Muscle Mass Index Research Articles

Association between changes in body composition and progression of liver fibrosis in patients with type 2 diabetes mellitus.

The correlation between type 2 diabetes mellitus (T2DM) and the occurrence of liver fibrosis is well-established. However, the longitudinal association between body composition and liver fibrosis progression in patients with T2DM remains incompletely explored. Total of 390 patients with T2DM underwent body composition assessments, followed by a median duration of 2.13 years. The calculated parameters included body mass index (BMI), fat mass index (FMI), trunk fat mass index (TFMI), appendicular skeletal muscle mass index (ASMI), muscle/fat mass ratio (M/F) and appendicular skeletal muscle mass/trunk fat mass ratio (A/T). Liver fibrosis was evaluated through liver stiffness measurement (LSM). Patients were classified according to BMI and body composition, followed by a comprehensive investigation into the impact of body composition changes on liver fibrosis outcomes. Among 72 patients with incident advanced liver fibrosis at readmission, ΔBMI, ΔFMI and ΔTFMI increased, while ΔM/F and ΔA/T decreased. Individuals who kept obese had a dramatically elevated hazard of incident advanced liver fibrosis compared to those who kept non-obese, with an adjusted odds ratio of 3.464. When TFMI heightened, the hazard of incident advanced liver fibrosis was 3.601 times higher compared to the decreased group. Additionally, individuals in increased ASMI and A/T groups showed a slight advantage in preventing incident advanced liver fibrosis compared to the stable groups. Stable obesity was associated with a greater hazard of liver fibrosis advancement, and an increase in TFMI may promote the progression of liver fibrosis. Maintaining a balanced muscle/fat ratio appeared to help prevent the progression.

Association of alpha-actinin-3 genotype with muscle mass and physical function in community-dwelling older adults.

Polymorphisms (rs1815739; R577X) in the gene encoding alpha-actinin-3 (ACTN3) are thought to be associated with body composition and physical function in older people and athletes. RR homozygotes are associated with greater expression of ACTN3 protein in muscle than the X-allele carriers. We aimed to investigate the association between ACTN3 R577X polymorphism and appendicular skeletal muscle mass, walking speed, and muscle strength in older adults. A cross-sectional analysis was performed on 265 community-dwelling older adults (mean age 74.0 ± 5.8years, 63.4% female) who provided data on ACTN3 gene polymorphisms and completed surveys in the Tarumizu study conducted between 2018 and 2019. Genetic polymorphisms were categorized as RR homozygous and X allele. Muscle mass was assessed using the appendicular skeletal muscle mass index (ASMI), and physical function was assessed based on walking speed and relative muscle strength. Those in the bottom 25% for each sex were considered "low" and the association with ACTN3 genotype was examined. Considering ACTN3 polymorphism, 72 participants were RR homozygotes (27.2%) and 193 were X-allele carriers (72.8%). After adjusting for potential confounders, RR homozygosity was associated with not having low muscle mass (odds ratio 0.39, 95% confidence interval 0.19-0.82, p = 0.013) but not with low walking speed and muscle strength. The association between ACTN3 genotype and physical function in community-dwelling older adults is not clear; however, it is considered to be associated with muscle mass.

Frailty or sarcopenia: which is a better indicator of mortality risk in older adults?

BackgroundDespite the different conditions, frailty and sarcopenia overlap regarding their common link: the assessment of walking speed and muscle strength. This study aimed to compare the frailty phenotype to the...

Examination of Sarcopenia with Obesity as a Prognostic Factor in Patients with Colorectal Cancer Using the Psoas Muscle Mass Index

Background: Sarcopenia, the age-related loss of muscle mass, is a negative prognostic factor in gastrointestinal cancer. Sarcopenia combined with visceral obesity (sarcopenic obesity) is associated with poor outcomes. We explored the influence of obesity and other factors on the prognosis of patients with colorectal cancer diagnosed with sarcopenia. Methods: We enrolled 211 patients with colorectal cancer diagnosed with preoperative sarcopenic obesity who underwent radical resection at Osaka University Hospital between January 2009 and January 2012. Muscle mass was assessed using the psoas muscle mass index. Obesity was evaluated by measuring the visceral fat area in the umbilical region. Patients were categorized into two groups: sarcopenia with obesity (SO) and sarcopenia without obesity (non-SO). Overall survival, cancer-specific survival, and cancer-related relapse-free survival (CRRFS) were compared between the two groups. Patient characteristics, including age, sex, body mass index, serum albumin, C-reactive protein, tumor markers, prognostic nutritional index (PNI), modified Glasgow prognostic score (mGPS), and geriatric nutritional risk index (GNRI), were also analyzed. Results: CRRFS was significantly shorter in the SO group than in the non-SO group (p = 0.028). PNI, mGPS, and GNRI were not identified as significant prognostic factors for CRRFS. Multivariate analysis highlighted sarcopenic obesity, elevated carcinoembryonic antigen levels, and unfavorable histological types as significant predictors of poor CRRFS outcomes. Conclusions: Sarcopenic obesity is an independent predictor of poor prognosis in patients with CRC. Thus, interventions aimed at increasing muscle mass and reducing visceral fat could potentially improve the prognosis of these patients.

Retinol-binding protein 4 is a potential biomarker of changes in lean mass in postmenopausal women.

Identifying biomarkers can help in the early detection of muscle loss and drive the development of new therapies. Research suggests a potential link between retinol-binding protein 4 (RBP4) and muscle mass, particularly in postmenopausal women. This study aimed to examine the association between baseline RBP4 levels and changes in appendicular lean mass (ALM), an indicator of muscle mass, in postmenopausal women. A 12-month follow-up period (n=153) included baseline and 12-month ALM assessments using DXA. ALM was normalized to squared height (ALMI). Baseline evaluations encompassed insulin resistance via HOMA-IR and immunoassay magnetic bead panel measurements of RPB4, IL-6, TNF-α, and IL-10. Postmenopausal women were categorized into higher (n=77) and lower (n=76) RPB4 groups based on baseline RPB4 values. Their changes in ALMI were compared using Mann-Whitney tests. General linear model was employed to evaluate the predictive power of baseline RBP4 for ALMI changes, adjusting for confounding variables: age, physical activity, smoking status, body fat, HOMA-IR, inflammatory markers (TNF-α and IL-6), and anti-inflammatory factor (IL-10). The higher RBP4 group exhibited a more pronounced reduction in ALMI compared to the lower RBP4 group (Higher RBP4 = -0.39kg/m2, 95% CI: -0.48 to -0.31kg/m2vs. Lower RBP4 = -0.24kg/m2, 95% CI: -0.32 to -0.15kg/m2, P=0.011). After adjusting for confounding factors, the association between baseline RBP4 changes and ALMI remained (b = -0.008, SE=0.002, P<0.001), indicating higher baseline RBP4 values linked to greater ALMI reduction. Our findings support RBP4 as a potential biomarker for changes in muscle mass in postmenopausal women.

Low muscle strength rather than low muscle mass is associated with cardiovascular autonomic neuropathy in patients with type 2 diabetes

Several studies have investigated whether sarcopenia is associated with diabetic microvascular complications, but very few have examined associations between sarcopenia and cardiovascular autonomic neuropathy (CAN) in patients with type 2 diabetes mellitus (T2DM). Therefore, we investigated associations of muscle strength (handgrip strength [HGS]) and mass (appendicular skeletal muscle mass index [ASMI]) and CAN in patients with T2DM. We enrolled 342 patients in this retrospective, cross-sectional study. Cardiovascular reflex tests were used to assess CAN according to Ewing’s protocol. Relative HGS was determined after normalizing absolute HGS to body weight (HGS/body weight [kg]). We defined low HGS and low ASMI according to a consensus report of the Asian Group for Sarcopenia. Logistic regression analyses were carried out to assess the associations between relative HGS or ASMI quartiles and the presence of CAN in patients with T2DM. The prevalence rates of CAN, low HGS, and low ASMI in the study subjects were 34.8%, 17.3%, and 18.7%, respectively. Low HGS was significantly more prevalent in patients with CAN than those without CAN (23.5% vs. 13.9%, p = 0.025). The CAN scores were significantly and negatively correlated with relative HGS but not with ASMI. Relative HGS was negative correlated with age, glycated hemoglobin, fasting plasma glucose, hsCRP, body mass index, and HOMA-IR and positively correlated with ASMI. The prevalence of CAN gradually increased with decreasing quartile of relative HGS (28.4% in Q4, 31.8% in Q3, 34.2% in Q2, and 45.3% in Q1, p = 0.02 for trend). Multivariable-adjusted prevalence ratios (PRs) for CAN, determined by comparing the first, second, and third quartiles with the fourth quartile of relative HGS, were 4.4 with a 95% confidence interval (95% CI) of [1.1 to 17.3]), 2.3 (95% CI [0.8 to 6.9]), and 1.2 (95% CI [0.4 to 3.7]), respectively. The prevalence of CAN and the PRs (95% [CI]) for CAN based on ASMI were not statistically significant. Our findings suggest that low muscle strength rather than low muscle mass was significantly associated with the presence of CAN. Therefore, HGS testing could help identify patients who would benefit from screening for earlier diagnosis of CAN.

Comparison of the influence of postoperative oral nutritional supplementation between octogenarian and non-octogenarian patients undergoing gastrectomy for cancer.

Despite recent reports, the effectiveness of postoperative oral nutritional supplementation (ONS) on body weight loss and malnutrition after gastrectomy remains controversial. We aimed to elucidate the effectiveness of ONS especially in octogenarian patients undergoing oncological gastrectomy. A total of 286 consecutive patients who underwent gastrectomy for gastric cancer were eligible. Postoperative body weight loss, malnutrition, and sarcopenia were compared between patients with and without postoperative ONS among octogenarian patients aged ≥ 80 years and non-octogenarian patients aged < 80 years. In this study, 36 (62.1%) octogenarian and 121 (53.1%) non-octogenarian patients continued postoperative ONS for three months. The clinicopathologic characteristics were not different between the ONS (-) and ONS (+) groups among the octogenarian and non-octogenarian patients. The changes in body weight and serum albumin levels at postoperative 1 year were different between the ONS (-) and ONS (+) groups (P = 0.03 and P = 0.04, respectively) among the octogenarian patients, but not between the two groups among the non-octogenarian patients (P = 0.99 and P = 0.29, respectively). Also, the decline in psoas muscle mass index at postoperative 6 months and 1 year was significantly lower in the ONS (+) group than in the ONS (-) group (P < 0.01 and P < 0.01, respectively). In addition, similar results were found in octogenarian patients who underwent distal gastrectomy. Postoperative ONS could prevent body weight loss, malnutrition, and sarcopenia especially in octogenarian patients who underwent gastrectomy for gastric cancer.

Neuromuscular Electrical Stimulation Under Deep Sedation Reduces the Incidence of ICU-Acquired Weakness in Critically Ill Patients With COVID-19 With Acute Respiratory Distress Syndrome.

The COVID-19 pandemic has led to an unprecedented increase in cases of acute respiratory distress syndrome (ARDS). In such cases, deep sedation using sedatives and muscle relaxants is commonly used to prevent patient self-inflicted lung injury during the early phase. However, such sedation limits the ability to perform early rehabilitation, leading to ICU-acquired muscle weakness (ICU-AW) and a worse prognosis. This study aimed to clarify the preventive effect of neuromuscular electrical stimulation (NMES) during deep sedation on ICU-AW and physical function at discharge in critically ill patients with COVID-19 with ARDS. A retrospective, single-center study was conducted on patients admitted to the ICU or advanced critical care center with severe COVID-19 with ARDS between March 1, 2020, and March 31, 2022. Patients who were managed with the Richmond Agitation-Sedation Scale between -4 and -5 for at least three days were included. Patients in the NMES group received NMES within two days of deep sedation, whereas those in the non-NMES group did not. The primary endpointwasthe incidence of ICU-AW at discharge from the ICU, and the secondary endpoints included physical activity levels, skeletal muscle mass index, time to active mobilization, and Barthel index (BI) at discharge. Statistical analyses included Pearson's chi-squared test, Fisher's exact test, and multiple logistic and linear regression analyses. Of the 129 patients, 68 (54 males and 14 females) were included after applying the exclusion criteria, with 38 in the NMES group and 30 in the non-NMES group. The incidence of ICU-AW was significantly lower in the NMES group (28.95% vs. 56.67%, p = 0.0211). NMES implementation (OR: 0.20, p = 0.03), ventilator weaning (OR: 0.10, p = 0.01), and duration of deep sedation (OR: 0.81, p < 0.01) were significant predictors of ICU-AW. Higher ICU Mobility Scale scores and shorter time to active mobilization were associated with a higher BI at discharge. Early rehabilitation using NMES during deep sedation may prevent ICU-AW in critically ill patients with COVID-19 with ARDS. NMES is associated with a reduced risk of ICU-AW and improved functional independence at discharge. This procedure can be safely performed in sedated patients and may help prevent ICU-AW, supporting early mobilization strategies in ARDS rehabilitation.

8413 Skeletal Muscle Mass, Insulin Sensitivity, And Beta-Cell Function In The Development Of Type 2 Diabetes: A 16-Year Prospective Cohort Study

Abstract Disclosure: H. Mun: None. S. Lee: None. S. Kim: None. S. Yoo: None. J. Son: None. Background: The relationship of relative muscle mass with beta-cell dysfunction and insulin resistance in the development of type 2 diabetes is unclear. We therefore aimed to evaluate longitudinal changes in glycemia, insulin sensitivity, and beta-cell function according to muscle mass. Methods: We prospectively evaluated 7090 middle-aged and older participants without diabetes at baseline every 2 years with oral glucose tolerance tests for 16 years in the Korean Genome Epidemiology Study. Weight-adjusted appendicular skeletal muscle mass was used to derive the muscle mass index (MMI). Using linear mixed-effect models, we assessed trajectories of fasting and 2-hour post-load glucose (2hPG), the composite insulin sensitivity index (ISIcomp), the 60-minute insulinogenic index (IGI60), and the disposition index (DI) according to sex-specific MMI tertiles before diagnosis with type 2 diabetes or the completion of follow-up. Results: During a median follow-up of 13.9 years, 1742 (24.5%) participants were diagnosed with type 2 diabetes. The risk of developing type 2 diabetes gradually increased as MMI decreased (multivariable-adjusted hazard ratio 1.36; 95% CI 1.29; 1.44 per SD decline in MMI). After age- and sex adjustment, significant differences were found in fasting and 2hPG trajectories between low and high MMI tertiles during follow-up (p &amp;lt; 0.001 for group-by-time interaction). The low MMI tertile showed significantly lower ISIcomp and DI at baseline compared to the high MMI tertile. The rate of increase in IGI60 was significantly lower in the low MMI tertile than in the high MMI tertile (0.0021 vs. 0.0191; p &amp;lt; 0.001) despite a progressive decline in ISIcomp during follow-up. The rate of decrease in DI was significantly greater in the low MMI tertile than in the high MMI tertile (-0.0228 vs. -0.006; p &amp;lt; 0.001). Conclusion: Sufficient muscle mass in middle-aged and older adults could protect against incident type 2 diabetes by preserving beta-cell function to compensate for aging-induced reductions in insulin action, independent of obesity. Presentation: 6/1/2024

7785 Muscle Strength and Physical Performance Are Closely Related to Muscle Quality Regardless of Muscle Mass or Diabetes Status

Abstract Disclosure: J. Seo: None. I. Jung: None. S. Park: None. D. Lee: None. J. Yu: None. H. Cho: None. K. Kim: None. E. Song: None. K. Kim: None. N. Kim: None. H. Yoo: None. S. Kim: None. K. Choi: None. N. Kim: None. C. Shin: None. Weakness or slowness is essential to define sarcopenia rather than less muscle mass. Myosteatosis is associated with low muscle strength and poor physical performance, and ectopic fat deposition is a characteristic of diabetes (DM). We investigated the association between muscle strength/physical performance and myosteatosis by considering DM status and muscle mass in community-dwelling older adults. A total of 982 subjects (447 men and 535 women) aged 54-83 years in 8th examination of the Korean Genome and Epidemiology Study Ansan cohort participated in this study. Handgrip strength (HSG), 4-m walking velocity (VEL) and 30-Seconds Sit-to-Stand Test (STST) were checked, appendicular skeletal muscle mass (ASM) and total muscle mass (TMM) by DXA were measured. In midthigh CT image, total muscle area (TMA) was measured and categorized into 3 components using Hounsfield Unit (HU): normal-attenuation muscle area (NAMA, 35-100HU), low-attenuation muscle area (LAMA, 0-34HU), and inter/intramuscular adipose tissue (IMAT) area. As muscle quality indices, the NAMA index, LAMA index, and IMAT index were defined by dividing each parameter by TMA. DM was diagnosed by fasting glucose ≥126 mg/dL, 2hr-OGTT glucose ≥200 mg/dL, HbA1c ≥6.5% or anti-diabetic medication. Subjects with DM (38% of total subjects) had higher age and body mass index (BMI) compared to non-DM subjects. Prevalence of low muscle mass (M:&amp;lt;7.0kg/m2, F:&amp;lt;5.4kg/m2 of ASM/height2) was not statistically different by the presence of DM (DM vs non-DM, 11.7% vs 9.7% in men, 3.6% vs 7.6% in women). However, prevalence of low HGS (M:&amp;lt;28kg, F:&amp;lt;18kg) and slow VEL (&amp;lt;1.0m/sec) was higher in DM subjects than non-DM subjects (DM vs non-DM, low HSG: 18.3% vs 5.6% in men, 28.0% vs 17.3% in women, slow VEL: 40.6% vs 30.7% in men, 61.7% vs 46.2% in women). After adjusting for age and BMI, men with DM had lower muscle mass (ASM, ASM/height2,), TMA and NAMA index but higher LAMA index and IMAT index compared to men without DM. Also, men with DM had lower HGS (p=0.001) and poor STST (p=0.008) than men without DM. In women, muscle mass and muscle quality indices were not significantly different with or without DM, but women with DM had worse STST than women without DM (p=0.013). Age and sex adjusted HSG, but not VEL and STST, was positively associated with muscle mass (ASM, ASM/height2, ASM/BMI, and TMM). Age and sex adjusted HSG, VEL, and STST were positively associated with NAMA index and negatively associated with LAMA index and IMAT index regardless of DM. Linear regression analysis revealed that both ASM and NAMA (or LAMA) indices were independent association factors for HGS. Subjects with DM showed a more pronounced decrease in physical performance and muscle strength than a decrease in muscle mass. In this population-based cohort, less myosteatosis was associated with greater muscle strength and better physical performance, regardless of muscle mass or DM status. Presentation: 6/2/2024

Effects of over 10 weeks of resistance training on muscle and bone mineral density in older people with sarcopenia over 70 years old: A systematic review and meta-analysis of randomized controlled trials

ObjectiveWe aimed to examine the effects of more than 10 weeks of resistance training (RT) on muscle structure, muscle function, and bone mineral density (BMD) in older people with sarcopenia over 70 years old MethodsPubMed, Web of Science, Embase, MEDLINE, Cochrane Library, and CINAHL databases were searched for randomized controlled trials. Standardized mean difference (MD) or standard mean difference (SMD) was used to pool the effect of the RT intervention ResultsThirteen studies with 2080 older adults with sarcopenia were included. Resistance exercise significantly affected handgrip strength (MD = 1.67 kg; P = 0.02) and isometric muscle strength (standard mean difference [SMD] = 0.53; P = 0.02). Significant differences in chair stand test (SMD = 0.40; P = 0.02) and skeletal muscle mass index (mean difference [MD] = 1.67 kg/m2; P = 0.0002) were found between the RT and control groups ConclusionMore than 10 weeks of RT has beneficial effects on muscle but no favorable effect on BMD in older people with sarcopenia over 70 years old.

Low serum Metrnl levels are associated with increased risk of sarcopenia in the older adults.

Sarcopenia is a geriatric syndrome characterized by progressive loss of muscle mass and function. Meteorin-like (Metrnl) is a secretory protein that has protective effects on skeletal muscle injury. However, the association of Metrnl level with sarcopenia remains unclear. A total of 772 community-dwelling older adults (median age = 76years), comprising 409 males and 363 females, from both urban and rural areas were enrolled. Serum Metrnl was measured by enzyme-linked immunosorbent assay. Appendicular skeletal muscle mass index (ASMI), grip strength, and gait speed were measured for the assessment of sarcopenia. We found that serum Metrnl levels were lower in patients with sarcopenia [median (IQR) = 180.1 (151.3-220.3) pg/mL] than older adults without sarcopenia [211.9 (163.2-270.0) pg/mL, P < 0.001]. Receiver-operating characteristic curve analysis showed that the optimal cut-off value of serum Metrnl level that predicted sarcopenia was 197.2pg/mL with a sensitivity of 59.2% and a specificity of 63.8% (AUC = 0.63, 95% CI = 0.59-0.67, P < 0.001). Multivariate logistic regression analyses showed that lower serum Metrnl level (< 197.2pg/mL) was significantly associated with increased risk of sarcopenia (adjusted OR = 2.358, 2.36, 95% CI = 1.528-3.685, P < 0.001). Moreover, serum Metrnl concentration was positively correlated with the components of sarcopenia including ASMI (r = 0.135, P < 0.001), grip strength (r = 0.102, P = 0.005), and gait speed (r = 0.106, P = 0.003). Taken together, our findings demonstrate that low serum Metrnl level is correlated with increased risk of sarcopenia in the older adults.

Creatinine clearance/eGFR ratio: a simple index for muscle mass related to mortality in ICU patients

IntroductionIn patients admitted to the intensive care unit (ICU), muscle mass is inversely associated with mortality. Although muscle mass can be estimated with 24-h urinary creatinine excretion (UCE), its use for risk prediction in individual patients is limited because age-, sex-, weight- and length-specific reference values for UCE are lacking. The ratio between measured creatinine clearance (mCC) and estimated glomerular filtration rate (eGFR) might circumvent this constraint. The main goal was to assess the association of the mCC/eGFR ratio in ICU patients with all-cause hospital and long-term mortality.MethodsThe mCC/eGFR ratio was determined in patients admitted to our ICU between 2005 and 2021 with KDIGO acute kidney injury (AKI) stage 0–2 and an ICU stay ≥ 24 h. mCC was calculated from UCE and plasma creatinine and indexed to 1.73 m2. mCC/eGFR was analyzed by categorizing patients in mCC/eGFR quartiles and as continuous variable.ResultsSeven thousand five hundred nine patients (mean age 61 ± 15 years; 38% female) were included. In-hospital mortality was 27% in the lowest mCC/eGFR quartile compared to 11% in the highest quartile (P < 0.001). Five-year post-hospital discharge actuarial mortality was 37% in the lowest mCC/eGFR quartile compared to 19% in the highest quartile (P < 0.001). mCC/eGFR ratio as continuous variable was independently associated with in-hospital mortality in multivariable logistic regression (odds ratio: 0.578 (95% CI: 0.465—0.719); P < 0.001). mCC/eGFR ratio as continuous variable was also significantly associated with 5-year post-hospital discharge mortality in Cox regression (hazard ratio: 0.27 (95% CI: 0.22—0.32); P < 0.001).ConclusionsThe mCC/eGFR ratio is associated with both in-hospital and long-term mortality and may be an easily available index of muscle mass in ICU patients.

Creatinine Filtration as a Novel Index of Muscle Mass and Adverse Outcomes among Older Adults

Creatinine Filtration as a Novel Index of Muscle Mass and Adverse Outcomes among Older Adults

Creatinine Filtration as an Indicator of Muscle Mass and Functional Status in Older Adults

Creatinine Filtration as an Indicator of Muscle Mass and Functional Status in Older Adults

Site-specific skeletal muscle mass and functional prognosis in geriatric stroke patients

BackgroundEvidence is scarce regarding prognostic value of site-specific muscle mass in geriatric stroke survivors. We aim to assess the association between four measures of muscle mass, namely the skeletal muscle mass index of the limbs (SMI), upper limb SMI (USMI), lower limb SMI (LSMI), and trunk muscle mass index (TMI), and the functional prognosis in stroke patients. MethodsThis study conducted a retrospective cohort analysis involving post-acute stroke inpatients. Muscle mass data were obtained through bioelectrical impedance analysis and computed by dividing each muscle mass by the square of the height. The study outcomes included the Functional Independence Measure (FIM) motor at discharge and FIM-motor gain. Multiple regression analysis was conducted to assess the association between SMI, USMI, LSMI, and TMI with outcomes, while adjusting for confounding factors. ResultsA total of 701 patients (mean age 72.8 years, 374 males) were analyzed. As a result, LSMI (β = 0.089, P = 0.003) and SMI (β = 0.083, P = 0.008) were significantly associated in the FIM-motor at discharge, with LSMI showing a stronger association. USMI (β = 0.019, P = 0.521) and TMI (β = 0.035, P = 0.231) showed no significant association. LSMI (β = 0.124, P = 0.003) and SMI (β = 0.116, P = 0.008) were significantly associated with FIM-motor gain; however, USMI (β = 0.027, P = 0.521) and TMI (β = 0.049, P = 0.231) showed no significant association with FIM-motor gain. ConclusionsDifferential associations were observed between site-specific muscle mass and functional prognosis in post-stroke patients. Among these, lower limb muscle mass was most strongly associated with activities of daily living (ADL) recovery.

Prognostic Value of Skeletal Muscle Mass and Body Mass Index in PKD

Prognostic Value of Skeletal Muscle Mass and Body Mass Index in PKD

Muscle Mass, Muscle Strength, and Health-Related Quality of Life in Kidney Transplant Recipients: Results of the TransplantLines Biobank and Cohort Study

IntroductionMuscles are crucial for daily activities, and kidney transplant recipients (KTR) often have reduced muscle mass and strength. We aimed to investigate the potential relationship of muscle mass and strength with physical health-related quality of life (HRQoL) in KTR. MethodsData from the TransplantLines Biobank and Cohort Studies were used. Muscle mass was assessed with appendicular skeletal muscle mass index (ASMI) and 24-hour urinary creatinine excretion rate index (CERI). Muscles strength was assessed by handgrip strength index (HGSI). HRQoL was measured using Short Form 36 physical component score (PCS). ResultsWe included 751 KTR (61% male, mean age 56±13y, median 3y post-transplant). Ordinary least squares regression analyses demonstrated that lower ASMI, CERI and HGSI were all non-linearly associated with lower PCS, independent of potential confounders and each other. Below median values, ASMI, CERI and HGSI were each associated with PCS, whereas above median values, associations were less pronounced. Compared to the 50th percentile, a decrease to the 10th percentile was associated with a decrease in PCS of 4.8% for ASMI (P=0.011), of 5.1% for CERI (P=0.008) and 13.2% for HGSI (P<0.001), whereas an increase to the 90th percentile was associated with an increase in PCS of only 0.7% for ASMI (P=0.54), of 3.6% for CERI (P=0.05) and -0.4% for HGSI (P=0.73). ConclusionsLow muscle mass and strength are potentially modifiable risk factors for impaired physical HRQoL in KTR. The non-linear associations suggest that KTR with low muscle mass or strength may particularly benefit from (p)rehabilitation interventions to improve HRQoL.

Evaluating Respiratory Muscle Strength in Sarcopenia Screening among Older Men in South Korea: A Retrospective Analysis.

To evaluate the potential of incorporating respiratory muscle strength, specifically maximal inspiratory pressure (MIP), and maximal expiratory pressure (MEP), along with traditional sarcopenia screening measures such as hand grip strength (HGS) and skeletal muscle mass index (SMI), to identify sarcopenia in older men. A retrospective analysis was conducted involving male patients aged 65 years and older who underwent measurements of respiratory muscle strength, HGS, and muscle mass at a general hospital in Korea from July 2016 to May 2022. Statistical analysis utilized independent t-tests and receiver operating characteristic (ROC) curves to assess the sensitivity and specificity of MIP, MEP, HGS, and SMI in sarcopenia screening. The cut-off values for sarcopenia screening were determined based on the area under the ROC curve (AUC). The analysis of 282 study participants revealed the following cut-off values for sarcopenia based on the AUC: for MIP, the cut-off value was 65.50 cmH2O (AUC=0.70, sensitivity: 0.63, specificity: 0.61), while for MEP, it was 84.50 cmH2O (AUC=0.74, sensitivity: 0.66, specificity: 0.68). This study showed the utility of respiratory muscle strength in screening for sarcopenia among older men. We suggest the screening cut-off values as 65.50 cmH2O for MIP and 84.50 cmH2O for MEP. Even when HGS and SMI measurements are not feasible, sarcopenia can be reasonably predicted based on respiratory muscle strength.

Association between improved dysphagia and increased trunk muscle mass in older patients with stroke undergoing convalescent rehabilitation

ObjectiveThe association between dysphagia and activities of daily living in patients with stroke has been reported, but the effect of improved dysphagia on the increase in trunk muscle mass is not clear. The aim of this study was to investigate the relationship between improved dysphagia and increased trunk muscle mass in older patients with stroke. Research Methods & ProceduresThis retrospective, case-control study enrolled patients with stroke aged ≥65 years. Dysphagia was evaluated using the Kuchi-Kara Taberu (KT) index. Patients were classified into two groups according to KT index at discharge: improved dysphagia group (≥ 57 scores) and non-improved dysphagia group (< 57 scores). The primary outcome of the study was trunk muscle mass index (TMI) gain from admission to discharge. Multiple regression analysis was performed to investigate the association between trunk muscle mass gain and improved dysphagia. ResultsThere were 153 participants with a mean age of 79.8 ± 7.7 years, and 89 (58%) were classified in the improved dysphagia group. The TMI gain was greater in the improved dysphagia group compared to that in the non-improved group. Multiple regression analysis showed that improved dysphagia (β: 0.776, 95% confidence interval: 0.643 to 0.909, p < 0.001) was independently associated with TMI gain. ConclusionImproved dysphagia was independently associated with trunk muscle mass gain, suggesting that improved dysphagia is important for trunk muscle mass gain in patients with stroke.