Odds Ratio Of Sarcopenia Research Articles

Dietary selenium intake and sarcopenia in American adults.

The relationship between dietary selenium intake and sarcopenia remains poorly understood. Therefore, this study investigates the associations between dietary selenium intake and sarcopenia among American adults. This cross-sectional study analyzed data from 19,696 participants in the National Health and Nutrition Examination Survey (NHANES) for the periods 1999-2006 and 2011-2018. Appendicular muscle mass, assessed using dual-energy x-ray absorptiometry and adjusted for body mass index, was used as a marker for sarcopenia. Dietary selenium intake was evaluated using the 24-h dietary recall system, and the study accounted for the complex sampling methodology and incorporated dietary sample weights in the analysis. Among the 19,696 participants, the prevalence of sarcopenia was found to be 8.46%. When compared to the lowest quintile of dietary selenium intake (Q1, < 80.10 μg/day), the odds ratios for sarcopenia in the second quintile (Q2, 80.10-124.61 μg/day) and the third quintile (Q3, >124.61 μg/day) were 0.80 [95% confidence interval (CI): 0.70-0.92, p = 0.002] and 0.61 (95% CI: 0.51-0.73, p < 0.001), respectively. A negative relationship was observed between dietary selenium intake and sarcopenia (non-linear: p = 0.285). Furthermore, sensitivity analyses revealed a robust association between selenium intake and the prevalence of sarcopenia after further adjusting for blood selenium levels. The results suggest an inverse association between dietary selenium intake and the prevalence of sarcopenia among American adults.

FRI052 Z-score Of The Log-transformed A Body Shape Index As A Screening Tool For Sarcopenia In Population With Central Obesity

Abstract Disclosure: H. Chung: None. Background: Sarcopenic obesity is related with a higher risk of cardiovascular disease, metabolic disease, and mortality than obesity alone. Nevertheless, few studies have investigated body shape indices for the assessment of sarcopenia in obese populations. The purpose of this study was to evaluate the accuracy of the Z-score of the log-transformed A Body Shape Index (LBSIZ) to assess sarcopenia in nationally representative populations with central obesity. Methods: Data from Korea NHANES (KNHANES) and the U.S. National Health and Nutrition Examination Survey (U.S. NHANES) were evaluated. Sarcopenia for the Korean population it was defined when appendicular skeletal mass index (ASMI ) &amp;lt; 7 kg/m2 in men or ASMI &amp;lt; 5.4 kg/m2 in women, according to the Asian Working Group for Sarcopenia and for the American population was defined when ASMI &amp;lt; 7 kg/m2 in men or ASMI &amp;lt; 5.5 kg/m2 in women, according to the revised European consensus on definition and diagnosis for sarcopenia. LBSIZ cut-off value was defined as that with the highest score of the Youden’s index. Changes in odds ratios (OR) for sarcopenia were investigated using restricted cubic spline (RCS) plots. Results: This study was conducted for population with central obesity in 4,855 Koreans and 8,010 Americans. Among these, 330 Koreans and 373 Americans were accompanied with sarcopenia. The cut-off values for the LBSIZ were 1.15 (sensitivity, 78%; specificity, 77%) for Korean men, 0.95 (sensitivity, 74%; specificity, 69%) for Korean women, 1.05 (sensitivity, 88%; specificity, 82%) for American men, and 0.45 (sensitivity, 77%; specificity, 71%) for American women in the development groups. Comparable results were verified in validation groups. The RCS plot indicated that ORs for sarcopenia rapidly increased with an increase in the LBSIZ cut-off value. Conclusion: The LBSIZ index is a powerful and reliable indicator of sarcopenia in adults with central obesity. Presentation: Friday, June 16, 2023

The High Prevalence of Sarcopenia in Rheumatoid Arthritis in the Korean Population: A Nationwide Cross-Sectional Study.

Rheumatoid arthritis (RA) includes musculoskeletal symptoms that lead to disuse atrophy of muscles and changes in body composition. Musculoskeletal symptoms and loss of physical function may be associated with sarcopenia, which is characterized by muscle loss. This study aimed to investigate the prevalence of sarcopenia and its association with RA in a Korean population. We analyzed nationwide data from the Korea National Health and Nutrition Examination Survey of 7389 men and 9798 women. Binomial logistic regression models were used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) for sarcopenia prevalence in participants with RA. The prevalence of sarcopenia was 23.0% in men, 25.0% in women, 61.5% in men with RA, 32.3% in women with RA, 22.8% in men without RA, and 24.9% in women without RA. After adjusting for potential confounding variables, the prevalence of sarcopenia was higher in men with RA than in men without RA (OR, 3.11; 95% CI, 1.29-7.46), but this difference was not observed in women. In subgroup analysis which was stratified by age (age under 40, age between 40 and 59, age over 60), the OR for sarcopenia was higher in men with age over 60 years (OR, 4.12; 95% CI, 1.48-11.44) and women with age between 40 and 59 (OR, 2.29; 95% CI, 1.05-5.00). The prevalence of sarcopenia was higher in Korean men with RA and women with RA in middle age, suggesting the management of muscle loss will be needed, especially in Koreans with RA.

Effects of exercise habits in adolescence and older age on sarcopenia risk in older adults: the Bunkyo Health Study.

Sarcopenia, defined as an age-associated loss of skeletal muscle mass and function, is a major risk factor for requiring long-term care. Because physical activity in adolescence and older age enhances peak muscle function in youth and prevents muscle function decline in older age, older adults with exercise habits during both periods may be at a lower risk for sarcopenia. We investigated the relationship between exercise habits in adolescence and older age and sarcopenia and its components in community-dwelling older Japanese adults. This study included 1607 community-dwelling individuals (aged 65-84, medians 73years, 679 men and 928 women) with complete health examinations, including measurements of skeletal muscle index, handgrip strength and gait speed, who were enrolled in the Bunkyo Health Study. We divided the participants into four groups according to exercise habits in adolescence and older age: no exercise in either period (none-none; NN), exercise only in adolescence (active-none; AN), exercise only in older age (none-active; NA) and exercise in both periods (active-active; AA). Multivariate-adjusted logistic regression models were used to estimate the odds ratios (ORs) and associated 95% confidence intervals (CIs) in each group for the prevalence of sarcopenia, defined as low muscle mass and low muscle performance, as compared with the NN group. Low muscle performance was defined as low muscle strength and/or low gait speed. The total prevalence of sarcopenia was 6.6% (45/679) in men and 1.7% (16/928) in women, the total prevalence of low muscle mass was 14.3% (97/679) in men and 5.2% (48/928) in women, and the total prevalence of low muscle performance was 25.6% (174/679) in men and 19.6% (182/928) in women. In men, the ORs (95% CIs) for sarcopenia, low muscle mass and low muscle performance were significantly lower in the AA group (sarcopenia: 0.29 [0.09-0.95], P=0.041; low muscle mass: 0.21 [0.09-0.52], P=0.001; and low muscle performance: 0.52 [0.28-0.97], P=0.038). In women, the OR (95% CI) for low muscle performance was significantly lower in the AA group than in the other groups (0.48 [0.27-0.84], P=0.010), whereas none of the ORs for sarcopenia and low muscle mass were significant. Older men with exercise habits in both adolescence and older age were at a lower risk of sarcopenia, low muscle mass and low muscle performance, whereas older women with exercise habits at both time periods were at a lower risk of low muscle performance.

Association between Active Mobility Index and sarcopenia among Japanese community-dwelling older adults.

BackgroundA physically active lifestyle, including physical and social activities, is needed to maintain muscle mass, strength, and physical performance. A large life space characterizes an active lifestyle, but the association between life space with physical and social activities and sarcopenia is unclear. This study aimed to examine the association between life space with physical and social activities, assessed using the Active Mobility Index (AMI), and sarcopenia in community‐dwelling Japanese older adults.MethodsThis study used a large, cross‐sectional cohort dataset from the National Center for Geriatrics and Gerontology‐Study of Geriatric Syndromes (NCGG‐SGS). Between 2013 and 2018, community‐dwelling Japanese adults aged ≥60 years participated in the NCGG‐SGS. Sarcopenia was identified by measuring muscle mass and strength based on the clinical definition. The secondary outcomes were sarcopenia indices, including lower muscle mass, lower muscle strength, and lower gait speed. AMI assessed life space with physical and social activities in each life space (distance from the respondent's home: <1, 1–10, or >10 km) during the past month by noting the frequency, primary purpose, type of transportation, interaction with others, and physical activity. The associations between quartile groups of AMI total, physical, and social scores and sarcopenia were examined using a logistic regression model.ResultsFrom all participants, 21 644 participants (age 73.5 ± 5.8 years, 54.7% female) were included in the analysis. The prevalence of sarcopenia was 4.1% (n = 894). For the AMI total score, referred to Q1 group, Q3 and Q4 groups were significantly associated with a reduced odds ratio (OR) of sarcopenia after adjusting for all covariates [adjusted OR (aOR) (95% confidence interval), Q3: 0.71 (0.57–0.89), Q4: 0.69 (0.55–0.87)]. Q3 and Q4 of the AMI physical score groups were also significantly associated with reduced OR of sarcopenia [Q3: 0.71 (0.57–0.89), Q4: 0.67 (0.54–0.84)]. For the AMI social score, only the Q4 group showed reduced OR for sarcopenia [0.79 (0.62–1.01)]. Q3 and Q4 of the AMI total score and physical score were associated with reduced OR of all sarcopenia indices (aOR 0.55–0.82, all P < 0.05), whereas Q4 of AMI social score was associated with all indices (aOR 0.85–0.81, all P < 0.05).ConclusionsThe extent of life space with physical activity was associated with sarcopenia in community‐dwelling older adults. A longitudinal study is needed to examine whether life space with physical and social activities affect the development of sarcopenia.

Association of physical activity with sarcopenia evaluated based on muscle mass and strength in older adults: 2008\u20132011 and 2014\u2009\u2212\u20092018 Korea National Health and Nutrition Examination Surveys

BackgroundAdequate physical activity (PA) is essential for preventing sarcopenia in older adults. However, there are insufficient epidemiological data on the intensity of PA needed to prevent age-related sarcopenia. The purpose of this study was to investigate the association of PA intensity with skeletal muscle mass and muscle strength.MethodsThis was a population-based study with a cross-sectional design that was conducted using data from the 2008 − 2011 and 2014 − 2018 Korea National Health and Nutrition Examination Surveys, which included a total of 11,162 participants aged ≥ 60 years. PA was assessed using the results of a questionnaire and organized by intensity, frequency, and duration. The study population was divided into the following groups based on PA intensity: no exercise, walking only, moderate PA, and vigorous PA. To assess sarcopenia, skeletal muscle index (SMI) and hand grip strength (HGS) were measured as indicators of muscle mass and strength, respectively. Logistic regression analysis was used to explore the relationship between PA intensity and sarcopenia.ResultsSMI and HGS were significantly higher in men and women engaged in moderate to vigorous PA than in those who did not exercise. The odds ratios (ORs) for sarcopenia defined based on SMI and HGS were lowest in men engaged in vigorous PA (0.444, 95% confidence interval [CI]: 0.242 − 0.818 and 0.450, 95% CI: 0.228 − 0.890, respectively). In women, the OR for sarcopenia defined based on HGS was the lowest in the group engaged in vigorous PA (0.441, 95% CI: 0.199 − 0.975), while there was no risk reduction for sarcopenia defined based on SMI.ConclusionsModerate to vigorous PA was highly correlated with SMI and HGS in men and women. Intensive PA was positively correlated with sarcopenia prevention, which can be monitored using HGS.

Car Driving Status and Living Arrangement Associated with Sarcopenia among Rural Japanese Older Adults: A Cross-Sectional Study.

Ensuring mobility after driving cessation is an important public health issue to prevent functional limitations, but this issue is still not fully understood in rural settings. The aim of this study was to test the hypothesis that being a non-driver and living alone is associated with a greater risk of sarcopenia among the community-dwelling elderly in rural Japanese areas. This study was conducted in 2018 and data from 738 participants were used. Sarcopenia was assessed by measuring walking speed, handgrip strength, and skeletal muscle mass. Car driving status and living arrangement were collected using self-reported questionnaires and face-to-face interviews. Four groups were set to determine combined conditions of car driving status and living arrangement. Logistic regression analysis was performed to estimate the odds ratio (OR) and a 95% confidence interval of sarcopenia after adjustment for confounding factors. Compared with the reference group (driver and living with others), the OR of sarcopenia was significantly higher in the non-driver and living alone group (OR = 2.21; 95% confidence interval, 1.02–4.80). Our findings suggest that the consideration of both driving status and living arrangement are important in the formulation of public health strategies to prevent sarcopenia in rural Japanese areas.

Sarcopenia is highly prevalent in children with autoimmune liver diseases and is linked to visceral fat and parent-perceived general health.

Patients with autoimmune hepatitis (AIH) and primary or autoimmune sclerosing cholangitis are at nutritional risk; their body composition and has not been extensively studied. We aimed to describe their body composition and identify clinical links. Using magnetic resonance imaging (MRI), two reviewers segmented total psoas muscle area (tPMSA), visceral fat area (VFA) and subcutaneous fat area (mm2 ) and measured visceral and subcutaneous thickness (mm). Clinical, laboratory and quality of life (QoL; using PedsQL) data were collected. Sarcopenia was defined as tPMSA ≤5th percentile. Analysis of variance, Wilcoxon rank test and multivariable modelling were performed. A paediatric cohort with non-alcoholic fatty liver disease (NAFLD) was used as a comparator following propensity score matching. Fifty-eight patients with autoimmune liver disease (AILD) (33 [57%] with AIH) were included: median age 16years (interquartile range [IQR]: 13-18), 33 (57%) male. Median time from diagnosis to MRI was 15months (IQR: 2-39months). Two patients (3%) had a BMIz indicative of mild malnutrition. tPMSA was measurable in 52 subjects (90%). Of those, 25 (48%) had sarcopenia. Sarcopenic patients had a lower blood urea nitrogen compared to non-sarcopenic (median [IQR]: 9.5 [8.0, 12.0] vs 11 [10, 14]mg/dL; P=.023). There was no difference in corticosteroid use between groups. The VFA of sarcopenic patients was higher (3156 [2064, 7492]) vs 2084 [688, 3092])mm2 ; P=.005). Patient-reported QoL negatively associated with VFA and general health negatively associated with VFA. Compared with NAFLD, the odds ratio for sarcopenia with AILD was 14.5 (95% confidence interval: 2.3-90.7). In autoimmune liver diseases, sarcopenia is highly prevalent, associated with increased visceral fat and QoL.

Computed tomography–defined low skeletal muscle mass as a prognostic marker for short-term mortality in critically ill patients: A systematic review and meta-analysis

ObjectiveLow skeletal muscle mass (LSMM) can be assessed by imaging modalities and is associated with several clinically relevant factors in critically ill patients. Our aim was to establish the effect of computed tomography (CT)–defined LSMM on short-term mortality in critically ill patients based on a large patient sample. MethodsThe MedLine library and the Cochrane and SCOPUS databases were screened for associations between CT-defined LSMM and short-term mortality in critically ill patients up to May 2021. The primary endpoint of the systematic review was the odds ratio of sarcopenia on mortality. In total, nine studies were selected as suitable for the analysis and included into the present analysis. ResultsThe studies included a total of 1563 critically ill patients with different underlying diagnoses. The pooled overall prevalence of LSMM was 50.9%. The pooled odds ratio for the effect of sarcopenia on short-term mortality was 2.78 (95% confidence interval, 2.05–3.75). ConclusionsCT-defined LSMM is highly prevalent in critically ill patients, has a relevant effect on short-term mortality, and should be included as a relevant prognostic biomarker in clinical routines.

Association of nutrient-derived dietary patterns with sarcopenia and its components in community-dwelling older Japanese: a cross-sectional study

BackgroundDiet is a modifiable factor affecting sarcopenia, and accumulating evidence links dietary factors to muscle mass, strength, and function in older adults. However, few studies have examined the association of dietary patterns with sarcopenia. This study examined the association of dietary patterns derived by reduced-rank regression (RRR) with sarcopenia and its components in community-dwelling older Japanese.MethodsWe conducted a cross-sectional study of 1606 community-dwelling adults aged 65 years or older. Dietary intake was assessed by a validated, self-administered diet history questionnaire. Nutrient-derived dietary patterns were identified by using RRR, with sarcopenia-related nutrients (protein, vitamin D, vitamin C, vitamin E, folate, vitamin K, magnesium, iron, and calcium intakes) as response variables. Sarcopenia was defined by using the algorithm of the Asian Working Group for Sarcopenia 2019. Multivariate regression and logistic regression were used to examine the association of dietary patterns with sarcopenia and its components.ResultsThe first RRR dietary pattern was characterized by high intakes of fish, soybean products, potatoes, most vegetables, mushrooms, seaweeds, and fruit and a low intake of rice and was associated with decreased prevalence of sarcopenia: the multivariable-adjusted odds ratio of sarcopenia was 0.57 (95% confidence interval, 0.34–0.94; p for trend=0.022) in the highest versus the lowest tertile of dietary pattern. This dietary pattern was also significantly positively associated with usual gait speed (β: 0.02, p=0.024).ConclusionsA dietary pattern characterized by high intakes of fish, soybean products, potatoes, most vegetables, mushrooms, seaweeds, and fruits and low rice intake was inversely associated with sarcopenia in community-dwelling older Japanese.

Z-score of the log-transformed A Body Shape Index predicts low muscle mass in population with abdominal obesity: The U.S. and Korea National Health and Nutrition Examination Survey

Background and objectiveSarcopenic obesity is associated with a higher risk of cardiometabolic disease and mortality than either sarcopenia or obesity alone. However, no study has investigated body shape indices for the assessment of sarcopenia in obese populations. Thus, this study aimed to evaluate the accuracy of body shape indices to assess sarcopenia in nationally representative populations with abdominal obesity.MethodsData from the U.S. National Health and Nutrition Examination Survey (U.S. NHANES) 1999–2006 and Korea NHANES (KNHANES) 2008–2011 were assessed. The association between Body Shape Index and sarcopenia was analyzed using a receiver operating characteristic curve. The Z-score of the log-transformed A Body Shape Index (LBSIZ) cut-off value was defined as that with the highest score of the Youden’s index. Changes in odds ratios (OR) for sarcopenia were investigated using restricted cubic spline (RCS) plots.ResultsThis study included 8,013 American and 4,859 Korean adults with abdominal obesity. The overall area under the curve (AUC) of LBSIZ for sarcopenia was 0.816 (95% CI: 0.794–0.838) in U.S. NHANES and 0.822 (95% CI: 0.799–0.844) in KNHANES, which was higher than that of the body roundness index, conicity index, and waist to height ratio (p with DeLong’s test <0.001). The cut-off values for the LBSIZ were 1.05 (sensitivity, 88.0%; specificity, 81.5%) for American men, 0.45 (sensitivity, 77.1%; specificity, 70.6%) for American women, 1.15 (sensitivity, 77.5%; specificity, 77.1%) for Korean men and 0.95 (sensitivity, 74.3%; specificity, 69.3%) for Korean women in the development groups. Comparable results were verified in validation groups. The RCS plot indicated that ORs for sarcopenia rapidly increased with an increase in the LBSIZ cut-off value.ConclusionThe increased LBSIZ could function as a reliable and cost-effective screening tool for assessing low muscle mass in populations with abdominal obesity.

Sarcopenia is associated with insomnia in Japanese older adults: a cross-sectional study of data from the Nagasaki Islands study

BackgroundSarcopenia is associated with increased mortality among older adults. Sleep-related problems have been studied as factors related to sarcopenia. This study was conducted to determine the relationship between sleep-related problems and sarcopenia among Japanese community-dwelling older adults using data from the Nagasaki Islands Study.MethodsThis cross-sectional study analyzed data collected from 2017 to 2018. A total of 1592 older adults (575 men, 36.1%) aged 65 years or older participated. Sarcopenia was evaluated using the skeletal muscle mass index and grasp powers based on the criteria of the Asian Working Group for Sarcopenia. Odds ratios for sarcopenia were calculated using logistic regression analysis. Furthermore, subgroup analysis was performed based on the following tertiles of age: 65–70 years, 71–78 years, and 79–98 years.ResultsThe number of participants with sarcopenia was 238 (14.9%). The median age of participants in the sarcopenia group (80 years; interquartile range: 74–84) was significantly higher than in the non-sarcopenia group (73 years; interquartile range 69–79; P < 0.001). In the sarcopenia group, 70.9% of participants had difficulty initiating and/or maintaining sleep, sleep duration tended to be longer (P < 0.001), and 33.3% of participants’ sleep duration was over 9 h. In a logistic regression analysis for sarcopenia, advancing age was the most prominent factor, and the adjusted odds ratio (95% confidence interval) of facing difficulty initiating and/or maintaining sleep was 1.60 (1.14–2.25). Despite longer sleep duration being a significant factor in the univariable analysis, it was not significant in the multivariable analysis. In the logistic regression analysis for sarcopenia among older adults aged 79–98 years, the odds ratio (95% confidence interval) among women was significantly low at 0.53 (0.33–0.83).ConclusionsSarcopenia is associated with difficulty initiating and/or maintaining sleep among Japanese older adults. In sarcopenia control measures, sleep/wake disorders related to insomnia are required to be evaluated in detail to help inform nursing and medical policy.

Sarcopenia in people living with the Human Immunodeficiency Virus: a systematic review and meta-analysis.

People living with HIV (PLHIV) experience greater loss of muscle mass and function than people without HIV. However, HIV is not routinely recognized as a sarcopenia risk factor outside of HIV literature. The purposes of this study were to establish the prevalence and predictors of sarcopenia among PLHIV, and to compare the prevalence of sarcopenia among PLHIV and people without HIV. A systematic literature search of the PubMed, Embase, Cinahl, and Scielo databases was performed following PRISMA and MOOSE guidelines. Identified articles were included if they evaluated sarcopenia among PLHIV using either the presence of low muscle mass only or low muscle mass in association with low muscle function. The pooled prevalence of sarcopenia among PLHIV and the odds ratio for sarcopenia in PLHIV compared with controls were calculated. From 13 studies and 2267 participants, the prevalence of sarcopenia among PLHIV was 24.1% (95% CI = 17.8-31.0%). PLHIV presented 6.1 greater odds (95% CI = 1.1-33.5) of sarcopenia compared with people without HIV, matched by age, sex, BMI, and ethnicity. Longer exposure to specific HIV drugs, tobacco and alcohol, lower education and employment rates, and greater HIV duration were associated with sarcopenia. In conclusion, PLHIV had a high prevalence of sarcopenia, related to both HIV and non-HIV risk factors. HIV should be considered a risk factor for sarcopenia in the general population. CRD42019131449.

Association of Dietary Variety Status and Sarcopenia in Korean Elderly.

BackgroundSarcopenia is associated with a variety of factors including age, diseases, exercise, and heredity. In particular, diet is known to affect changes in muscle mass loss.MethodsThe purpose of this study was to analyze the diversity of food intake according to the presence of sarcopenia in elderly people over 65 years old using the 2008 to 2011 Korea National Health and Nutrition Examination Survey. The differences in subjects' general characteristics, lifestyle, and intake of 15 food groups were compared, and the risk odds ratio (OR) for sarcopenia was calculated for each food intake by gender.ResultsThe proportion of sarcopenia was 27.7% for males and 24.3% for females. The sarcopenia group had significantly lower intakes of nuts and seeds, meats, and milks than the non-sarcopenia group in males. The females had significantly lower intake of fruits, milks, and beverages in non-sarcopenia group. The dietary diversity score was significantly lower in females with sarcopenia than non-sarcopenia group. Regression analysis of the risk OR for sarcopenia according to food group intake showed that the subjects in the lowest tertile (<31.1 g) had a 1.83 times (95% confidence interval [CI], 1.13–2.42) risk for sarcopenia in males. In case of milks intake of females, the risk for sarcopenia increased 1.39 times (95% CI, 1.11–1.86) in subjects with the lowest tertile (<30.1 g).ConclusionsDietary diversity status was the most vulnerable to female with sarcopenia. Sarcopenia was associated with meat intake in male and milk intake in female.

Relationship between water intake and skeletal muscle mass in elderly Koreans: A nationwide population-based study.

The purposes of this study were to evaluate the correlation between sarcopenia and water intake and investigate lack of daily water intake in the presence of sarcopenia in an elderly population. Data from 3656 participants (1582 men and 2074 women) were analyzed using the Korea National Health and Nutrition Examination Survey. Sarcopenia was defined in accordance with the criteria of the Asia Working Group for Sarcopenia. Water intake was assessed using the dietary water adequacy ratio and was calculated by dividing the daily water intake from fluid by the recommended daily amount of 1000 mL in men and 900 mL in women. Water intake from food (g/d and cup/d) and dietary water adequacy ratio (mL) were significantly lower in the sarcopenia group (757.8 g, 890.1 g, and 0.74 mL in men; 511.9 g, 757.8 g, and 0.70 mL in women, respectively) than in the non-sarcopenia group (878.4 g, 1015.1 g, and 0.81 mL in men; 581.3 g, 790.5 g, 0.74 mL in women, respectively). In elderly men, the odds ratio of sarcopenia in the lowest quartile increased to 1.47 (range, 1.13-1.91) in Model 2 compared with that in the highest quartile. In elderly women, the odds ratio of sarcopenia in the lowest quartile increased to 1.50 (range, 1.08-2.08) in Model 2 compared with that in the highest quartile. The prevalence of sarcopenia in the elderly population was related to inadequate dietary water intake after adjusting for covariates. Adequate water intake in the elderly should be recommended to prevent dehydration-related complications, including sarcopenia.

IMPACT OF DIABETES ON THE PREVALENCE OF MALNUTRITION AND SARCOPENIA IN AGED HOSPITALIZED PATIENTS

The prevalence of diabetes is expected to rise sharply worldwide in the coming decades, due not only to obesity and sedentary lifestyles, but also to aging per se. Diabetes is associated with a higher incidence of decreased skeletal muscle mass (sarcopenia) and physical disabilities. Sarcopenia and physical disabilities may be due to the combined effects of reduced physical activity, inflammation, obesity and insulin resistance. Further, malnutrition may be frequent in very old diabetic patients, and contribute to the risk of sarcopenia and physical disabilities. At the same time it may paradoxically lead to a “false” improvement in insulin sensitivity and glycemic control, in a phenomenon of reverse causality. Results were prospectively collected during a case-control study involving 580 consecutively hospitalized patients with a bioimpedance assessment. Age ranged from 70.2 to 101.8 years (84.8 ± 6.2), with 184/396 male/female. The prevalence of malnutrition, assessed by the Mini Nutritional Assessment (MNA), was similar in diabetic (13.1%) and control patients (11.2%). Sarcopenia, was previously defined by a Fat Free Mass Index <15.1 kg/m2 and 17.5 kg/m2 in European women and men, respectively. Its prevalence in our cohort amounts to 57.2% in the 383 control versus 34.5% in the 197 diabetic patients (p < 0.0001). Diabetics were 2.7 years younger and counted more men, but even after adjusting for age and sex in a logistic regression model the odds ratio of sarcopenia remained unchanged at 0.41 (95% CI: 0.28 - 0.59).

High Levels of Heavy Metals Increase the Prevalence of Sarcopenia in the Elderly Population.

BackgroundDespite increasing concern regarding health problems as a result of environmental pollutants, no association of toxic heavy metals with sarcopenia has been demonstrated in the general population. We investigated the association of heavy metals, including lead, mercury and cadmium, with sarcopenia in the Korean population.MethodsParticipants included 344 males and 360 females older than 65 years based on data from the fourth and fifth Korea National Health and Nutritional Examination Surveys. Measurements of blood lead, mercury and cadmium levels were performed. To evaluate the cumulative effect of the three heavy metals, subjects were categorized into quartiles. Sarcopenia was defined according to the criteria for the Asia Working Group for Sarcopenia (AWGS) (SMI<5.4 kg/m2 in females and <7.0 kg/m2 in males).ResultsOf 704 elderly persons (344 in males and 360 in females), prevalences of sarcopenia were 26.7% (92/344) in male and 7.5% (27/360) in female. Mean serum levels of lead in sarcopenia group were significantly higher than non-sarcopenia males (P=0.03). After adjustment for confounding factors, odds ratio for sarcopenia were increased with concentration category of lead (P=0.005 and P<0.001), mercury (P=0.001 and P<0.001) and cadmium (P=0.010 and P<0.001) in males and females, respectively.ConclusionsThis study demonstrates that high levels of blood lead, mercury and cadmium increase the prevalence of sarcopenia in both genders of elderly populations.

Higher free thyroxine levels are associated with sarcopenia in elderly Koreans

BackgroundSkeletal muscle is a major target of thyroid hormone action. Although sarcopenia is associated with adverse health outcomes in the elderly, few studies have examined the association between sarcopenia and thyroid hormone levels in elderly Asians. We investigated the relationship between thyroid hormone levels and sarcopenia in elderly Koreans. Methods658 individuals (324 males and 334 females) ≥60 years old who visited the Health Screening and Promotion Center at Ajou University Hospital were recruited for the study. Whole-body dual-energy X-ray absorptiometry was performed, and gait speed and hand grip strength were measured. The rate and odds ratios for sarcopenia were calculated for free thyroxine (fT4) and thyroid stimulating hormone (TSH) levels. ResultsThe fT4 concentration was negatively associated with muscle mass in males (r2 = 0.031, p = 0.001) and females (r2 = 0.019, ps = 0.011). The highest rate of sarcopenia occurred in the highest fT4 quartile in males and females. However, no significant differences were found among TSH quartiles in either sex. TSH was not significantly associated with the risk of sarcopenia in males or females, whereas the fT4 concentration was associated with the risk of sarcopenia in both sexes. ConclusionsHigher fT4 levels, not lower TSH levels might have an adverse effect on sarcopenia especially in elderly people.

Relationship between Stage of Chronic Kidney Disease and Sarcopenia in Korean Aged 40 Years and Older Using the Korea National Health and Nutrition Examination Surveys (KNHANES IV-2, 3, and V-1, 2), 2008–2011

BackgroundProtein-energy wasting is common in patients with end-stage kidney disease. However, few studies have examined the relationship between early stages of chronic kidney disease (CKD) and sarcopenia.MethodsWe conducted a cross-sectional study based on data in the Korea National Health and Nutrition Examination Survey, 2008–2011. In total, 11,625 subjects aged 40 years or older who underwent dual-energy X-ray absorptiometry were analyzed. Sarcopenia was defined based on values of appendicular skeletal muscle mass as a percentage of body weight (ASM/Wt) two standard deviations below the gender-specific mean for young adults. Estimated glomerular filtration rates (eGFR) were calculated using the CKD-EPI equation.ResultsMean age, body mass index (BMI), and HOMA-IR were higher and caloric intake, physical activity, and vitamin D level were lower in the sarcopenia groups in both men and women. As the stage of CKD increased, the prevalence of sarcopenia increased, even in the early stages of CKD (normal and CKD1, 2, and 3-5: 2.6%, 5.6%, and 18.1% in men and 5.3%, 7.1%, and 12.6% in women, respectively; p < 0.001). In addition, a correlation analysis showed that GFR and ASM/Wt had significant correlations in both men and women. Logistic regression analyses, after adjusting for age, BMI, caloric intake, log(physical activity), vitamin D level, and log(HOMA-IR), showed that the odds ratio for sarcopenia with respect to CKD 3–5 was 1.93 (95% CI = 1.02–3.68) in men but was not statistically significant in women.ConclusionsThe prevalence of sarcopenia was higher in elderly Korean patients with even mildly reduced kidney function. Stage of CKD was associated with an increased prevalence of sarcopenia in men but not women. Thus, we should evaluate the risk of sarcopenia and work to prevent it, even in patients with early CKD.

Secondary hyperparathyroidism and its relationship with sarcopenia in elderly women

Low dietary intake of calcium and poor vitamin D status during aging can result in mild secondary hyperparathyroidism, which may be associated with low muscle mass and reduced strength in the elderly. The aim of this study was to investigate whether low vitamin D, high parathormone (PTH), or both, are associated with sarcopenia. A total of 105 women, 35 with sarcopenia and 70 without sarcopenia, were enrolled in the present study. Body composition measurements were performed by DXA and sarcopenia was defined as skeletal muscle mass index<5.45kg/m2 and grip strength lower than 20kg. Three-day dietary records were taken and adjustments for energy intake made. The estimated average requirement (EAR) method was adopted as a cut-off point for estimating the prevalence of inadequate intake. Serum total calcium, phosphorus, creatinine, intact PTH, and 25(OH)D were measured. Only 1% of the patients met the daily adequate intake for vitamin D and 11% met the daily adequate intake for calcium. Notably, the prevalence of sarcopenia was higher in hyperparathyroidism (25(OH)D<20ng/mL and PTH>65pg/dL) than in the absence of hyperparathyroidism (41.2 vs 16.2%, respectively; p=0.046). The odds ratio for sarcopenia in hyperparathyroidism cases was 6.81 (95%CI 1.29–35.9) compared with participants who had low PTH and a high 25(OH)D concentration. The present study showed that vitamin D insufficiency associated with secondary hyperparathyroidism increased the risk of sarcopenia, suggesting that the suppression of hyperparathyroidism by ensuring adequate calcium and vitamin D intake should be considered in interventional studies to confirm potential benefits.