Occurrence Of Sarcopenia Research Articles

Function, sarcopenia and osteoporosis 10 years after a femoral neck fracture in patients younger than 70 years

Background and purposeA femoral neck fracture (FNF) may have long-term effects on the patient's function, also in patients younger than 70 years. These long-term effects are not well described, since most studies have short follow-ups. The aim of this study was to investigate clinical outcome by performance-based functional tests, hand grip strength, and hip function in different subgroups. The secondary aim was to study surgical complications, bone mineral density (BMD) and occurrence of sarcopenia 10 years after a FNF. Patients and methodsA prospective multicenter study with a 10-year follow-up of patients aged 20–69 years with a FNF treated with internal fixation (IF). Five-times sit-to-stand test (5TSST), 4-m walking speed test, hand grip strength (HGS) and Harris Hip Score (HHS) were performed.A radiographic examination of the hip was performed and re-operations were registered. Bone mineral density (BMD) at the hip, spine and total body composition were assessed with dual energy x-ray absorptiometry (DXA). Present sarcopenia was determined by the combination of reduced functional performance and low fat-free mass index (FFMI). ResultsA total of 58 patients were included. 5TSTS was normal in 45% of the patients and old age was associated with poorer performance (p<0.001). 76% of the study population had a normal speed gait and likewise, old age (p = 0.005) and walking aids (p = 0.001) were associated with poor performance. HGS was normal in 82% of the men and 64% of the women. HHS showed that 85% had a good/excellent function. A major re-operation was performed in 34% of the patients with displaced FNF and in 20% of patients with non-displaced FNF. 74% displayed osteopenia and 12% osteoporosis. 17% of the men and 38% of the women had sarcopenia. InterpretationThe majority of patients less than 70 years of age with a FNF treated with IF, had normal functional tests, muscle strength and a good hip function ten years post-operatively. However, one in ten had osteoporosis, and one third was sarcopenic which indicate the importance of encouraging regular muscle preserving resistance training after hip fracture.

Preoperative psoas muscle index a modern prognostic factor in the follow-up of patients with rectal cancer who underwent surgery

Abstract Background: The incidence of rectum cancer is rising worldwide. New prognostic factors need to be applied to improve patients’ prognosis. The incidence of sarcopenia has been observed in various malignancies. The quantity of skeletal muscle mass is reflected in the psoas muscle index (PMI), suggesting the presence of sarcopenia. Our aim is to investigate the association of postoperative prognosis of patients with rectum cancer with the occurrence of preoperative sarcopenia with quantitative and qualitative reduction of skeletal muscle mass. Material and method: We performed a multidisciplinary research and we examined patients diagnosed with rectal cancer. The PMI was determined at the lower edge of the L3 vertebral body, using CT scan. We present our research partial results within three cases. Results: The PMI of three male patients with rectum cancer who received neoadjuvant chemoradiotherapy was: Case 1 has a PMI of 7.378 cm2/m2, the mean psoas muscle density was 50.14 UH. Case 2 has a PMI of 6,942 cm2/m2 and a mean psoas density of 43.81 UH. Case 3 has a PMI of 8.4885 cm2/m2 and an average density of 43.85 UH in the right and left psoas. Conclusions: The PMI value can be calculated with simple radiologic measurements, thus determining the diagnosis of sarcopenia. Calculations are performed using standard preoperative CT-scans. A PMI value above the threshold limit is promising in the short term, but in the long term it is not responsible for the deterioration of patients’ general condition and tumor recurrence.

Characterization of the gut microbiota in hemodialysis patients with sarcopenia

PurposeMaintenance hemodialysis (MHD) patients are at high risk of sarcopenia. Gut microbiota affects host metabolic and may act in the occurrence of sarcopenia importantly. This study aimed to study the characterization of the gut microbiota in MHD patients with sarcopenia, and to further reveal the complex pathophysiology of sarcopenia in MHD patients.MethodsFecal samples and clinical data were collected from 30 MHD patients with sarcopenia, and 30 age-and-sex-matched MHD patients without sarcopenia in 1 general hospital of Jiangsu Province from December 2020 to March 2021. 16S rRNA sequencing technology was used to analyze the genetic sequence of the gut microbiota for evaluation of the diversity, species composition, and differential microbiota of the two groups.ResultsCompared to MHD patients without sarcopenia, the ACE index of patients with sarcopenia was lower (P = 0.014), and there was a structural difference in the β-diversity between the two groups (P = 0.001). At the genus level, the relative abundance of Tyzzerella_4 in the sarcopenia group was significantly higher than in the non-sarcopenia group (P = 0.039), and the relative abundance of Megamonas (P = 0.004), Coprococcus_2 (P = 0.038), and uncultured_bacterium_f_Muribaculaceae (P = 0.040) decreased significantly.ConclusionThe diversity and structure of the gut microbiota of MHD patients with sarcopenia were altered. The occurrence of sarcopenia in MHD patients may be influenced by gut microbiota.

Angiotensin II inhibition: a potential treatment to slow the progression of sarcopenia.

Sarcopenia is defined as the progressive and generalized loss of skeletal muscle mass and strength, which is associated with increased likelihood of adverse outcomes including falls, fractures, physical disability, and mortality. The etiology of sarcopenia has been postulated to be multifactorial with genetics, aging, immobility, nutritional deficiencies, inflammation, stress, and endocrine factors all contributing to the imbalance of muscle anabolism and catabolism. The prevalence of sarcopenia is estimated to range from 13 to 24% in adults over 60 years of age and up to 50% in persons aged 80 and older. As the population continues to age, the prevalence of sarcopenia continues to increase and is expected to affect 500 million people by the year 2050. Sarcopenia impacts the overall health of patients through limitations in functional status, increase in hospital readmissions, poorer hospital outcomes, and increase in overall mortality. Thus, there exists a need to prevent or reduce the occurrence of sarcopenia. Here, we explore the potential mechanisms and current studies regarding angiotensin receptor blockers (ARBs) and angiotensin-converting enzyme (ACE) inhibitors on reducing the development of sarcopenia through the associated changes in cardiovascular function, renal function, muscle fiber composition, inflammation, endothelial dysfunction, metabolic efficiency, and mitochondrial function.

Conditions associated with sarcopenia and sarcopenic obesity among community-dwelling older people

Objective: to investigate the factors associated with sarcopenia and sarcopenic obesity (SO) in community-dwelling older people. Methods: This was a cross-sectional community-based study. Sarcopenia was diagnosed according to the cutoff points of hand grip strength (HGS), and SO was identified through a low HGS concomitant with a high body fat percentage, according to sex, determined using electrical bioimpedance. Calorie and protein intake was estimated using a 24-hour recall. Socio-demographic data were obtained by means of an interview and the level of physical activity was assessed using a specific instrument. Results: Prevalence of 43% and 19.6% were observed for sarcopenia and SO, respectively. Older people aged ≥ 70 years have a significantly higher risk for sarcopenia in 183% (PR = 2.83; 95% CI = [1.62 to 4.96]; p value &lt; 0.001) compared to those aged 60 to 69 years. The prevalence of sarcopenia was higher in males, among those who contribute to family support, present comorbidities and are less physically active. The prevalence of SO and sarcopenia was high, but this study did not allow us to observe statistically significant associations. Calorie and protein intakes were predominantly inadequate throughout the sample, however, there was no association with sarcopenia and SO. Conclusion: Advance years of life was shown to be a factor associated with sarcopenia, and with SO. Contributing to family support and insufficient physical activity were determining conditions for the occurrence of sarcopenia.

A study of correlations between metabolic syndrome factors and osteosarcopenic adiposity

BackgroundAging reduces the quality and strength of bones and muscles and increases body fat, which can lead to the simultaneous occurrence of sarcopenia, osteopenia, and adiposity, a condition referred to as OsteoSarcopenic Adiposity (OSA).While previous studies have demonstrated that metabolic syndrome is associated with sarcopenia, osteopenia, and adiposity, the relationship between metabolic syndrome and OSA remains largely unknown.MethodsWe analyzed data for a sample of middle-aged individuals from a Health Management Center database, which was collected in 2016–2018. There are 2991 cases of people over 50 years from a physical examination center in a hospital in Taiwan during 2016–2018. In addition to descriptive statistics, chi-squared test, analysis of variance, and multinomial logistic regression analysis were conducted to examine OSA risk and associated factors.ResultsBased on multinomial logistic regression analysis, in different OSA severity level (1–3 more serious), those who are with metabolic syndrome has increased the 2.49–2.57 times risk of OSA (p < 0.001) in OSA = 2 and 3 groups while there is no significant difference in OSA =1 group.ConclusionThe prevalence of OSA may impair the health and quality of life in the elderly group, especially those diagnosed with metabolic syndrome, increasing the risk of OSA. These results can help promote early diagnosis and treatment of OSA in clinical settings, particularly among aging individuals with abnormal physical function, the group with the highest OSA incidence.

Effects of hormonal changes on sarcopenia in chronic kidney disease: where are we now and what can we do?

Sarcopenia or muscle wasting is a progressive and generalized skeletal muscle disorder involving the accelerated loss of muscle mass and function, often associated with muscle weakness (dynapenia) and frailty. Whereas primary sarcopenia is related to ageing, secondary sarcopenia happens independent of age in the context of chronic disease states such as chronic kidney disease (CKD). Sarcopenia has become a major focus of research and public policy debate due to its impact on patient's health‐related quality of life, health‐care expenditure, morbidity, and mortality. The development of sarcopenia in patients with CKD is multifactorial and it may occur independently of weight loss or cachexia including under obese sarcopenia. Hormonal imbalances can facilitate the development of sarcopenia in the general population and is a common finding in CKD. Hormones that may influence the development of sarcopenia are testosterone, growth hormone, insulin, thyroid hormones, and vitamin D. Although the relationship between free testosterone level that is low in uraemic patients and sarcopenia in CKD is not well‐defined, functional improvement may be seen. Unlike testosterone, it is known that vitamin D is associated with muscle strength, muscle size, and physical performance in patients with CKD. Outcomes after vitamin D replacement therapy are still controversial. The half‐life of growth hormone (GH) is prolonged in patients with CKD. Besides, IGF‐1 levels are normal in patients with Stage 4 CKD—a minimal reduction is seen in the end‐stage renal disease. Unresponsiveness or resistance of IGF‐1 and changes in the GH/IGF‐1 axis are the main causes of sarcopenia in CKD. Low serum T3 level is frequent in CKD, but the net effect on sarcopenia is not well‐studied. CKD patients develop insulin resistance (IR) from the earliest period even before GFR decline begins. IR reduces glucose utilization as an energy source by hepatic gluconeogenesis, decreasing muscle glucose uptake, impairing intracellular glucose metabolism. This cascade results in muscle protein breakdown. IR and sarcopenia might also be a new pathway for targeting. Ghrelin, oestrogen, cortisol, and dehydroepiandrosterone may be other players in the setting of sarcopenia. In this review, we mainly examine the effects of hormonal changes on the occurrence of sarcopenia in patients with CKD via the available data.

Malnutrition and Sarcopenia Combined Increases the Risk for Mortality in Older Adults on Hemodialysis.

Aim: Sarcopenia and malnutrition are highly prevalent in older adults undergoing hemodialysis (HD) and are associated with negative outcomes. This study aimed to evaluate the role of sarcopenia and malnutrition combined on the nutritional markers, quality of life, and survival in a cohort of older adults on chronic HD.Methods: This was an observational, longitudinal, and multicenter study including 170 patients on HD aged >60 years. Nutritional status was assessed by 7-point-subjective global assessment (7p-SGA), body composition (anthropometry and bioelectrical impedance), and appendicular skeletal muscle mass (Baumgartner's prediction equation). Quality of life was assessed by KDQoL-SF. The cutoffs for low muscle mass and low muscle strength established by the 2019 European Working group on sarcopenia for Older People (EWGSOP) were used for the diagnosis of sarcopenia. Individuals with a 7p-SGA score ≤5 were considered malnourished, individuals with low strength or low muscle mass were pre-sarcopenic, and those with low muscle mass and low muscle strength combined as sarcopenic. The sample was divided into four groups: sarcopenia and malnutrition; sarcopenia and no-malnutrition; no-sarcopenia with malnutrition; and no-sarcopenia and no-malnutrition. Follow-up for survival lasted 23.5 (12.2; 34.4) months.Results: Pre-sarcopenia, sarcopenia, and malnutrition were present in 35.3, 14.1, and 58.8% of the patients, respectively. The frequency of malnutrition in the group of patients with sarcopenia was not significantly higher than in the patients without sarcopenia (66.7 vs. 51.2%; p = 0.12). When comparing groups according to the occurrence of sarcopenia and malnutrition, the sarcopenia and malnutrition group were older and presented significantly lower BMI, calf circumference, body fat, phase angle, body cell mass, and mid-arm muscle circumference. In the survival analysis, the group with sarcopenia and malnutrition showed a higher hazard ratio 2.99 (95% CI: 1.23: 7.25) for mortality when compared to a group with no-sarcopenia and no-malnutrition.Conclusion: Older adults on HD with sarcopenia and malnutrition combined showed worse nutritional parameters, quality of life, and higher mortality risk. In addition, malnutrition can be present even in patients without sarcopenia. These findings highlight the importance of complete nutritional assessment in patients on dialysis.

Význam sarkopenie a myosteatózy u kandidátů transplantace jater na peritransplantační průběh a přežívání pacientů a štěpů

Introduction: Sarcopenia (severe muscle depletion) and myosteaosis (pathological fat accumulation in muscle) are frequent muscle abnormalities in patients with cirrhosis associated with unfavorable prognosis. The aim of our study was to evaluate the impact of sarcopenia and myosteatosis in liver transplant (LT) candidates in our center on the peritransplant course and patient and graft survival. Methods: This prospective study included adult LT candidates who underwent clinical and laboratory examination. The skeletal muscle index (SMI) at L3 level and radiodensity of psoas major muscle (PM-RA) were evaluated by CT. Results: Pretransplant sarcopenia was found in 49 of 103 patients (47.6%) and myosteatosis in 53 (51.5%) patients. Patients with sarcopenia had lower BMI, waist circumference, occurrence of hypertension and metabolic syndrome and lower triglyceride and C-peptide levels than patients without sarcopenia. Patients with myosteatosis had higher Child-Pugh score and lower HDL-cholesterol levels than patients without myosteatosis. Pretransplant SMI negatively correlated with the amount of blood transfusions given during LT and occurrence of biliary complications. Patients with myosteatosis had higher need for blood transfusions during LT and after LT, and higher number of surgical revisions. Occurrence of sarcopenia had no significant effect on patient and graft survival. Patients with myosteatosis had worse long-term survival than patients without myosteatosis, the graft survival did not differ. Conclusion: Sarcopenia and myosteatosis are frequent muscle abnormalities in LT candidates with negative impact on peritransplant course. Myosteatosis was associated with a worse long-term survival in our study. Key words: sarcopenia – myosteatosis – liver transplantation – prevalence – complications – survival

Influencing Factors and Molecular Pathogenesis of Sarcopenia and Osteosarcopenia in Chronic Liver Disease

The liver plays a pivotal role in nutrient/energy metabolism and storage, anabolic hormone regulation, ammonia detoxification, and cytokine production. Impaired liver function can cause malnutrition, hyperammonemia, and chronic inflammation, leading to an imbalance between muscle protein synthesis and proteolysis. Patients with chronic liver disease (CLD) have a high prevalence of sarcopenia, characterized by progressive loss of muscle mass and function, affecting health-related quality of life and prognosis. Recent reports have revealed that osteosarcopenia, defined as the concomitant occurrence of sarcopenia and osteoporosis, is also highly prevalent in patients with CLD. Since the differentiation and growth of muscles and bones are closely interrelated through mechanical and biochemical communication, sarcopenia and osteoporosis often progress concurrently and affect each other. Osteosarcopenia further exacerbates unfavorable health outcomes, such as vertebral fracture and frailty. Therefore, a comprehensive assessment of sarcopenia, osteoporosis, and osteosarcopenia, and an understanding of the pathogenic mechanisms involving the liver, bones, and muscles, are important for prevention and treatment. This review summarizes the molecular mechanisms of sarcopenia and osteosarcopenia elucidated to data in hopes of promoting advances in treating these musculoskeletal disorders in patients with CLD.

Association Between Interleukin-12 and Sarcopenia.

BackgroundEmerging studies have proposed that cytokines secreted following macrophage polarization may contribute to skeletal muscle aging. The current study primarily aimed to determine whether these cytokines have an impact on the progression of sarcopenia in an elderly population.MethodsIn total, 120 elderly adults aged 65 years and older who underwent health examinations from 2015 to 2019 were included in this retrospective study. Sarcopenia was based on the criteria proposed by the European Working Group on Sarcopenia in Older People in 2019. Macrophages and cytokines datasets were obtained from Gene Expression Omnibus (GEO) database. Comprehensive assessments were performed for muscle strength, muscle mass, gait speed, tumor growth factor-β (TGF-β), and interleukin-12 (IL-12). Thereafter, the association between sarcopenia and cytokines was analyzed using regression models.ResultsLow muscle strength and low-speed gait were negatively associated with IL-12 [β: −8.96 (95% CI: −14.12, −3.79) and −7.16 (95% CI: −12.54, −1.78), respectively]. Participants with more sarcopenia components and more severe sarcopenia had lower IL-12 (P for trend < 0.001). Conversely, more amount of sarcopenia components were associated with increased TGF-β (P for trend < 0.05). A definite diagnosis of sarcopenia was associated with decreased IL-12 and increased TGF-β with β of −8.96 (95% CI: −14.12, −3.79) and 147.75 (95% CI: 36.27, 259.23). Furthermore, increased IL-12 levels were significantly associated with reduced occurrence of sarcopenia with and odd ratio (OR) of 0.36 (95% CI: 0.15–0.834).ConclusionOur findings on the relationship between cytokines and age-related muscle loss showed that IL-12 may be an early diagnosis indicator for sarcopenia in the elderly population.

Chrono-Nutrition Has Potential in Preventing Age-Related Muscle Loss and Dysfunction.

The mammalian circadian clock systems regulate the day–night variation of several physiological functions such as the sleep/wake cycle and core body temperature. Disturbance in the circadian clock due to shiftwork and chronic jetlag is related to the risk of several disorders such as metabolic syndrome and cancer. Recently, it has been thought that shiftwork increases the risk of sarcopenia which is characterized by age-related decline of muscle mass and its dysfunctions including muscle strength and/or physical performance. First, we summarize the association between circadian rhythm and the occurrence of sarcopenia and discuss its mechanistic insight by focusing on the muscle function and molecular clock gene in knockout or mutant mice. The clock gene knockout or mutant mice showed early aging phenotypes, including low survival rate and muscle loss. It suggests that improvement in the disturbance of the circadian clock plays an important role in the aging process of healthy muscles. Nutritional intake has the potential to augment muscle growth and entrain the peripheral clock. Second, we discuss the potential of chrono-nutrition in preventing aging-related muscle loss and dysfunction. We also focus on the effects of time-restricted feeding (TRF) and the distribution of protein intake across three meals.

Cross-sectional associations among P3NP, HtrA, Hsp70, Apelin and sarcopenia in Taiwanese population

BackgroundSarcopenia is a multifactorial pathophysiologic condition of skeletal muscle mass and muscle strength associated with aging. However, biomarkers for predicting the occurrence of sarcopenia are rarely discussed in recent studies. The aim of the study was to elucidate the relationship between sarcopenia and several pertinent biomarkers.MethodsUsing the Gene Expression Omnibus (GEO) profiles of the National Center for Biotechnology Information, the associations between mRNA expression of biomarkers and sarcopenia were explored, including high temperature requirement serine protease A1 (HtrA1), procollagen type III N-terminal peptide (P3NP), apelin, and heat shock proteins 70 (Hsp72). We enrolled 408 community-dwelling adults aged 65 years and older with sarcopenia and nonsarcopenia based on the algorithm proposed by the Asian Working Group for Sarcopenia (AWGS). Muscle strength is identified by hand grip strength using an analogue isometric dynamometer. Muscle mass is estimated by skeletal mass index (SMI) using a bioelectrical impedance analysis. Physical performance is measured by gait speed using 6 m walking distance. The associations between these biomarkers and sarcopenia were determined using receiver operating characteristic (ROC) curve analysis and multivariate regression models.ResultsFrom the GEO profiles, the sarcopenia gene set variation analysis score was correlated significantly with the mRNA expression of APLNR (p < 0.001) and HSPA2 (p < 0.001). In our study, apelin was significantly associated with decreased hand grip strength with β values of − 0.137 (95%CI: − 0.229, − 0.046) in men. P3NP and HtrA1 were significantly associated with increased SMI with β values of 0.081 (95%CI: 0.010, 0.153) and 0.005 (95%CI: 0.001, 0.009) in men, respectively. Apelin and HtrA1 were inversely associated with the presence of sarcopenia with an OR of 0.543 (95%CI: 0.397–0.743) and 0.003 (95%CI: 0.001–0.890) after full adjustment. The cutoff point of HtrA1 was associated with the presence of sarcopenia with an OR of 0.254 (95%CI: 0.083–0.778) in men. The cutoff point of apelin was negatively associated with the presence of sarcopenia with an OR of 0.254 (95%CI: 0.083–0.778).ConclusionOur study highlights that P3NP, HtrA, and apelin are useful for diagnosis of sarcopenia in the clinical setting.

Effects of progressive elastic band resistance exercise for aged osteosarcopenic adiposity women.

Osteosarcopenic adiposity (OSA), which is described as the concurrent occurrence of osteopenia, sarcopenia, and adiposity, can lead to frailty and increase the risk of physical disability in elderly women. Progressive elastic band resistance exercise training (peRET) is considered a safe and feasible exercise intervention for elderly women with sarcopenic obesity. This study investigated the effects of elastic band resistance exercise on the physical capacity and body composition of elderly women with osteosarcopenic adiposity. A total of 15 and 12 women were randomly assigned to the experimental (12weeks of resistance exercise) and control groups (no exercise intervention), respectively. Lean mass (measured using a dual-energy X-ray absorptiometer) and physical capacity assessments (such as timed up and go test and single leg stance tests) were conducted at baseline, 12weeks (end of intervention), and 6months after the intervention. Outcome differences within the study and control groups were analyzed using repeated-measures analysis of variance with a post-hoc test. The Mann-Whitney U test was used to examine differences between groups at different time points. After the intervention, no body composition changes in muscle mass and fat were observed between the study and control groups. Moreover, muscle mass and fat body composition did not significantly differ at different time points. The bone density was higher in the study group, with a higher T-score than their baseline values, but did not significantly differ compared with the control group. The study group exhibited more improved physical function than the control group, but the effect did not last after 6months of follow-up. A 12-week progressive elastic band resistance training program effectively increased the physical capacity and improved the bone density; however, without persistent training, the positive effect diminished at 6-month follow-up.

Sarcopenia is associated with the presence of nonalcoholic fatty liver disease in Zhejiang Province, China: a cross-sectional observational study

BackgroundCurrently, both non-alcoholic fatty liver disease (NAFLD) and sarcopenia have attracted extensive attention in public health. However, the relationship between NAFLD and sarcopenia remains unclear. This study aimed to clarify the sex-specific association between sarcopenia and NAFLD according to the Asian Working Group for Sarcopenia (AWGS).MethodsDual-energy X-ray absorptiometry (DXA) and hepatic ultrasonography were measured in 578 participants (92 men and 486 women) during their annual health examinations. Multivariate logistic regression models were used to explore the association between NAFLD and sarcopenia with its two components.ResultsA total of 154 participants (30 men and 124 women) had NAFLD. The prevalence of sarcopenia was higher among the participants with NAFLD than among those without NAFLD (men: 20.0% vs. 9.7%, P = 0.295, women: 15.3% vs. 8.0%, P = 0.019). Low muscle mass (LMM) was independently associated with NAFLD in both men and women (men: odds ratio [OR], 2.88; 95% confidence interval [CI] 1.52–5.46; women: OR, 2.08; 95% CI 1.63–2.67). However, low muscle strength (LMS) was independently associated with NAFLD only in male participants, with an OR of 1.15 (95% CI 1.02–1.28).ConclusionThe occurrence of sarcopenia was associated with a higher risk of NAFLD, especially in men, as demonstrated by lower muscle mass and lower muscle strength.

Mitochondrial Quality Control in Sarcopenia: Updated Overview of Mechanisms and Interventions.

Sarcopenia is a common geriatric disorder characterized by decreased muscle strength, low muscle mass and poor physical performance. This aging-related skeletal muscle deterioration leads to adverse outcomes and severely impairs the quality of life of patients. The accumulation of dysfunctional mitochondria with aging is an important factor in the occurrence and progression of sarcopenia. Mitochondrial quality control (MQC) fundamentally ensures the normal mitochondrial functions and is comprised of four main parts: proteostasis, biogenesis, dynamics and autophagy. Therefore, any pathophysiologic factors compromising the quality control of homeostasis in the skeletal muscle may lead to sarcopenia. However, the specific theoretical aspects of these processes have not been fully elucidated. Current therapeutic interventions using nutritional and pharmaceutical treatments show a modest therapeutic efficacy; however, only physical exercise is recommended as the first-line therapy for sarcopenia, which can ameliorate skeletal muscle deficiency by maintaining the homeostatic MQC. In this review, we summarized the known mechanisms that contribute to the pathogenesis of sarcopenia by impairing normal mitochondrial functions and described potential interventions that mitigate sarcopenia through improving MQC.

Anthropometric indicators as a discriminator of sarcopenia in community-dwelling older adults of the Amazon region: a cross-sectional study

BackgroundSarcopenia is a geriatric syndrome associated with negative health outcomes and the use of viable alternative screening tools may help in the diagnosis of this condition. This study aimed to analyze the association of sarcopenia with anthropometric indicators among community-dwelling older adults and to identify cut-off points for such indicators as a discriminant criterion for predicting sarcopenia.MethodsThis was a cross-sectional study conducted on community-dwelling older adults ≥60 years old (n = 411) of both sexes from Macapá, Amapá, Brazil. Socioeconomic, clinical and anthropometric data (arm circumference - AC, waist circumference - WC, calf circumference - CC and body mass index – BMI) were collected using a structured form. Sarcopenia was identified according to the EWGSOP 2 consensus. The association between anthropometric indicators and sarcopenia was performed using logistic regression and cut-off points established from the ROC Curve. Statistical significance was defined as p ≤ 0.05.ResultsAdjusted analysis indicated an independent and inverse association between sarcopenia and the anthropometric indicators: AC (odds ratio, OR: 0.63; 95% confidence interval, 95%CI: 0.53–0.76), CC (OR: 0.73; 95%CI: 0.62–0.85), WC (OR: 0.93; 95%CI: 0.90–0.97) and BMI (OR: 0.64; 95%CI: 0.53–0.76). The following cut-off points for older men and women represented the discriminant criterion for the presence of sarcopenia: WC (≤97 and ≤ 86 cm), CC (≤33 and ≤ 31 cm), AC (≤27 cm) and BMI (≤24.8 kg/m2 and ≤ 24.5 kg/m2) (area under the ROC curve superior to 0.70). BMI and AC were the indicators with the highest ability to discriminate older adults of both sexes with sarcopenia.ConclusionsAn increase of one unit of the indicators can reduce the probability of occurrence of sarcopenia. All indicators were considered to discriminate the occurrence of sarcopenia, with emphasis on BMI and AC, and could be used to screen for this condition among community-dwelling older adults.

Impact of CT-based body composition parameters at baseline, their early changes and response in metastatic cancer patients treated with immune checkpoint inhibitors

PurposeCT-based Body-composition (BC) parameters correlate with the patients’ outcome in metastatic cancer patients treated with chemotherapies or targeted therapies. Our aim was to investigate similar associations regarding immune checkpoint inhibitor (CPI). MethodsPatients were consecutively included as they were treated with CPI at our institution for a metastatic solid cancer with baseline CT-scan (CT0) and early evaluation CT-scan (CT1, 2 months later). At each evaluation, the areas corresponding to psoas muscles alone, skeletal muscle, subcutaneous, visceral and total adipose tissues at L3 vertebral level were extracted and weighted by height2, providing PMI, SMI, SATI, VATI and TATI, respectively, and their changes (Δt-) from the first day of treatment to CT1. Correlations between continuous BC-parameters and progression free survival (PFS) were evaluated in men, women and whole population with univariate Cox regressions. After dichotomizing the BC-parameters per whole-population and sex-specific tertiles, uni- and multivariate Cox models were built to identify independent predictors of the PFS. ResultsBetween December 2013 and December 2016, 117 patients were included (55 women, mean age: 62.4) and 78 showed a progression (median PFS = 125 days, 95 %CI = 87–117). Changes in BC-parameters did not depend on sex. None of the baseline BC-parameters correlated with PFS while Δt-PMI and Δt-SATI did (multivariate HR = 2.41, p = 0.0008 and HR = 2.82, p = 0.0004, respectively). ConclusionsThe occurrence of subcutaneous adipopenia and sarcopenia after beginning CPI treatment, estimated through Δt-SATI and Δt-PMI, correlated with higher risk of progression.

Associations between sarcopenia and white matter alterations in older adults with diabetes mellitus: A diffusion tensor imaging study.

Aims/IntroductionOlder adults with diabetes mellitus are susceptible to sarcopenia. Diffusion tensor imaging studies have also shown that patients with diabetes have altered white matter integrity. However, the relationship between these structural changes in white matter and sarcopenia remains poorly understood.Materials and MethodsThe study included 284 older patients (aged ≥65 years) who visited the Tokyo Metropolitan Geriatric Hospital Frailty Clinic. We used diffusion tensor imaging to measure fractional anisotropy (FA) and mean diffusivity (MD) to evaluate changes in white matter integrity. We investigated the associations between sarcopenia, or its diagnostic components, and FA or MD in seven white matter tracts considered to be associated with sarcopenia according to the patients’ diabetes status.ResultsWe found significantly low FA or high MD values in the bilateral anterior thalamic radiations (ATR) and right inferior fronto‐occipital fasciculus (IFOF) of patients with Asian Working Group for Sarcopenia 2019‐defined sarcopenia, in all patients and those with diabetes. Using binominal regression analyses, we associated low FA values in the left ATR and right IFOF with sarcopenia in all patients and those with diabetes, after adjusting for age, gender, HbA1c, blood pressure, cognitive function, physical activity, depression, nutritional status, and inflammation.ConclusionsWhite matter alterations in left ATR and right IFOF are associated with the prevalence of sarcopenia in patients with diabetes. Specific changes to the left ATR and right IFOF tracts could play critical roles in the occurrence of sarcopenia in patients with diabetes.

Sarcopenic obesity: Myokines as potential diagnostic biomarkers and therapeutic targets?

Sarcopenic obesity (SO) is a condition characterized by the occurrence of both sarcopenia and obesity and imposes a heavy burden on the health of the elderly. Controversies and challenges regarding the definition, diagnosis and treatment of SO still remain because of its complex pathogenesis and limitations. Over the past few decades, numerous studies have revealed that myokines secreted from skeletal muscle play significant roles in the regulation of muscle mass and function as well as metabolic homeostasis. Abnormalities in myokines may trigger and promote the pathogenesis underlying age-related and metabolic diseases, including obesity, sarcopenia, type 2 diabetes (T2D), and SO. This review mainly focuses on the role of myokines as potential biomarkers for the early diagnosis and therapeutic targets in SO.