SI was defined as 100 × creatinine / cystatin C. Diagnosis of sarcopenia based on the Asian Working Group for Sarcopenia 2019 consensus. Logistic regression model, linear regression model, and natural spline model were used to analyze the association between SI and sarcopenia. Results A total of 7,118 participants with a mean age of 60.6 ± 10.1 were included, 53.4% females. In males, the prevalence of sarcopenia decreased by 25% for every 10 increase in SI, and skeletal muscle mass index (SMI) increased by 0.04, odds ratio (OR), β, and 95% confidence interval (CI) were 0.75 (0.65–0.87), 0.04 (0.02–0.05), both P &lt; 0.001. In females, the SI was not significantly associated with sarcopenia, OR and 95% CI were 0.99 (0.9 ~ 1.08), P = 0.775; for every 10 increase in SI, the SMI in females decreased by 0.03, β and 95% CI were -0.03 (-0.04 ~ -0.01), P = 0.001. Conclusion In the Chinese community, the SI is negatively associated with sarcopenia in males and has moderate diagnostic test performance. It was not associated with sarcopenia in females, and using the SI to screen for sarcopenia in females may not be a reliable method.

Association of low muscle mass index and sarcopenic obesity with knee osteoarthritis: a systematic review and meta-analysis.

Sarcopenia and knee osteoarthritis are common age-related diseases that have become important public health issues worldwide. Few studies have reported the association between muscle mass loss and knee osteoarthritis. This may be due to the high level of heterogeneity between studies stemming from different definitions of muscle mass loss. The systematic searches were carried out in PubMed and Web of Science from the inception of the databases until 13 January 2023, by two independent researchers. Pooled odds ratios (ORs) for overall and subgroup analyses were obtained using either a random effects model (I2 >50%) or fixed effects model (I2 ≤50%) in Stata. Of the 1,606 studies identified, we ultimately included 12 articles on the association between muscle mass and knee osteoarthritis (prospective: n = 5; cross-sectional: n = 7). Low-quality evidence indicated that low muscle mass index and sarcopenic obesity increase the odds of knee osteoarthritis (low muscle mass index OR: 1.36, 95% CI: 1.13-1.64; sarcopenic obesity OR: 1.78, 95% CI: 1.35-2.34). However, no association was observed between general sarcopenia or low muscle mass with knee osteoarthritis. This systematic review and meta-analysis revealed that low muscle mass index and sarcopenic obesity were associated with an increased risk of developing knee osteoarthritis.

Accuracy of Fat Mass and Muscle Mass Measured by Bioelectrical Impedance Analysis in Predicting Osteoporosis in Older Adults

Background: Osteoporosis is a prevalent bone disease characterized by reduced bone mineral density (BMD) and increased fracture risk. This study aimed to evaluate the accuracy of fat mass (FM) and muscle mass measured by bioelectrical impedance analysis (BIA) in predicting osteoporosis in older adults. Methods: A cross-sectional study was conducted on 109 outpatients aged 60 years and older. FM parameters (total fat mass, visceral fat level, and fat mass index [FMI]) and muscle mass parameters (total muscle mass, appendicular skeletal muscle mass [ASM], and appendicular skeletal muscle mass index [ASMI]) were measured using BIA. Osteoporosis was diagnosed based on BMD measurements using dual-energy X-ray absorptiometry (DXA). Receiver operating characteristic (ROC) curves were used to determine cut-off points and assess the accuracy of BIA parameters in predicting osteoporosis. Results: The prevalence of osteoporosis was 52.3% (n=57). The optimal cut-off points for predicting osteoporosis were: total fat mass &gt;36.25%, visceral fat level &gt;12.05, FMI &gt;7.82 kg/m2, total muscle mass &lt;37.82 kg, ASM &lt;16.795 kg, and ASMI &lt;6.895 kg/m2. Among the FM parameters, visceral fat level had the highest accuracy (AUC = 60.9%, sensitivity = 64.9%, specificity = 78.8%) while FMI had the lowest (AUC = 53.5%, sensitivity = 56.1%, specificity = 57.7%). For muscle mass parameters, ASM showed the highest accuracy (AUC = 74.0%, sensitivity = 70.2%, specificity = 76.9%). Conclusion: BIA-derived FM and muscle mass parameters, particularly visceral fat level and ASM can be used to predict osteoporosis in older adults with good accuracy. This non-invasive and accessible method may be useful as a screening tool for osteoporosis, especially in settings where DXA is unavailable.

Associations of Muscle-Related Metrics With Respiratory Disease in Chinese Adults: A Prospective Cohort Study.

There is limited evidence about the association of muscle mass, strength and quality with respiratory disease, especially in Chinese populations. We aimed to comprehensively examine such associations and identify better metrics with more clinical and public health relevance. We conducted a prospective cohort study based on data from the second resurvey of the China Kadoorie Biobank (CKB) study in participants with no prevalent respiratory disease or cancer. Arm muscle quality was calculated as the ratio of grip strength to arm muscle mass. Low muscle mass, grip strength and arm muscle quality were defined as the sex-specific lowest quintiles of corresponding variables. Cox proportional hazard models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) for respiratory disease. In total, 17 510 participants aged 38-88 (65.4% women; mean age 57.8 ± 9.6) were enrolled in 2013-2014 and followed up until 31 December 2018. During a median follow-up of 4.82 years, 1346 participants developed respiratory disease. After adjustment for sociodemographic characteristics, lifestyle factors and medical histories, the elevated HR of respiratory disease was 1.31 (1.14-1.51) for low grip strength and 1.25 (1.09-1.44) for low arm muscle quality. Grip strength and arm muscle quality exhibited a linearly inverse association between respiratory disease (p = 0.137 and 0.102), with each standard deviation (SD) decrease in grip strength and arm muscle quality associated with a 22% (95% CI: 11%-34%) and 14% (95% CI: 7%-22%) increased risk of respiratory disease. No association was found for low total muscle mass index and low appendicular muscle mass index. Low grip strength and arm muscle quality are associated with increased risks of respiratory disease, and they are better muscle-related metrics for identifying adults at high risk of respiratory disease. Chinese adults may need to maintain normal muscle mass, strength and quality to achieve better respiratory health, but this needs to be validated in appropriately designed clinical trials.

Relationship between skeletal muscle mass change and swallowing function improvement among stroke patients with dysphagia during rehabilitation

ABSTRACT Objectives The purpose of this study was to evaluate the relationship between changes in skeletal muscle mass and improvements in swallowing function in stroke patients with dysphagia during rehabilitation. Methods The study included 145 patients with a stroke or dysphagia. The two groups were divided into two groups: those with improved skeletal muscle mass index (SMI) at discharge and those without. Clinical data, including SMI, and Mann Assessment of Swallowing Ability (MASA), were collected from the database. Results The increase in MASA was significantly higher in the group with increased SMI than in the group with no increase in SMI. In the multivariate analysis, the duration of rehabilitation and the group with increased SMI were associated with increased MASA. Conclusion SMI gain and the duration of rehabilitation per day were associated with improved swallowing function in patients with stroke.

Impact of resistance training and chicken intake on vascular and muscle health in elderly women.

Resistance training is a well-known exercise therapy for preventing and improving lacks of muscle mass, strength, and quality with advances in age; however, its effects on arterial stiffness are not beneficial. Additionally, a higher intake of protein, which is an effective nutrient for muscle health, results in lower arterial stiffness. Whether the combination of moderate to high-intensity resistance training and high-protein intake would improve muscle mass, strength, and quality and cancel the resistance training-induced increase in arterial stiffness in elderly women remains unclear. Ninety-three elderly women (67.2±5.3years) were randomly divided into four groups; sedentary control (CON), higher dietary animal protein intake (HP), resistance training (RT), and combination of RT and HP (RT+HP) groups. Participants in the RT and RT+HP groups completed 12weeks of resistance training (exercise intensity at 70% of one-repetition maximum (1-RM), three sets with 10 repetitions of leg extension and curls, 3days/week). In addition to the daily diet, the HP and RT+HP groups consumed steamed chicken breast as a high-protein diet. Percent changes in thickness (indices of muscle mass) and echo intensity (index of muscle quality) in the quadriceps muscle, 1-RM of leg extension and curls (index of muscle strength), and circulating C1q levels (a potential biomarker of muscle fibrosis) in the RT and RT+HP groups significantly improved after both RT and RT+HP interventions (P<0.05). Percent changes in carotid-femoral pulse wave velocity (cfPWV) and carotid β-stiffness (indices of arterial stiffness), and circulating angiotensin II (a vasoconstrictor peptide hormone) levels via each intervention were significantly higher in the RT group (4.9±12.7%, 13.8±13.5%, 94.9±132.7%, respectively), as compared with the CON group (-2.5±5.9%, 0.2±8.1%, 21.2±79.3%, respectively) (P<0.05). Of note, no significant differences in the cfPWV, carotid β-stiffness, and circulating angiotensin II levels between the RT+HP (-2.4±9.3%, 2.4±10.3%, -5.7±29.6%, respectively) and CON groups were observed. Furthermore, significant positive relationships between the percent changes in circulating angiotensin II levels, and cfPWV (r=0.438, P<0.01) and carotid β-stiffness (r=0.328, P<0.01) were observed. The combination of moderate to high-intensity resistance training and regular intake of steamed chicken breast as a high-protein food could increase muscle mass, strength, and quality and could cancel resistance training-induced increases in arterial stiffness in elderly women.

Effect of vitamin D, omega-3 supplementation, or a home exercise program on muscle mass and sarcopenia: DO-HEALTH trial.

We aimed to investigate the effect of daily supplemental vitamin D, omega-3s, and a thrice-weekly home exercise program, alone or in combination, on change of appendicular lean muscle mass index (ALMI) and incident sarcopenia in older adults. This is a secondary endpoint analysis of a 3-year randomized, double-blind, placebo-controlled trial with a 2 × 2 × 2 factorial design among 2157 community-dwelling, healthy adults aged 70 + years, from 2012 to 2018 (DO-HEALTH). Participants were randomized to 2000 IU/d vitamin D and/or 1 g/d marine omega-3s and/or exercise. Change in ALMI over 3 years was calculated in all participants who underwent dual energy X-ray absorptiometry (DXA) (n = 1495) using mixed effect models. Incident sarcopenia was analyzed based on the Sarcopenia Definitions and Outcomes Consortium in all non-sarcopenic participants (n = 1940). Among 1495 participants (mean age 74.9 (sd 4.4); 63.3% were women; 80.5% were at least moderately physically active at baseline) mean gait speed at baseline was 1.2 m/s (sd 0.3), mean ALMI at baseline was 6.65 (SD 0.95) in women, and 8.01 (SD 0.88) kg/m2 in men. At year 3, average change of ALMI was -0.09 (sd 0.34) kg/m2 (-1.35%) in women and - 0.17 (sd 0.33) kg/m2 (-2.0%) in men. None of the treatments individually or in combination had a benefit on ALMI change compared to control over 3 years, with omega-3s showing a small protective effect on ALMI at year 1 only (-0.021 vs. no-omega-3s -0.066 kg/m2, p = 0.001). Of 1940 non-sarcopenic participants at baseline, 88 (4.5%) developed incident sarcopenia over 3 years. None of the treatments individually or in combination reduced the odds of incident sarcopenia compared with placebo. Among healthy, physically active older adults, ALMI and incidence of sarcopenia were not improved by treatment of daily 2000 IU vitamin D, daily 1 g omega-3s, or a simple home exercise program compared with control over 3 years.

Serum creatinine- and cystatin C-based indices are associated with the risk of subsequent sarcopenia: evidence from the China Health and Retirement Longitudinal Study.

Serum creatinine (Cr)- and cystatin C (CysC)-based indices have been suggested as alternative markers for sarcopenia, but their predictive value for sarcopenia risk is uncertain, which was investigated in the present study in the Chinese population with the middle and older ages. Data from the China Health and Retirement Longitudinal Study (CHARLS) were collected in the 2011 and 2015 waves. All participants were free of sarcopenia at the baseline. Sarcopenia was diagnosed when low muscle mass and grip strength or low physical performance were present. Four indices were computed: predictive skeletal muscle mass index (pSMI), total-body muscle mass (TBMM), creatinine-to-cystatin C ratio (CCR), and sarcopenia index (SI). Restricted cubic splines and logistic regression models were used to assess the effects of these indices on sarcopenia risk. Among 4,527 participants without sarcopenia at the baseline (2011), the median age was 58 year-old (IQR: 52-65), with 52.7% women. Followed up in year 2015, the incidence of sarcopenia was 20.8 per 1,000 person-years (376/4,527). Neither CCR nor SI showed linear or non-linear associations with the risk of subsequent sarcopenia. However, a decrease in pSMI and TBMM was significantly associated with an increased risk of sarcopenia [adjusted per-SD decrease OR, 2.93; 95% CI, 2.09-4.13, p < 0.001; adjusted per-SD decrease OR: 2.38, 95% CI: 1.80-3.16, p < 0.001, respectively]. In the middle and older age of Chinese population, decreased pSMI and TBMM were associated with an increased risk of subsequent sarcopenia, whereas CCR and SI showed no such correlation. Thus, pSMI and TBMM may serve as potential biological indicators for predicting the risk of sarcopenia, and decreased pSMI and TBMM may be the early biomarkers for diagnosis and intervention of sarcopenia.

Metagenomic Analysis Identifies Sex-Related Gut Microbial Functions and Bacterial Taxa Associated With Skeletal Muscle Mass.

This study aimed to explore the association between gut microbiota functional profiles and skeletal muscle mass, focusing on sex-specific differences in a population under 65 years of age. Stool samples from participants were analysed using metagenomic shotgun sequencing. Skeletal muscle mass and skeletal muscle mass index (SMI) were quantified (SMI [%] = total appendage muscle mass [kg]/body weight [kg] × 100) using bioelectrical impedance analysis. Participants were categorized into SMI quartiles, and associations between gut microbiota, functional profiling and SMI were assessed by sex, adjusting for age, BMI and physical activity. The cohort included 1027 participants (651 men, 376 women). In men, Escherichia coli (log2 fold change 3.08, q = 0.001), Ruminococcus_B gnavus (log2 fold change 2.89, q = 0.014) and Enterocloster sp001517625 (log2 fold change 2.47, q = 0.026) were more abundant in the lowest SMI compared to the highest SMI group. In contrast, Bifidobacterium bifidum (log2 fold change 3.13, q = 0.025) showed higher levels in the second lowest SMI group in women. Microbial pathways associated with amino acid synthesis (MET-SAM-PWY: log2 fold change 0.42; METSYN-PWY: log2 fold change 0.44; SER-GLYSYN-PWY: log2 fold change 0.20; PWY-5347: log2 fold change 0.41; P4-PWY: log2 fold change 0.53), N-acetylneuraminate degradation (log2 fold change 0.43), isoprene biosynthesis (log2 fold change 0.20) and purine nucleotide degradation and salvage (PWY-6353: log2 fold change 0.42; PWY-6608: log2 fold change 0.38; PWY66-409: log2 fold change 0.52; SALVADEHYPOX-PWY: log2 fold change 0.43) were enriched in the lowest SMI in men (q < 0.10). In women, the second lowest SMI group showed enrichment in energy-related pathways, including lactic acid fermentation (ANAEROFRUCAT-PWY: log2 fold change 0.19), pentose phosphate pathway (PENTOSE-P-PWY: log2 fold change 0.30) and carbohydrate degradation (PWY-5484: log2 fold change 0.31; GLYCOLYSIS: log2 fold change 0.29; PWY-6901: log2 fold change 0.27) (q < 0.05). This study highlights sex-specific differences in gut microbiota and functional pathways associated with SMI. These findings suggest that gut microbiota may play a role in muscle health and point toward microbiota-targeted strategies for maintaining muscle mass.

Myostatin as a plausible biomarker for early stage of sarcopenic obesity

Since sarcopenic obesity (SO) impacts negatively on our health, early detection of SO is essential. However, prevalence of SO in an apparently healthy population has not been well examined. This study aimed to elucidate the prevalence and related factors of SO in middle-aged women, and to investigate useful diagnostic criteria for SO. Body component analyses were conducted on 432 female Osaka University employees aged 30–59 during their health checkups. Healthy (H) and SO groups were defined using cutoff values of 5.7 kg/m2 for skeletal muscle mass index and 30% for percent body fat. Serum myostatin and insulin levels were additionally measured. Among 432 participants, the prevalence of SO was 6.3%. Grip strength (P < 0.0001) was lower and triglyceride (P = 0.0004) and low-density lipoprotein cholesterol (P = 0.0105) levels, and Homeostatic Model Assessment of Insulin Resistance (P = 0.0262) were higher in the SO group than in the H group. Serum myostatin levels in the SO group were lower than in the H group (3,107 pg/mL vs. 3,957 pg/mL, P = 0.0003). Myostatin levels may be suppressed in individuals with SO without any pre-existing conditions. Our diagnostic criteria for SO could reveal the risks for metabolic-related diseases and may be useful for the early detection of SO.

Can simple measures from clinical practice serve as a proxy for sarcopenic obesity and identify mortality risk?

BackgroundSarcopenic obesity is a condition where loss of muscle mass occurs alongside fat gain, and it is considered a risk factor for mortality. However, the use of various definitions for this condition has led to conflicting results.AimTo investigate whether the coexistence of low muscle mass and abdominal obesity, defined using two simple measures employed in clinical practice, is a risk factor for mortality in individuals aged 50 or older.MethodsA longitudinal study with a 14-year follow-up was conducted involving 5,440 participants of the English Longitudinal Study of Ageing. Abdominal obesity and low muscle mass were respectively defined based on high waist circumference and low skeletal muscle mass index (SMMI) determined by an equation. The sample was divided into four groups: non-low muscle mass/non-abdominal obesity (NLMM/NAO), non-low muscle mass/abdominal obesity (NLMM/AO), low muscle mass/non-abdominal obesity (LMM/NAO), and low muscle mass/abdominal obesity (LMM/AO). Cox regression models were used to estimate the mortality risk as a function of muscle mass and abdominal obesity status.ResultsLMM/AO increased the risk of death by 83% (HR:1.83; 95%CI: 1.35–2.66) compared to those in the NLMM/NAO group. AO alone was not associated with a greater risk of mortality (HR:1.09; 95%CI: 0.93–1.27), whereas LMM alone increased the risk by 40% (HR:1.40; 95%CI:1.18–1.66).ConclusionsIdentifying LMM/AO in individuals aged 50 or older can be crucial for predicting the risk of mortality. Simple and easily applicable measures can serve as a proxy for sarcopenic obesity and aid in implementing the necessary interventions.

Quantifying the Enhancement of Sarcopenic Skeletal Muscle Preservation Through a Hybrid Exercise Program: Randomized Controlled Trial.

Sarcopenia is characterized by the loss of skeletal muscle mass and muscle function with increasing age. The skeletal muscle mass of older people who endure sarcopenia may be improved via the practice of strength training and tai chi. However, it remains unclear if the hybridization of strength exercise training and traditional Chinese exercise will have a better effect. We designed a strength training and tai chi exercise hybrid program to improve sarcopenia in older people. Moreover, explainable artificial intelligence was used to predict postintervention sarcopenic status and quantify the feature contribution. To assess the influence of sarcopenia in the older people group, 93 participated as experimental participants in a 24-week randomized controlled trial and were randomized into 3 intervention groups, namely the tai chi exercise and strength training hybrid group (TCSG; n=33), the strength training group (STG; n=30), and the control group (n=30). Abdominal computed tomography was used to evaluate the skeletal muscle mass at the third lumbar (L3) vertebra. Analysis of demographic characteristics of participants at baseline used 1-way ANOVA and χ2 tests, and repeated-measures ANOVA was used to analyze experimental data. In addition, 10 machine-learning classification models were used to calculate if these participants could reverse the degree of sarcopenia after the intervention. A significant interaction effect was found in skeletal muscle density at the L3 vertebra, skeletal muscle area at the L3 vertebra (L3 SMA), grip strength, muscle fat infiltration, and relative skeletal muscle mass index (all P values were <.05). Grip strength, relative skeletal muscle mass index, and L3 SMA were significantly improved after the intervention for participants in the TCSG and STG (all P values were <.05). After post hoc tests, we found that participants in the TCSG experienced a better effect on L3 SMA than those in the STG and participants in the control group. The LightGBM classification model had the greatest performance in accuracy (88.4%), recall score (74%), and F1-score (76.1%). The skeletal muscle area of older adults with sarcopenia may be improved by a hybrid exercise program composed of strength training and tai chi. In addition, we identified that the LightGBM classification model had the best performance to predict the reversion of sarcopenia.

Phase angle is a useful predicting indicator for protein-energy wasting and cardiovascular risk among maintenance hemodialysis patients

Protein-energy wasting (PEW) is a major contributor to the high mortality among maintenance hemodialysis (MHD) patients. Cardiovascular disease (CVD) is the leading cause of death in dialysis patients, and PEW can significantly increase cardiovascular mortality in MHD patients. Previous studies have confirmed that PA may be a good objective indicator for determining the nutritional status and prognosis of MHD patients. Our study aimed to determine the predictive value of phase angle (PA) as detected by bioelectrical impedance analysis (BIA) on PEW and cardiovascular (CV) risk among MHD patients. Our retrospective observational study involved 161 adult patients with HD. The Cardiovascular risk score is a risk model based on the Japan Dialysis Outcome and Practice Patterns Study (J-DOPPS). We established LASSO logistic regression analysis model to identify key parameters related to body composition that can predict PEW in MHD patients. The area under the curve (AUC) values for PA, appendicular skeletal muscle mass index (ASMI), body cell mass (BCM), and mid-arm circumference (MAC) in predicting PEW in male MHD patients were relatively large, with 0.708, 0.674, 0.663, and 0.735, respectively. The predicted PEW values of these parameters were slightly lower in female patients than in men. We incorporated PA, ASMI, BCM, and MAC into a model that predicted the incidence of PEW in maintenance hemodialysis patients using LASSO technology. We discovered that the model predicted a greater AUC of PEW occurrence than any single factor, 0.877 for men and 0.76 for women. The results of the univariate logistic regression analysis showed that the low PA tertile array group had a greater incidence of PEW than the high PA group (P < 0.001). Additionally, we also found that lower PA was associated with higher CV risk scores. The PA detected by bioelectrical impedance analysis could predict the risk of PEW and cardiovascular events among patients with MHD. When used in conjunction, PA, ASMI, BCM, and MAC have a high diagnostic efficacy for PEW in patients on maintenance hemodialysis.

Association between sarcopenia and the foot-ankle function in type 2 diabetic foot ulcer

BackgroundThe diabetic foot (DF) ulcer is the severe complication of type 2 diabetes mellitus (T2DM). Sarcopenia is characterized as the loss of muscle mass and strength, resulting in the increased risk of fracture and physical disability. Sarcopenia may affect the foot-ankle function in DF ulcer patients, compromise the quality of life.ObjectiveThe aim was to clarify the effect of sarcopenia on foot-ankle function in patients with DF ulcer.MethodsIn total of 108 T2DM patients with DF ulcer were enrolled. Based on the examination of muscle mass by dual energy X-ray absorptiometry (DXA) and grip strength and 5x sit-to-stand test, the DF patients were divided into sarcopenia and non-sarcopenia groups. The severity of DF ulcer was evaluated by Wagner classification. The foot-ankle function was evaluated by American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Score.ResultsDF patients with sarcopenia showed advanced age, lower BMI, longer duration of T2DM, and more severe Wagner classification, reduced appendicular skeletal muscle mass index (ASMI), grip strength, transcutaneous oxygenpressure (TcPO2) and prolonged time of 5X sit-to-stand test. The stratified comparison analysis indicated that severity of sarcopenia and DF ulcer, reduced TcPO2, and grip strength were aggravated with the impaired foot-ankle function (P < 0.05). Multivariate Logistic analysis showed that age, TcPO2, and severe sarcopenia were risk factors deteriorating the foot-ankle function.ConclusionThe sarcopenia is a key risk factor of decreasing foot-ankle function in patients with DF ulcer. Thus, the prevention of muscle mass and strength loss could be considered as part of comprehensive therapy for DF ulcer.

Association Between Sarcopenia and Acupressure Testing in Older Adults Requiring Long-Term Care.

Background and Objectives: This study analyzed the relationship between pressure pain test outcomes and sarcopenia in elderly patients and explored possible clinical applications. Materials and Methods: The participants included 143 older adults requiring long-term care who could be diagnosed with sarcopenia. Along with sarcopenia diagnosis, the participants underwent acupressure testing symmetrically at nine sites (occiput, lower cervical, trapezius, supraspinatus, second rib, lateral epicondyle, gluteus, greater trochanter, and knee), totaling 18 sites. The analyses included comparisons of sarcopenia status and total tender points between the groups and a multivariable analysis. The association between sarcopenia and the number of tender points were examined based on correlations between the number of tender points and grip strength, walking speed, and skeletal muscle mass index (SMI). Intergroup comparisons and multivariable analysis of tender points with and without sarcopenia were performed to investigate specific tender points associated with sarcopenia. Results: An independent association was observed between sarcopenia and the number of tender points (p = 0.001). Furthermore, the number of tender points was correlated with grip strength (ρ = -0.536, p < 0.001), walking speed (ρ = -0.200, p = 0.028), and SMI (ρ = -0.394, p < 0.001). The supraspinatus (p = 0.029, 95% confidence interval: 1.221-35.573) and lower cervical (p = 0.039, 95% confidence interval: 1.050-7.245) regions were identified as specific tender points. Conclusions: In older adult patients requiring long-term care, sarcopenia is associated with an increased number of tender points throughout the body, with the supraspinatus and lower cervical regions potentially being specific tender points. Acupressure testing for tenderness may be a useful assessment parameter in sarcopenia patients.

Comparison of the ability between dual-energy X-ray absorptiometry and bioelectrical impedance analysis for diagnosing low skeletal muscle mass and sarcopenia in patients with chronic liver disease.

Sarcopenia and osteoporosis adversely impact the clinical outcomes of patients with chronic liver disease (CLD). The Japan Society of Hepatology (JSH) sarcopenia criteria utilize bioelectrical impedance analysis (BIA) for assessing muscle mass rather than dual-energy X-ray absorptiometry (DXA), which can simultaneously diagnose these comorbidities. We investigated the correlations and interchangeability between the appendicular skeletal muscle mass index (ASMI) values determined using BIA and DXA and evaluated the diagnostic ability of DXA for sarcopenia and osteosarcopenia in patients with CLD. This cross-sectional study included 173 patients with CLD. Sarcopenia was defined as low ASMIBIA according to the JSH and Asian Working Group for Sarcopenia (AWGS) criteria (ASMIBIA cutoff) or low ASMIDXA according to the AWGS criteria (ASMIDXA cutoff) and low handgrip strength. For women, a provisional cutoff value was set for ASMIDXA using the ASMIBIA cutoff (ASMIDXA-altered cutoff). We found that ASMIBIA and ASMIDXA were significantly correlated (r=0.921; P<0.001). The Bland-Altman plots demonstrated substantial agreement between ASMIBIA and ASMIDXA, with a mean difference of 0.0116kg/m2. The prevalence rates of sarcopenia and osteosarcopenia diagnosed using the ASMIBIA cutoff were 26.0% and 17.3%, respectively. The kappa coefficients for the prevalence of sarcopenia and osteosarcopenia were 0.759 and 0.775 between ASMIBIA cutoff and ASMIDXA cutoff and 0.780 and 0.806 between ASMIBIA cutoff and ASMIDXA-altered cutoff, respectively. The utilization of DXA can facilitate the comprehensive assessment and management of musculoskeletal comorbidities in patients with CLD.

Clinical mechanism of muscle mass loss during neoadjuvant chemotherapy in older patients with esophageal cancer: a prospective cohort study.

In older patients with locally advanced esophageal cancer (LAEC), loss of skeletal muscle mass during neoadjuvant chemotherapy (NAC) is associated with poor clinical outcomes. This study aimed to investigate factors associated with loss of skeletal muscle mass during NAC in older patients with LAEC. This was a single-center exploratory prospective cohort study. Consecutive patients aged ≥65years with LAEC scheduled for curative esophagectomy after NAC were enrolled between October 2021 and December 2023. As a primary endpoint, loss of skeletal muscle mass index (ΔSMI: pre-NAC minus post-NAC value) was calculated from computed tomography images before and after NAC. Significant pre-NAC and during-NAC factors with ΔSMI were detected with a multivariate regression model. Statistical significance was considered as two-tailed P <0.05. A total of 69 patients were analyzed. The mean age was 72.9years, and 53 (77%) were male. Mean SMI before and after NAC was 43.1 and 40.9cm2/m2, and mean ΔSMI was 2.2cm2/m2. In multivariate analysis, ΔSMI was associated with increased sitting time during NAC (per 1min/day, adjusted coefficient 0.007, 95% confidence interval [CI] 0.001 to 0.013, P = 0.016), decreased Geriatric Nutritional Risk Index during NAC (per 1 score, adjusted coefficient -0.146, 95% CI -0.213 to -0.013, P = 0.002), and worsening decreased appetite during NAC (vs. no worsening, adjusted coefficient 1.571, 95% CI 0.279 to 2.862, P = 0.018). It was hypothesized that the inactivity-related mechanism and malnutrition-related mechanism are important for skeletal muscle mass loss during NAC in older patients with LAEC.

High Fat Mass Index is Associated with Endometrial Hyperplasia in Polycystic Ovary Syndrome Patients: A Retrospective Study.

To assess body composition, glucolipid metabolism, and uric acid levels in PCOS (Polycystic Ovary Syndrome) patients to determine their relationship with the risk of endometrial hyperplasia (EH). A total of 232 patients were included and divided into groups according to whether they had PCOS and endometrial pathology (Group A: non-PCOS and normal endometrium; Group B: PCOS and normal endometrium; Group C: non-PCOS and EH; Group D: PCOS and EH). Body composition differences between groups and correlations between body composition, glucolipid metabolism, and uric acid levels were analyzed. In Group D, the patient's PSM (Percent Skeletal Muscle) of Trunk, PBF (Percent Body Fat) of Arm, free mass index, FMI (Fat Mass Index), and appendicular skeletal muscle mass index were significantly higher than in Groups A, B, and C. Waist-hip rate, PBF, PBF of Trunk, PSM of Leg, skeletal muscle mass index and visceral fat level were significantly higher than in Groups A and B. FMI was an independent risk factor for EH in PCOS patients, the AUC for FMI prediction of endometrial hyperplasia in PCOS patients was 0.82. FMI had significant positive correlations with fasting glucose, fasting insulin, HOMA-IR (Homeostatic Model Assessment for Insulin Resistance), total cholesterol, triglyceride, low-density lipoprotein, triglyceride/high-density lipoprotein, and uric acid levels. FMI was correlated with HOMA-IR and uric acid at 0.602 and 0.649 respectively in PCOS patients. Increased FMI and altered glucolipid metabolism as key factors associated with a higher risk of EH in patients with PCOS. Monitoring body composition and metabolic health in PCOS patients could help identify those at greater risk of EH, guiding preventive interventions.