Prevalence Of Low Muscle Mass Research Articles

Associations between skeletal muscle mass index, nutritional and functional status of patients with oesophago-gastric cancer

Cancer patients frequently suffer from disease-related malnutrition and functional decline. The aim of the current study is to investigate the association between traditional methods of nutritional assessment (unintentional weight loss, Patient Generated-Subjective Global Assessment, anthropometric measurements), functional assessment and muscle mass assessment in oesophago-gastric cancer patients prior to surgery. A cross-sectional study was performed in 108 consecutive patients with oesophageal and gastric cancer who were admitted for surgery in the First Department of Surgery, Laikon General Hospital, Athens, Greece. The assessment of muscle mass was based on preoperative Skeletal Muscle Mass Index (SMI) values. The assessment of malnutrition was based on the Patient Generated Subjective Global Assessment, whereas laboratory markers and anthropometric measurements were also recorded. Muscle strength and physical performance were evaluated by measuring patients' handgrip strength and gait speed respectively. 76.8% of the study sample were severely malnourished and moderately or suspected of being malnourished, while the prevalence of low muscle mass was 49.1%. Age was significantly higher in low SMI patients compared to normal SMI individuals (67.2±9.2 vs 60±10.8, p<0.001). Albumin was significantly lower in low SMI compared to normal SMI patients, as well as BMI, mid-upper arm circumference, calf circumference and corrected mid arm muscle area. Moreover, malnourished patients exhibited higher rates of low muscle mass (57.8% vs 42.2%, p=0.022) than well-nourished patients. SMI was also significantly correlated with patients' handgrip strength and gait speed. Low muscle mass is strongly correlated with malnutrition and should be taken into consideration when evaluating the nutritional status of patients with oesophago-gastric cancer.

Levels of skeletal muscle mass and handgrip strength in adults from 10 regions of China

Objective: To describe the regional and population-related differences in skeletal muscle mass and handgrip strength across the 10 regions of China. Methods: 24 533 participants aged 38-88 years from the second resurvey of China Kadoorie Biobank were included in our analyses. Appendicular and trunk skeletal muscle mass were assessed using the bioelectrical impedance analysis (TANITA). Handgrip strength was measured using Jamar hand-held dynamometer. Low muscle mass and low muscle strength were defined as the lowest quintile of height-adjusted appendicular muscle mass or handgrip strength according to the Consensus Report of the Asian Working Group for Sarcopenia. We analyzed the mean value of absolute muscle mass, height-adjusted muscle mass, weight-adjusted muscle mass and handgrip strength. We also reported the prevalence of low muscle mass and low muscle strength. Results: The average appendicular and total skeletal muscle mass were (22.0±0.02) kg and (49.7±0.05) kg in men, which were higher than in women [(15.9±0.02) kg and (37.2±0.04) kg, respectively]. The handgrip strength was (32.6±0.06) kg in men, which was higher than (19.9±0.05) kg in women. The absolute muscle mass was higher in north area and urban region (P<0.001). The weight-adjusted muscle mass showed reverse patterns of regional difference compared with height-adjusted muscle mass. Both muscle mass and handgrip strength decreased by age (trend P<0.001), with a larger decline observed in handgrip strength. According to AWGS criteria, the proportions of low muscle mass and strength increased by age. Among participants over 80 years old, the prevalence of low muscle mass and strength were 56.2% and 74.5% in men, and 35.7% and 66.0% in women. Conclusions: Levels of skeletal muscle mass and strength varied greatly among people from 10 regions and among participants with different demographic characteristics. The prevalence of low muscle mass and strength was extremely high in elderly.

Comparisons of different indices of low muscle mass in relationship with cardiometabolic disorder

This study aimed to evaluate the most valid index among various indices of low muscle mass in assessing cardiometabolic risks in a Korean population. Appendicular lean mass index (ALMI, kg/m2), fat mass index (FMI, kg/m2), FMI-adjusted ALMI (ALMfmi), ratio of ALM to weight index (ALMwt), ratio of ALM to body mass index (ALMbmi) and ratio of ALM to truncal fat index (ALMtrunkfat) were measured by dual energy X-ray absorptiometry in 17,870 participants from 2008 to 2011. We adopted all the aforementioned indices of low muscle mass expressed as sex- and age-specific standard deviation scores (Z-scores). Low muscle mass for age was defined as Z-score <−1. The prevalence of low muscle mass was approximately 16% across all indices. Low muscle mass defined by ALMI had low muscle mass and low fat mass, and ALMfmi had low muscle mass at the same FMI. However, low muscle mass defined by ALMwt, ALMbmi and ALMtrunkfat had similar muscle mass with high FMI. The receiver operating characteristic curve in metabolic syndrome showed that the ALMtrunkfat was 0.74 in male and 0.69 in female, indicating that ALMtrunkfat was the best discrimination index for metabolic syndrome. This study showed that ALMtrunkfat could be a useful indicator for screening cardiometabolic risk factors, particularly in normal or overweight Asian population.

A Prospective Observational Study Evaluating Sarcopenia By Using the Bioelectrical Impedance Analysis in Elderly Patients with Hematologic Malignancies

[Introduction] Sarcopenia is characterized by age-related decline of skeletal muscle plus low muscle strength and/or physical performance. Previous studies have confirmed the association of sarcopenia and adverse health outcomes, such as falls, disability, hospital admission, long term care placement, poorer quality of life, and mortality, which denotes the importance of sarcopenia in the health care for older people. Population-based studies reported that the prevalence of sarcopenia in Japanese healthy adults aged≥60 years was 8.5% among men and 8.0% among women. Sarcopenia was recently identified as a poor prognostic factor in patients with solid tumors. In cancer patients, sarcopenia is associated with treatment failure, chemotherapy toxicity, and a shorter time to tumor progression related to survival. In contrast to solid tumors, the clinical relevance of sarcopenia in hematologic malignancies is still unknown. The present study investigated the prevalence of sarcopenia based on the criteria of the Asian Working Group for Sarcopenia (AWGS) in elderly patients with hematologic malignancies.[Patients and Methods] We prospectively analyzed 56 elderly patients aged≥60 years with hematologic malignancies diagnosed at our institution between 2015 and 2018. Appendicular skeletal muscle mass (ASM) was measured at diagnosis by using multifrequency bioelectrical impedance analysis (BIA) (InBody 720). BIA is suitable for body composition monitoring in elderly patients as a fast, noninvasive, and convenient method. Skeletal muscle index (SMI) was defined as the ratio of ASM divided by height in square centimeters. We also evaluated physical function by using short physical performance buttery (SPPB). Sarcopenia was defined according to the AWGS algorithm, in which the patient has low muscle mass, and low muscle strength or low physical performance. Low muscle mass was defined as a skeletal muscle index (SMI: ASM/height2) of <7.0kg/m2 in men and <5.7kg/m2 in women. Pre-sarcopenia was defined as having only low muscle mass. Low muscle strength was defined as a handgrip strength of <26kg in men and <18kg in women; and low physical performance, as a gait speed of <0.8m/sec. The study protocol was approved by the Institutional Review Board of Yokohama Municipal Citizen's Hospital, and it was carried out in accordance with the Declaration of Helsinki.[Results] Median age at diagnosis was 77 years (60-93 years), with 34 males and 22 females. The diagnosis included non-Hodgkin lymphoma (NHL, n=36), multiple myeloma (MM, n=9), myelodysplastic syndrome (MDS, n=10), and acute myeloid leukemia (AML, n=1). The prevalence of low muscle mass (pre-sarcopenia) was 41% (14/34) in men and 77% (17/22) in women. The prevalence of low muscle strength was 35% (12/34) in men and 41% (9/22) in women. The prevalence of low physical performance status (Gait speed:<0.8m/sec) was 6% (2/34) in men and 9% (2/22) in women. The prevalence of sarcopenia based on a diagnosis of low muscle mass, low muscle strength, and low physical performance was 24% (8/34) in men and (8/22) 36% in women. The prevalence of low SPPB score (<10) was 9% (3/34) in men and 18% (4/22) in women. Among 36 NHL patients, the diagnosis included DLBCL (n=15), FL (n=10), MALT (n=3), SMZBCL (n=3), MCL (n=2), and others. The prevalence of sarcopenia was 25% (5/20) in men and 50% (8/16) in women. The mean age was 83 years in the sarcopenic group (n=13, 36%) and 73 years in the non-sarcopenic group (n=23, 64%) (p=0.0001). Sarcopenic patients displayed a similar level of serum albumin, LDH, sIL2-R, and BMI when compared with patients who were not sarcopenic. However, sarcopenic patients displayed significantly lower levels of serum dehydroepiandrosterone-sulfate (DHEA-S) and a higher CCI score than patients who were not sarcopenic. Sarcopenic patients failed to complete the treatment planned as compared with non-sarcopenic patients (p=0.001).[Conclusion] These results demonstrated that the prevalence of sarcopenia in elderly patients with hematologic malignancies is higher than that in the Japanese general elderly population. In particular, the prevalence of sarcopenia in female NHL patients is higher than that in male NHL patients. Several factors such as age, serum DHEA-S or comorbidities may affect the incidence of sarcopenia. Since our results are based on a small-sized analysis, further large prospective studies are warranted to verify this conclusion. DisclosuresNo relevant conflicts of interest to declare.

Prevalence of older adults with low muscle mass living in a residential continuing care retirement community in Florida

Muscle mass, strength, and function have been shown to decline with aging, and if of sufficient magnitude can result in sarcopenia. This study’s objective was to determine the prevalence of low muscle mass in a group of adults living in a “premier” Florida residential continuing care retirement community. The sample consisted of 80 older adults, ranging from young old (65-74 years) to the oldest old (85+ years) with the oldest participant being 94 years. Skeletal muscle mass was assessed via bioelectrical impedance analysis. Skeletal muscle index values were calculated and compared with established cut-off values to classify each individual’s muscle mass as normal or low (sarcopenic). The prevalence of sarcopenia among the males was 66% and among females was 73%. When examined by age, 56% of those in their 70s, 73% of those in their 80s, and 79% of adults in their 90s had low muscle mass indicative of sarcopenia. This study found a higher prevalence for sarcopenia in females and males, especially among the oldest groups, than previously reported in a nationally representative sample of adults. This study’s findings also suggest the need for further studies examining whether the prevalence of low muscle mass among adults in either classification varies with socioeconomic status and ethnicity. Continuing care retirement communities may provide excellent environments for the screening, diagnosis, and implementation of exercise and nutritional programs for residents to help prevent or attenuate sarcopenia’s deleterious effects. Nurse practitioners must incorporate screening for sarcopenia in their wellness package for their patients. Screening, nutritional education and support and exercise prescriptions are vital to prevent associated decline from sarcopenia.

Prevalence of sarcopenia and its components in community-dwelling outpatient older adults and their relation with functionality

Aim Sarcopenia is recognized with its adverse functional outcomes. We aimed to report the prevalence of European Working Group on Sarcopenia in Older People (EWGSOP) defined sarcopenia and its individual components in community dwelling outpatient older adults and study the correlations of EWGSOP defined sarcopenia, muscle mass, muscle strength, and physical performance with functional status. Material and methods The subjects were prospectively recruited from the geriatrics outpatient clinics of our university hospital. Body composition was assessed with bioimpedance analysis. Muscle strength was assessed by measurement of hand grip strength with hydraulic hand dynamometer, physical performance was assessed by 4 meter usual gait speed (UGS). Impaired muscle function was defined as presence of low muscle strength and or slow gait speed. As a measure of functionality, modified version of Katz activities of daily living (ADL) and Lawton instrumental activities of daily living (IADL) were assessed. Results A total of 242 community dwelling outpatients with mean age of 79.4 ± 5.7 years were enrolled. 31.8% were male. Prevalence of low muscle mass was 2.1% and impaired muscle function was 71.1%. Prevalence of EWGSOP defined sarcopenia was 0.8% (1.3% in men and 0.6% in women). Most correlated parameter with ADL and IADL was the usual gait speed (r = 0.49, r = 0.63; p < .001, respectively). Grip strength was also correlated with ADL and IADL (r = 0.28, r = 0.35; p < .001). However, the skeletal muscle mass index (SMMI) was not correlated with ADL, IADL (p = .22, p = .22, respectively). In regression analysis, both ADL score and IADL scores were most related to UGS (beta = 0.5 and 0.6, p < .001), age (beta = –0.25 and –0.2, p < .001) and then sarcopenia (beta = 0.1 and 0.1, p < .05) but was not related to hand grip strength or SMMI. Conclusions The prevalence of sarcopenia was low as 0.8% albeit the presence of impaired muscle function in more than 2/3 of the cases. We have found that EWGSOP defined sarcopenia had association with ADL and IADL. The gait speed component of sarcopenia had the strongest associations with functional measures but SMMI component did not have any relation. We suggest that although low muscle mass may be a parameter related to worse functionality, it should not be regarded prerequisite for presence of sarcopenia analogous to low bone mineral density for osteoporosis.

The impact of DXA-derived fat-free adipose tissue on the prevalence of low muscle mass in older adults.

To investigate the impact of eliminating fat-free adipose tissue (aFFAT) on the prevalence of low muscle mass in older adults. Three hundred and forty-three (153 men and 190 women) well-functioning Japanese older adults (aged 65-79) had their appendicular lean mass (aLM) and appendicular fat mass (aFM) measured using dual-energy X-ray absorptiometry (DXA). aFFAT was then estimated from DXA-derived aFM (aFM = (FM/0.15)*0.85). Both traditional cutoffs and those corrected for aFFAT were used for diagnosing low muscle mass. With traditional cutoff values, the prevalence of low muscle mass using the unadjusted aLM index was 20.1%. After adjusting the aLM index for aFFAT, the prevalence increased to 49.0% (p < 0.001). However, when the cutoff values were also adjusted for aFFAT, the prevalence of low muscle mass only increased to 23.0% (p < 0.001). Further, ~5% of the participants (7 men and 8 women) were newly classified as having low muscle mass after correction for aFFAT. However, several women (n = 5) were not classified as having low muscle mass using the corrected cutoff value, although they would have been when using the non-corrected cutoff. Adjusting for the effect of aFFAT on DXA-derived aLM significantly increases the prevalence of low muscle mass in older adults. For clinical research and practice, the influence of aFFAT on DXA-derived aLM may need to be taken into consideration when diagnosing low muscle mass.

Associations of Muscle Mass and Strength with All-Cause Mortality among US Older Adults.

Recent studies suggested that muscle mass and muscle strength may independently or synergistically affect aging-related health outcomes in older adults; however, prospective data on mortality in the general population are sparse. We aimed to prospectively examine individual and joint associations of low muscle mass and low muscle strength with all-cause mortality in a nationally representative sample. This study included 4449 participants age 50 yr and older from the National Health and Nutrition Examination Survey 1999 to 2002 with public use 2011 linked mortality files. Weighted multivariable logistic regression models were adjusted for age, sex, race, body mass index (BMI), smoking, alcohol use, education, leisure time physical activity, sedentary time, and comorbid diseases. Overall, the prevalence of low muscle mass was 23.1% defined by appendicular lean mass (ALM) and 17.0% defined by ALM/BMI, and the prevalence of low muscle strength was 19.4%. In the joint analyses, all-cause mortality was significantly higher among individuals with low muscle strength, whether they had low muscle mass (odds ratio [OR], 2.03; 95% confidence interval [CI], 1.27-3.24 for ALM; OR, 2.53; 95% CI, 1.64-3.88 for ALM/BMI) or not (OR, 2.66; 95% CI, 1.53-4.62 for ALM; OR, 2.17; 95% CI, 1.29-3.64 for ALM/BMI). In addition, the significant associations between low muscle strength and all-cause mortality persisted across different levels of metabolic syndrome, sedentary time, and LTPA. Low muscle strength was independently associated with elevated risk of all-cause mortality, regardless of muscle mass, metabolic syndrome, sedentary time, or LTPA among US older adults, indicating the importance of muscle strength in predicting aging-related health outcomes in older adults.

What is the best adjustment of appendicular lean mass for predicting mortality or disability among Japanese community dwellers?

BackgroundAge-related declines in skeletal muscle mass and strength, representing “sarcopenia,” are a growing concern in aging societies. However, the prevalence of low muscle mass based on the height2-adjustment has been shown to be extremely low, and a more appropriate definition of low muscle mass is needed, particularly for Asian women. The aim of this study was to explore the most appropriate adjustment of appendicular lean mass (ALM) for predicting mortality or disability risk using ALM or any of 5 adjustments of ALM among community-dwelling Japanese.MethodsSubjects comprised 1026 men and 952 women between 40 and 79 years old at baseline (1997–2000) who participated in the National Institute for Longevity Sciences - Longitudinal Study of Aging, Japan. ALM (kg) and 5 adjusted indices of ALM (ALM/leg length, ALM/height, ALM/height2, ALM/weight, and ALM/body mass index [BMI]) were assessed at baseline. Disability was defined by long-term care insurance certification based on responses to a survey mailed in 2013, and death records were obtained as vital statistics until December 2014. Crude and adjusted Cox proportional hazard models were used to estimate hazard ratios for mortality or disability by sex-stratified quintiles of each ALM index (ALM and adjusted ALM) or sarcopenia-related indices. The area under the curve (AUC) was calculated with the multivariate-adjusted logistic regression model. Additionally, mixed-effects analyses were used to clarify the age-related ALM indices decline over 12 years (n = 1838).ResultsCrude Cox proportional hazard models and multivariate-adjusted logistic model (AUC) indicated that higher ALM and ALM/BMI in women, and higher ALM, ALM/leg length, ALM/height, and ALM/BMI in men were associated with lower risks for mortality or disability than ALM/height2. The mixed effect model indicated all ALM indices in men, and ALM, ALM/leg length, and ALM/height in women could better predict age-related lean muscle mass decline.ConclusionsUnadjusted ALM in women, and ALM/leg length, ALM/height, ALM/BMI, and ALM in men may be more appropriate for predicting future mortality or disability than ALM/height2. Considering the age-related muscle mass decline, unadjusted ALM would be the first variable to assess, regardless of sex, in this Japanese cohort study.

The influence of different muscle mass measurements on the diagnosis of cancer cachexia.

BackgroundProgressive loss of muscle mass is a major characteristic of cancer cachexia. Consensus definitions for cachexia provide different options to measure muscle mass. This study describes the effect of different methods to determine muscle mass on the diagnosis of cancer cachexia. In addition, the association of cachexia with other features of cachexia, quality of life, and survival was explored.MethodsPrior to chemotherapy, cachexia was assessed by weight loss, body mass index, and muscle mass measurements, the latter by mid‐upper arm muscle area (MUAMA), computed tomography (CT) scans, and bio‐electrical impedance analysis (BIA). In addition, appetite, inflammation, muscle strength, fatigue, quality of life, and survival were measured, and associations with cachexia were explored.ResultsIncluded were 241 patients with advanced cancer of the lung (36%), colon/rectum (31%), prostate (18%), or breast (15%). Mean age was 64 ± 10 years; 54% was male. Prevalence of low muscle mass was as follows: 13% with MUAMA, 59% with CT, and 93% with BIA. In turn, the prevalence of cachexia was 37, 43, and 48%, whereby weight loss >5% was the most prominent component of being defined cachectic. Irrespective of type of muscle measurement, patients with cachexia presented more often with anorexia, inflammation, low muscle strength, and fatigue and had lower quality of life. Patients with cachexia had worse overall survival compared with patients without cachexia: HRs 2.00 (1.42–2.83) with MUAMA, 1.64 (1.15–2.34) with CT, and 1.50 (1.05–2.14) with BIA.ConclusionsAlthough the prevalence of low muscle mass in patients with cancer depended largely on the type of muscle measurement, this had little influence on the diagnosis of cancer cachexia (as the majority of patients was already defined cachectic based on weight loss). New studies are warranted to further elucidate the additional role of muscle measurements in the diagnosis of cachexia and the association with clinical outcomes.

Prevalence of low muscle mass according to body mass index in older adults

ObjectiveLow muscle mass has been associated with increased morbi-mortality and should be identified for optimizing preventive and therapeutic strategies. This study evaluates the prevalence of bioelectrical impedance analysis (BIA)-derived low muscle mass in older persons using definitions found through a systematic literature search and determines the link between body mass index (BMI) and low muscle mass. MethodsWe performed a systematic search of trials involving ≥100 persons that derived low muscle mass from BIA and reported cut-offs for low muscle mass normalized for body height or weight. These cut-offs were applied to all adults ≥65 y who underwent a BIA measurement at Geneva University Hospital between 1990 and 2011 (N = 3181). The association between BMI and low muscle mass was evaluated through multivariate logistic regressions. ResultsWe identified 15 cut-offs based on the fat-free mass index (FFMI), skeletal muscle index (SMI), or skeletal muscle percentage (SMP). Depending on the definition, the prevalence of low muscle mass was 17% to 68% in women and 17% to 85% in men. The risk of low muscle mass increased with a BMI <18.5 kg/m2 when using cut-offs based on FFMI (odds ratio [OR] ♀ 14.28–24.04/♂ 25.42–50.64) or SMI (OR ♀ 3.56–4.56/♂ 7.07–8.87) and decreased with a BMI ≥25 kg/m2 (FFMI: OR ♀ 0.03–0.04/♂ 0.01–0.04; SMI: OR ♀ 0.18–0.25/♂ 0.14–0.18). The opposite association appeared between BMI and cut-offs based on SMP. ConclusionThe prevalence of low muscle mass varies widely depending on the definition, especially in persons with BMI <18.5 or ≥25 kg/m2.

Sarcopenia among patients receiving hemodialysis: weighing the evidence.

BackgroundThere is no consensus on how best to define low muscle mass in patients with end‐stage renal disease. Use of muscle mass normalized to height‐squared has been suggested by geriatric societies but may underestimate sarcopenia, particularly in the setting of excess adiposity. We compared four definitions of low muscle mass in a prevalent hemodialysis cohort.MethodsACTIVE/ADIPOSE enrolled prevalent patients receiving hemodialysis from the San Francisco and Atlanta areas from June 2009 to August 2011. Whole‐body muscle mass was estimated using bioelectrical impedance spectroscopy, performed before a midweek dialysis session (n = 645; age 56.7 ± 14.5 years, 41% women). We defined low muscle mass as muscle mass of 2SD or more below sex‐specific bioelectrical impedance spectroscopy‐derived means for young adults (18–49 years) from National Health and Nutrition Examination Survey and indexed to height2, body weight (percentage), body surface area (BSA) by the DuBois formula, or Quételet's body mass index (BMI). We compared prevalence of low muscle mass among the four methods and assessed their correlation with strength and physical performance.ResultsThe prevalence of low muscle mass ranged from 8 to 32%. Muscle mass indexed to height2 classified the smallest percentage of patients as having low muscle mass, particularly among women, whereas indexing by BSA classified the largest percentage. Low muscle mass/height2 was present almost exclusively among normal or underweight patients, whereas indexing to body weight and BMI classified more overweight and obese patients as having low muscle mass. Handgrip strength was lower among those with low muscle mass by all methods except height2. Handgrip strength was directly and modestly correlated with muscle mass normalized by percentage of body weight, BSA, and BMI (ρ = 0.43, 0.56, and, 0.64, respectively) and less so with muscle/height2 (ρ = 0.31, P < 0.001). The difference in grip strength among patients with low vs. normal muscle mass was largest according to muscle/BMI (−6.84 kg, 95% CI −8.66 to −5.02, P < 0.001). There were significant direct correlations of gait speed with muscle mass indexed to percentage of body weight, BSA, and BMI but not with muscle mass indexed to height2.ConclusionsSkeletal muscle mass normalized to height2 may underestimate the prevalence of low muscle mass, particularly among overweight and obese patients on hemodialysis. Valid detection of sarcopenia among obese patients receiving hemodialysis requires adjustment for body size.

The Prevalence and Prognostic Value of Low Muscle Mass in Cancer Patients: A Review of the Literature

An increasing number of studies underline the clinical value of low muscle mass as a prognostic factor for adverse outcomes in cancer patients. However, studies show large heterogeneity because of the lack of a standardized approach to measure muscle mass and the lack of reference populations. As a result, the interpretation of data and further progress are severely hampered, hindering the implementation of muscle measurement in oncological care. This review summarizes the methods of diagnosing low muscle mass in cancer patients, the difference between underlying syndromes such as sarcopenia and cachexia, and the association with clinical outcomes described so far.

Low skeletal muscle mass index is associated with function and nutritional status in residents in a Turkish nursing home

Introduction: To determine the prevalence of low muscle mass (LMM) and the relationship between LMM with functional and nutritional status as defined using the LMM evaluation method of European Working Group on Sarcopenia in Older People (EWGSOP) criteria among male residents in a nursing home.Methods: Male residents aged >60 years of a nursing home located in Turkey were included in our study. Their body mass index (BMI) kg/m2, skeletal muscle mass (SMM-kg) and skeletal muscle mass index (SMMI-kg/m2) were calculated. The participants were regarded as having low SMMI if they had SMMI <9.2 kg/m2 according to our population specific cut-off point. Functional status was evaluated with Katz activities of daily living (ADL) and Lawton Instrumental Activities of Daily Living (IADL). Nutritional assessment was performed using the Mini Nutritional Assessment (MNA). The number of drugs taken and chronic diseases were recorded.Results: One hundred fifty-seven male residents were enrolled into the study. Their mean age was 73.1 ± 6.7 years with mean ADL score of 8.9 ± 2.0 and IADL score of 8.7 ± 4.6. One hundred twelve (71%) residents were aged >70 years. Thirty-five men (23%) had low SMMI in group aged >60 years, and twenty-eight subjects (25%) in the group aged >70 years. MNA scores were significantly lower in residents with low SMMI compared with having normal SMMI (17.1 ± 3.4 versus 19.6 ± 2.5, p = 0.005). BMI was significantly lower in the residents with low SMMI compared with normal SMMI (19.6 ± 2.7 versus 27.1 ± 4.1, p< 0.001). ADL scores were significantly different between residents with low SMMI and normal SMMI in those aged >70 years (8.1 ± 2.6 versus 9.1 ± 1.6, p = 0.014). In regression analyses, the only factor associated with better functional status was the lower age (p = 0.04) while the only factor associated with better nutrition was higher SMMI (p = 0.01).Conclusions: Low SMMI detected by LMM evaluation method of EWGSOP criteria is prevalent among male nursing home residents. There is association of low SMMI with nutritional status and probably with functional status within the nursing home setting using the EWGSOP criteria with Turkish normative reference cut-off value.

Low muscle mass is associated with metabolic syndrome only in nonobese young adults: the Korea National Health and Nutrition Examination Survey 2008-2010

Little is known about the relationship between body composition and metabolic risk factors in young adults. We hypothesized that low muscle mass (LMM) is associated with metabolic syndrome (MetS) and its components in young adults and that the associations vary by obesity. A cross-sectional analysis was conducted using the Korea National Health and Nutrition Examination Survey data. In total, 5300 young adults aged 19 to 39 years were evaluated. Low muscle mass was defined as an appendicular skeletal muscle mass/weight less than 1 SD below the mean for each participant's corresponding sex and age group. Obesity was defined as a body mass index greater than or equal to 25 kg/m2. The prevalence of LMM was higher in obese than nonobese participants (37.6% vs 9.6%). In the nonobese participants, the prevalence of MetS, high waist circumference, high triglycerides, and high blood pressure was significantly greater in the LMM group than in the high muscle mass group. In the nonobese group, compared with high muscle mass participants, those with LMM had odds ratios for MetS of 3.6 (95% confidence interval, 1.48-8.76; P < .001) and 3.6 (95% confidence interval, 1.48-8.71; P < .001) in men and women, respectively, after adjusting for confounding factors. However, no significant association of LMM with MetS or its components was found in obese participants. In conclusion, our results suggest that young adults with LMM may have a high risk of MetS, especially when they are nonobese. Interventions aimed at increasing muscle mass at younger ages may have the potential to reduce MetS.

Elderly women who received Helicobacter pylori-eradicating therapy have reduced risk of low skeletal muscle mass.

BackgroundSarcopenia is associated with adverse outcomes such as physical disability, poorer quality of life, and death. Helicobacter pylori (HP) eradication increases ghrelin secretion, which may be a possible treatment for sarcopenia. We investigated whether HP eradication reduces the risk of low muscle mass (LMM), which is an integral component of sarcopenia.Materials and methodsHealthy, asymptomatic women aged ≥60 years who participated in a health screening program were enrolled. Subjects with a history of HP eradication were compared with those who were HP IgG+, but had not received HP-eradicating therapy. Body composition was measured by multifrequency bioelectrical impedance analysis. LMM was defined as body muscle mass 2 standard deviations below the mean muscle mass of healthy women aged 20–39 years from the same program. Multivariable analysis was used to identify sarcopenia risk factors.ResultsThree hundred seventy-two women had received HP eradication, while 689 HP IgG+ women had not. The prevalence of LMM was significantly lower in those who received HP eradication (13.7% vs 21.6%, P=0.002). Multivariable analysis identified risk factors for LMM as age, white blood cell count, serum total protein concentration, and the metabolic syndrome. HP eradication (odds ratio: 0.632, 95% confidence interval: 0.440–0.824, P=0.013) was a significant preventive factor, and exercise (odds ratio: 0.710, 95% confidence interval: 0.504–1.002, P=0.051) had a preventive tendency.ConclusionHP eradication might reduce LMM risk. This finding should be confirmed in prospective longitudinal studies to determine the long-term effects of HP eradication on sarcopenia.

Ultrasound-Based Detection of Low Muscle Mass for Diagnosis of Sarcopenia in Older Adults

ObjectiveTo establish muscle-specific cut-off values for ultrasound-based detection of low muscle mass, and to assess its prevalence in a population of frail older subjects when applying the cut-points of different muscles and those of different sarcopenic indices. DesignCross-sectional study. SettingGeriatric outpatient clinic and clinical research laboratory. MethodsA total of 44 older adults (30 women and 14 men, mean age 82 years, range 67-93 years) and 60 younger individuals (30 women and 30 men, mean age 26 years, range 20-36 years) participated. Body composition and thickness of 4 lower limb muscles (rectus femoris, vastus lateralis, tibialis anterior, medial gastrocnemius) were respectively assessed by bioelectrical impedance analysis (BIA) and ultrasonography. Main Outcome MeasurementsSite-specific cut-points for ultrasound-based assessment of low muscle mass (muscle thickness values 2 standard deviations below the gender-specific means of our sample of younger subjects) and comparative prevalence rates of low muscle mass. ResultsThe following site-specific cut-points for muscle thickness were identified: rectus femoris: 20 mm in men and 16 mm in women; vastus lateralis: 17 mm in men and 15 mm in women; tibialis anterior: 23 mm in men and 22 mm in women; and medial gastrocnemius: 13 mm in both men and women. The prevalence of low muscle mass in older adults was highly dependent on the muscle being investigated; it varied from 86% for thigh muscles to 30% for leg muscles. Moreover, the prevalence of low muscle mass was highly dependent on the applied diagnostic criterion and on the adopted cut-off value; it ranged from 2% to 75% for different BIA-derived criteria. ConclusionsWe suggest that muscle ultrasonography provides physiatrists with a practical and accurate tool for identifying individuals with low muscle mass. However, the usability of cut-off values established in our group of healthy younger subjects of white ethnicity to identify low muscle mass in older individuals of different ethnic groups remains to be demonstrated in future studies.

Relationship between low muscle mass and anemia in Korean elderly men: Using the Korea National Health and Nutrition Examination Survey (KNHANES IV–V)

Background/purposeLow muscle mass and anemia are important health problems. According to previous research, there may be an association between low muscle mass and anemia. However, the relationship between low muscle mass and anemia in the elderly is not fully understood. The purpose of the current study was to evaluate the relationship between low muscle mass and anemia in Korean men, ≥ 65 years of age. MethodsThe present study included 1464 men aged ≥ 65 years from the Korea National Health and Nutrition Examination Survey (2008–2011). A whole body dual energy X-ray absorptiometry (DXA) scan was performed on all participants. Low muscle mass is defined as having an appendicular skeletal mass divided by the height squared (kg/m2), and more than two standard deviations less than the gender-specific mean value of the young reference group. Anemia is defined as hemoglobin levels under 13 g/dL. ResultsThe mean age of the participants was 71.66 years. In our study, the cut-off value of low muscle mass, according to the definition, was 6.07 kg/m2. The prevalence of low muscle mass in Korean elderly men was 8.3%. The prevalence of anemia was 9.6% in the normal group and 27.3% in the low muscle mass group (p < 0.001). After adjusting for age, body mass index, chronic disease status, energy intake, iron intake and lifestyle factors, the odds ratio for low muscle mass was 2.83 (95% confidence interval = 1.41–5.66). ConclusionThe results of this study suggest that low muscle mass, determined through DXA, is related to anemia in Korean elderly men aged ≥ 65 years.

Implication of Sarcopenia and Sarcopenic Obesity on Lung Function in Healthy Elderly: Using Korean National Health and Nutrition Examination Survey.

Previous studies have demonstrated a positive association between obesity and decreased lung function. However, the effect of muscle and fat has not been fully assessed, especially in a healthy elderly population. In this study, we evaluated the impact of low muscle mass (LMM) and LMM with obesity on pulmonary impairment in healthy elderly subjects. Our study used data from the Korea National Health and Nutrition Examination Survey from 2008 to 2011. Men and women aged 65 yr or older were included. Muscle mass was measured by dual-energy X-ray absorptiometry. LMM was defined as two standard deviations below the sex-specific mean for young healthy adults. Obesity was defined as body mass index ≥ 25 kg/m2. The prevalence of LMM in individuals aged over 65 was 11.9%. LMM and pulmonary function (forced vital capacity and forced expiratory volume in 1 second) were independently associated after adjusting for age, sex, body mass index, smoking status, alcohol consumption, and frequency of exercise. LMM with obesity was also related to a decrease in pulmonary function. This study revealed that LMM is an independent risk factor of decreased pulmonary function in healthy Korean men and women over 65 yr of age.

Association between chronic hepatitis C virus infection and low muscle mass in US adults.

Given that low muscle mass can lead to worse health outcomes in patients with chronic infections, we assessed whether chronic hepatitis C virus (HCV) infection was associated with low muscle mass among US adults. We performed a cross-sectional study of the National Health Examination and Nutrition Study (1999-2010). Chronic HCV-infected patients had detectable HCV RNA. Low muscle mass was defined as <10th percentile for mid-upper arm circumference (MUAC). Multivariable logistic regression was used to determine adjusted odds ratios (aORs) with 95% confidence intervals (CIs) of low muscle mass associated with chronic HCV. Among 18513 adults, chronic HCV-infected patients (n=303) had a higher prevalence of low muscle mass than uninfected persons (13.8% vs 6.7%; aOR, 2.22; 95% CI, 1.39-3.56), and this association remained when analyses were repeated among persons without significant liver fibrosis (aOR, 2.12; 95% CI, 1.30-3.47). This study demonstrates that chronic HCV infection is associated with low muscle mass, as assessed by MUAC measurements, even in the absence of advanced liver disease.