Prevalence Of Sarcopenia In Patients Research Articles

Frailty and sarcopenia in patients with cirrhosis awaiting liver transplantation: evidence from a single-centre, prospective cohort study.

Sarcopenia and frailty are common complications in patients with cirrhosis evaluated for liver transplantation (LT). Although the negative impact of sarcopenia on patient's outcome has been well studied, the prognostic role of frailty is not as clear. We assessed the prevalence of sarcopenia and frailty and the clinical impact of frailty in a prospective cohort of cirrhosis patients with and without hepatocellular carcinoma (HCC) listed for LT. Patients with cirrhosis were prospectively recruited at the time of admission into the waiting list. Clinical and lab values were collected. Physical frailty was assessed by liver frailty index (LFI) and patients were categorized into robust (< 3.2); pre-frail (between 3.2 and 4.5), and frail (> 4.5). Skeletal muscle mass was evaluated via skeletal muscle index (SMI) obtained from last CT scan before LT; sarcopenia was defined by SMI < 50 cm2/m2 in males and < 39 cm2/m2 in females. 105 patients were included, of which 42 (40%) had hepatocellular carcinoma (HCC). In patients without HCC (63.5% males, median age 61 years), 36.5% were frail, 50.8% were pre-frail and 12.7% were robust. Frail patients were older than non-frail patients (63 vs. 56; p = 0.008) and had more severe liver disease (Child C: 65% vs. 37.5%; p = 0.02). Prevalence of sarcopenia in patients without HCC was 63%, with similar value of median SMI between frail and not frail patients (p = 0.454). Patients with HCC (78.6% males, 65years old) were 21.4% frail, 61.9% pre-frail, and 16.7% robust. Frail patients had more severe liver disease (Child C: 77% vs. 18.2%; p = 0.004), whereas age was comparable to non-frail patients; among patients without HCC, during a median follow-up of 263days, 17% died (of which 72% were frail) and 10 patients were delisted due to clinical improvement (none of whom were frail). Among those with HCC, during a median follow-up of 289 days, 4 (9%) patients died of which 50% were frail. Frailty and sarcopenia are common complications in patients with cirrhosis awaiting LT. Frailty appears to be associated with an increased risk of mortality during wait-list time especially in those with decompensated cirrhosis. At univariate analysis Meld score, Child score and presence of frailty were found to be associated with shorter survival, however, at multivariate analysis presence of frailty and Child C vs. A/B were the only independent predictor of death. Larger cohorts are required to confirm these results.

The prevalence and effects of sarcopenia in patients with metabolic dysfunction-associated steatotic liver disease (MASLD): A systematic review and meta-analysis

Background and AimsSarcopenia is a common complication in patients with metabolic dysfunction- associated steatotic liver disease (MASLD). However, the prevalence and its impact on the survival of sarcopenia in patients with MASLD is unknown. In this study, we aimed to assess the prevalence and effects of sarcopenia in patients with MASLD. MethodsSystematic review and meta-analysis of full texts of relevant studies were searched from inception until June 12, 2024 in five databases (PubMed, Cochrane Library, Embase, Web of Science, and the China National Knowledge Infrastructure). Next, we assessed the prevalence of sarcopenia in MASLD, and calculated the ORs and HRs between sarcopenia and MASLD based on the adjusted data from individual studies. Statistical analyses were performed using Stata 11.0. ResultsOf the 2,984 records considered, 29 studies recruiting 63,330 patients were included. The pooled prevalence of sarcopenia in patients with MASLD was 23.5% overall (95% CI; 19.1%-27.9%, I2 = 99.6%), and was higher in Asian patients, male, cross-sectional studies, when BIA were employed to measure muscle mass, one criterion of diagnosis sarcopenia, MASLD was diagnosed employing MRI, and moderate-quality studies. Sarcopenia was associated with MASLD patients (adjusted odds ratio [aOR] 2.08, 95% CI 1.58-2.74, I2 = 93.6%) with similar findings in subgroups stratified by age, study design, methods for measuring muscle mass, assessment method to detect sarcopenia, and study quality. The association between all-cause mortality further supports the association between sarcopenia and poor prognosis with MASLD (aHR 1.59, 95% CI 1.33-1.91, I2 =0%). ConclusionsSarcopenia was strongly associated with MASLD progression and was a risk factor not only for MASLD pathogenesis but was also markedly correlated with MASLD-associated mortality.

Sarcopenia in Patients with Advanced Gastrointestinal Well-Differentiated Neuroendocrine Tumors.

Neuroendocrine neoplasms (NENs) are slow-growing tumors. Sarcopenia is defined as the loss of muscle mass, strength, and physical performance. First-line NEN therapy is somatostatin analogs, which could be responsible for malabsorption conditions, such as pancreatic exocrine insufficiency (EPI) with underlying sarcopenia. Evaluate the prevalence of sarcopenia in patients with NENs at diagnosis and during follow-up. A retrospective single-center study was conducted, including patients with advanced intestinal NENs G1/G2 (excluded pancreatic NENs). CT scans were analyzed at diagnosis and after 6 months of therapy, and the skeletal muscle index was assessed. A total of 30 patients (F:M = 6:24) were enrolled, with the following primary tumor sites: 25 in the ileum, 1 stomach, 2 jejunum, and 2 duodenum. At diagnosis, 20 patients (66.6%) showed sarcopenic SMI values, and 10 patients (33.3%) showed non-sarcopenic SMI values. At follow-up, three more patients developed sarcopenic SMI values. Statistical significance in relation to the presence of sarcopenia was found in the group of patients with carcinoid syndrome (p = 0.0178), EPI (p = 0.0018), and weight loss (p = 0.0001). Sarcopenia was present in 2/3 of the patients with advanced intestinal NENs at the diagnosis and during the follow-up. It is reasonable to consider this condition to improve clinical outcomes.

Evaluation of Sarcopenia in Patients with Monoclonal Gammopathy of Undetermined Significance.

Background: We aimed to determine the prevalence of sarcopenia in patients with monoclonal gammopathy of undetermined significance (MGUS) and to evaluate the links between MGUS and sarcopenia. Methods: Eighty-two patients with a diagnosis of MGUS were enrolled in the study. Muscle strength was measured using the handgrip dynamometer. Physical performance was assessed by assessing gait speed over a 6-minute walking test. Muscle mass was determined using a bioelectrical impedance analyzer. Results: Sarcopenia was confirmed in 34.15% of patients. Male predominance was demonstrated in MGUS subjects with sarcopenia, particularly patients with low hand grip strength, low appendicular skeletal muscle mass (ASMM), or low ASMM index (p < 0.001, 0.013, and 0.001, respectively). Higher age and lower serum free light-chain Lambda levels were shown in MGUS patients with low muscle function scores compared to normal scores (p < 0.001, and 0.014, respectively). In addition, having a low ASMM score was related to low body mass index and high-risk group (p = 0.020, 0.033, respectively). Conclusions: We demonstrated that the frequency of sarcopenia is high in patients with MGUS. Whether sarcopenia has a possible role as a factor contributing to the pathogenesis of MGUS should be supported by further studies containing longitudinal data.

Prevalence and Clinical Impact of Sarcopenia in Patients Undergoing Total Joint Arthroplasty: A Systematic Review and a Meta-Analysis

BackgroundSarcopenia is a progressive loss of skeletal muscle mass and function. It is associated with adverse outcomes after several orthopaedic procedures. However, its role in total joint arthroplasty (TJA) is not fully explored. Therefore, we wanted to conduct a systematic review and meta-analysis to answer the following questions: (1) What is the prevalence of sarcopenia in patients undergoing TJA?; (2) What factors are associated with the prevalence of sarcopenia in patients undergoing TJA?; What is the impact of sarcopenia on medical outcomes following TJA?; and (4) What is the impact of sarcopenia on surgical outcomes following TJA? MethodsElectronic databases PubMed, Scopus, Cochrane, and Google Scholar were searched. The data were pooled using the random-effects model and graphically represented by a forest plot. We included a total of 13 studies, evaluating 399,097 patients. ResultsThe pooled prevalence of sarcopenia was 20.1% (95% confidence interval [CI] 13.6 to 28.8%; P < .00001; I2 = 94.7%) in total knee arthroplasty (TKA) and 5.2% (95% CI 0.1 to 69.7%; P = .128; I2 = 99.6%) in total hip arthroplasty (THA). Meta-regression found no links between age, sex, body mass index, diabetes, obesity, arthroplasty type, and sarcopenia prevalence in TJA. Sarcopenia increased risk of blood transfusion (odds ratio [OR] 4.68 [95% CI 3.51 to 6.25]; P < .00001), pneumonia (OR 1.94 [95% CI 1.14 to 3.30]; P = .01), urinary tract infection (UTI) (OR 1.64 [95% CI 1.31 to 2.05]; P < .001), prosthetic fracture (OR 2.12 [95% CI 1.51 to 2.98]; P < .0001), prosthetic dislocation (OR 1.99 [95% CI 1.62 to 2.44]; P < .00001), and mechanical loosening (OR 1.78 [95% CI 1.43 to 2.22]; P < .00001) in TKA. Sarcopenic patients were at an increased risk of UTI (OR 1.79 [95% CI 1.32 to 2.43]; P = .0002) and prosthetic loosening (OR 1.97 [95% CI 1.10 to 3.53]; P = .02) post-THA. ConclusionsBaseline sarcopenia was prevalent in patients undergoing TJA. It was associated with an increased risk of UTI and prosthetic loosening following TKA and THA. Increased risk of blood transfusion, pneumonia, prosthetic fractures, and mechanical loosening following TKA.

Evaluating sarcopenia prevalence and SARC-F effectiveness in elderly Spanish women with RA: a comparative study of EWGSOP criteria.

The European Working Group on Sarcopenia in Older People (EWGSOP) has put forward two key proposals for diagnosing sarcopenia: the EWGSOP1 in 2010 and the EWGSOP2 in 2019. These proposals are currently the most widely used guidelines for diagnosing sarcopenia. However, data on the prevalence of sarcopenia in patients with rheumatoid arthritis (RA) based on EWGSOP criteria are limited. This study aimed to: (a) establish the prevalence of sarcopenia in an elderly Spanish cohort of women with RA using both EWGSOP1 and EWGSOP2 criteria; and (b) evaluate the effectiveness of the SARC-F questionnaire in detecting sarcopenia. In this observational, cross-sectional study, 67 women aged over 65 years who met the ACR 2010 criteria for RA were consecutively recruited from a tertiary university hospital. Assessments included: (a) demographic and anthropometric data; (b) RA-related variables (disease history, analytical evaluation, activity, disability, quality of life); and (c) sarcopenia-related variables (muscle strength, gait speed, skeletal muscle mass, and SARC-F questionnaire). The prevalence of sarcopenia was determined using both EWGSOP1 and EWGSOP2 criteria. Furthermore, the effectiveness of the SARC-F questionnaire for detecting sarcopenia were calculated. The prevalence of sarcopenia was 43% according to the EWGSOP1 criteria and 16% according to the EWGSOP2 criteria. Patients diagnosed with sarcopenia based on the latter criteria also met the EWGSOP1's criteria for sarcopenia. Agreement between the two sets of EWGSOP criteria was poor. The SARC-F questionnaire demonstrated an inherently high sensitivity (100%) as well as good specificity (75%) and diagnostic accuracy (79%) in detecting sarcopenia according to EWGSOP2 criteria. The prevalence rate of sarcopenia among elderly Spanish women with RA varies significantly depending on whether EWGSOP1 or EWGSOP2 criteria are applied. The SARC-F questionnaire is effective for predicting sarcopenia when used in conjunction with the EWGSOP2 criteria, which is currently the most accepted standard in clinical practice.

Impact of perioperative high-protein nutritional support on postoperative outcomes in the treatment of primary lung cancer: Russian prospective multicenter comparative study (NUTRILUNC-study)

BACKGROUND: Up to 60% of lung cancer pts experience weight loss. Prevalence of sarcopenia in patients (pts) with non-small cell lung cancer (NSCLC) is about 43% and is an independent predictor of worse overall survival. It was shown that nutritional support improves outcomes in pts with cancer. AIM: To evaluate impact of perioperative nutritional support on surgical treatment outcomes of patients with NSCLC. MATERIALS AND METHODS: Patients with primary NSCLC (n=112, 69 males), aged 57,2±8,2, awaiting lung surgery and being at risk of malnutrition (Nutritional Risk Screening Assessment 2002 score ≥3) were randomized into 2 groups. Study group (n=55) received oral nutritional support (Nutridrink Compact Protein, Nutricia LLC), 250 ml/d (36 g of protein, 612 kcal) for 14 d before and 14 d after surgery in addition to standard diet. Control group (n=57) had a standard diet. The number of respiratory complications after surgery, length of hospitalization, anthropometric, functional, laboratory parameters, quality of life (according to Quality of Life Questionnaire Core-30) were assessed. Results were presented as mean ± standard deviation. Differences were considered significant at p ≤0.05. RESULTS: In the study group there were fewer respiratory complications (p 0.01), and a shorter length of hospitalization (p=0.03). Body weight in the study group did not change significantly, while in the control group it decreased (0.15±3.7 kg versus loss of 3.47±3.6 kg). Results of six-minute walk test and hand grip dynamometry were higher in the study group then in the control group (411.8±56.0 m versus 383.2±52.1 m; 33.5±8.4 kg versus 27.1±6.8 kg). Quality of life was better in the study group, p 0.05. The total protein and albumin levels were higher in the study group (70.9±5.6 g/l versus 63.1±4.0 g/l; 38.5±5.8 g/l versus 33.2±3.0 g/l). One patient in study group experienced 1st grade diarrhea. CONCLUSION: In patients with NSCLC at risk of malnutrition perioperative nutritional support with high protein oral nutritional support has a positive effect on surgical treatment outcomes.

Prevalence and clinical characteristics of Sarcopenia in older adult patients with stable chronic obstructive pulmonary disease: a cross-sectional and follow-up study

BackgroundThe relationship between sarcopenia and chronic obstructive pulmonary disease (COPD) has been increasingly reported, and there is some overlap regarding their clinical features and pulmonary rehabilitation (PR) strategies. No Korean study has reported the actual prevalence of sarcopenia in patients with stable COPD who are recommended for pulmonary rehabilitation. This study evaluated the prevalence and clinical features of sarcopenia in older adult outpatients with stable COPD and the changes after 6 months.MethodsIn this cross-sectional and 6-month follow-up study, we recruited 63 males aged ≥ 65 diagnosed with stable COPD. Sarcopenia was diagnosed using the AWGS 2019 criteria, which included hand grip strength testing, bioelectrical impedance analysis, Short Physical Performance Battery administration, and Strength, Assistance with walking, Rising from a chair, Climbing stairs, and Falling screening tool administration. A 6-minute walk test (6 MWT) was conducted, forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), maximal inspiratory and expiratory pressures (MIP and MEP, respectively) and peak expiratory flow (PEF) were assessed, and patient-reported questionnaires were administered.ResultsAt baseline, 14 (22%) patients were diagnosed with possible sarcopenia, and eight (12.6%) were diagnosed with sarcopenia. There were significant differences in the age; body mass index; Body mass index, airflow Obstruction, Dyspnea, and Exercise index; modified Medical Research Council dyspnea scores; and International Physical Activity Questionnaire scores between the normal and sarcopenia groups. Whole-body phase angle, MIP, MEP, PEF, and 6-minute walk distance (6 MWD) also showed significant differences. Over 6 months, the proportion of patients with a reduced FEV1 increased; however, the proportion of patients with sarcopenia did not increase.ConclusionA relatively low prevalence of sarcopenia was observed in older adult outpatients with stable COPD. No significant change in the prevalence of sarcopenia was found during the 6-month follow-up period.Trial registrationThe study was registered with the Clinical Research Information Service (KCT0006720). Registration date: 30/07/2021.

Sarcopenia and osteoarthritis: meta-analysis

In clinical practice, a connection between the progression of osteoarthritis and the development of sarcopenia is frequently observed, but individual scientific studies provide conflicting results. Therefore, there is a need to conduct a comparative review and meta-analysis to assess the prevalence of sarcopenia in patients with knee osteoarthritis. Several databases from 2010 to 2023 were examined. Sarcopenia prevalence data were summarized using odds ratios (ORs) with their 95 % confidence intervals (CIs). A total of 504 articles were studied, which included 7,495 participants with a mean age of 68.4 years; 72.4 % were female. As a result, the prevalence of sarcopenia in patients with knee osteoarthritis was 45.2 %, while in the control group it was 31.2 %. The study found that the prevalence of sarcopenia in knee osteoarthritis was more than twice as high as in the control group (OR = 2.07; 95 % CI: 1.43–3.00; I2 = 85 %).

Sarcopenia in systemic sclerosis: prevalence and impact—a systematic review and meta-analysis

ObjectiveThis review aims to provide an estimate of sarcopenia prevalence and its impact on clinical characteristics in patients with systemic sclerosis (SSc).DesignSystematic review and meta-analysis.Data sourcesEmbase, Medline, Web of Science...

Analysis of Risk Factors for the Association of Sarcopenia in Patients with Type 2 Diabetes Mellitus.

Previous studies have shown that the prevalence of sarcopenia in patients with type 2 diabetes mellitus (T2DM) has increased significantly over the years. However, the risk factors for the association of sarcopenia in patients with T2DM are unknown. Therefore, we attempted to investigate the risk factors through measurement and analysis of the patients' data from April 2020 to April 2022. A total of 334 hospitalized patients with T2DM were divided into sarcopenia group (n=101) and non-sarcopenia group (n=233). Clinical factors were compared between the two groups and also between the two genders. Receiver operating characteristic curve (ROC) was used to analyze the ROC diagnostic ability of related factors in sarcopenia. (1) Among the 334 patients, the overall prevalence of sarcopenia was 30.2%; 41.3% in men and 20.1% in women. (2) The multifactorial logistic regression analysis showed that gender (specifically for men; OR=4.997, 95% CI: 2.611-9.564), low body mass index (BMI) (OR=1.525, 95% CI: 1.353-1.718), lower 25(OH)D levels (OR=1.076, 95% CI:1.036-1.117), and lower IGF-1 (OR=1.013, 95% CI:1.006-1.020) were independent risk factors (P < 0.05). (3) ROC curve analysis results showed that BMI, 25 (OH) D, IGF-1, and testosterone (for men) had predictive significance for sarcopenia with T2DM (P < 0.05). However, the AUC of 25 (OH) D, IGF-1 and testosterone (for men) were all <0.7, while the AUC of BMI and the combined factors were all >0.7, has great predictive significance. The prevalence of sarcopenia in hospitalized patients with T2DM is higher in men than in women. Low BMI and lower serum levels of 25 (OH) D and IGF-1 are risk factors of sarcopenia in patients with T2DM. Low BMI, 25(OH)D, IGF-1, and testosterone (for men) all contributed to the prediction of sarcopenia, among which BMI and combined factors were more significant.

Prevalence and clinical impact of sarcopenia in liver transplant recipients: A meta-analysis.

The prevalence of sarcopenia in patients undergoing liver transplantation (LT) remains to be determined partly because of different diagnostic criteria. Sarcopenia has recently been recognized as a new prognostic factor for predicting outcomes in LT candidates. To estimate the prevalence of sarcopenia and evaluate its clinical effect on LT candidates. This systematic search was conducted in PubMed, Web of Science, Embase, and Cochrane Library for original English-language articles that investigated the prevalence and influence of sarcopenia in patients undergoing LT from database inception to November 30, 2022. Cohort studies of the definition of sarcopenia that estimate sarcopenia prevalence and evaluate its effect on clinical outcomes and the risk of mortality were included. Twenty-five studies involving 7760 patients undergoing LT were included. The pooled prevalence of sarcopenia in patients undergoing LT was 40.7% [95% confidence intervals (95%CI): 32.1-49.6]. The 1-, 3-, and 5-year cumulative probabilities of post-LT survival in patients with preoperative sarcopenia were all lower than those without sarcopenia (P < 0.05). Sarcopenia was associated with an increased risk of post-LT mortality in patients undergoing LT (adjusted hazard ratio: 1.58; 95%CI: 1.21-2.07). Patients with preoperative sarcopenia had a longer intensive care unit stay, a high risk ratio of sepsis, and serious post-LT complications than those without sarcopenia. Sarcopenia is prevalent in a substantial proportion of patients undergoing LT and is strongly and independently associated with higher a risk of mortality risk.

Physical performance and sarcopenia assessment in patients with a recent fracture visiting the Fracture Liaison Service

SummaryImpaired physical performance is associated with increased fracture risk. Performance on four physical functioning tests and prevalence of sarcopenia were assessed for 1789 fracture patients and compared to reference data. Performance was low on all tests, especially for patients with a hip, major or ≥ 1 prevalent vertebral fracture.Purpose IntroductionImpaired physical performance and sarcopenia are associated with increased fracture risk. This study aims to assess physical performance and the prevalence of sarcopenia in patients with a recent clinical fracture attending the Fracture Liaison Service (FLS) compared to population means.MethodsIn this cross-sectional study, chair stand test (CST), handgrip strength (HGS), timed-up-and-go (TUG), 6-min walking-test (6MWT), and sarcopenia (following EWGSOP2) were assessed. The proportion of patients with impaired/poor performance compared to reference data was calculated (Z-score: ≥ − 2SD to < − 1 (impaired) and < − 2 SD (poor)). Associations of fracture type, sex, age, and time since fracture with Z-scores were assessed using linear regression analyses.ResultsA total of 1789 consecutive FLS patients were included (median age (IQR): 66 (59–74), 70.7% females, 3.9 (± 1.6) months after fracture). The prevalence of impaired/poor performance for CST, HGS, TUG, and 6MWT was 39.2%, 30.4%, 21.9%, and 71.5%, respectively (expected proportion of 16%) and 2.8% had sarcopenia. Lower Z-scores (P < 0.001) were found for hip, major, and ≥ 1 prevalent vertebral fracture (VF) in CST (major: regression coefficient (B) (95%CI) = − 0.25 [− 0.34, − 0.16]; hip: B = − 0.32 [− 0.47, − 0.17], VF: B = − 0.22 [− 0.34, − 0.11]), TUG; (major: B = − 0.54 [− 0.75, − 0.33]; hip: B = − 1.72 [− 2.08, -1.35], VF: B = − 0.61 [− 0.88, − 0.57]), 6MWT (major: B = − 0.34 [− 0.47, − 0.21]; hip: B = − 0.99 [− 1,22, − 0.77], VF: B = − 0.36 [− 0.53, − 0.19]).ConclusionsPhysical performance is significantly lower in FLS patients compared to healthy peers, especially in patients with hip, major or prevalent VF. These findings underline the need to assess and improve the physical performance of FLS patients, despite a low prevalence of sarcopenia.

Prevalence of sarcopenia in patients with chronic kidney disease: a global systematic review and meta-analysis.

Sarcopenia is a risk factor for adverse clinical outcomes in chronic kidney disease (CKD) patients, including mortality. Diagnosis depends on adopted consensus definition and cutoff values; thus, prevalence rates are generally heterogeneous. We conducted a systematic review and meta-analysis to investigate the global prevalence of sarcopenia and its traits across the wide spectrum of CKD. A systematic search was conducted using databases, including MEDLINE and EMBASE, for observational studies reporting the prevalence of sarcopenia. We considered sarcopenia according to the consensus definition of the European Working Group on Sarcopenia in Older People (EWGSOP), the Asian Working Group for Sarcopenia, the Foundation for the National Institutes of Health Sarcopenia Project, and the International Working Group on Sarcopenia (IWGS). Subgroup analyses by CKD stages, consensus, and gender were performed. Pooled prevalence was obtained from random-effect models. A total of 140 studies (42041 patients) across 25 countries were included in this systematic review and meta-analyses. Global prevalence of sarcopenia was 24.5% [95% confidence interval (CI): 20.9-28.3) and did not differ among stages (P=0.33). Prevalence varied according to the consensus definition from 11% to 30%, with no significant difference (P=0.42). Prevalence of severe sarcopenia was 21.0% (95% CI: 11.7-32.0), with higher rates for patients on dialysis (26.2%, 95% CI: 16.6-37.1) compared to non-dialysis (3.0%, 95% CI: 0-11.1; P<0.01). Sarcopenic obesity was observed in 10.8% (95% CI: 3.5-21.2). Regarding sarcopenia traits, low muscle strength was found in 43.4% (95%CI: 35.0-51.9), low muscle mass in 29.1% (95% CI: 23.9-34.5), and low physical performance in 38.6 (95% CI: 30.9-46.6) for overall CKD. Prevalence was only higher in patients on dialysis (50.0%, 95% CI: 41.7-57.4) compared to non-dialysis (19.6%, 95% CI: 12.8-27.3; P<0.01) for low muscle strength. We found a high global prevalence of sarcopenia in the wide spectrum of CKD. Low muscle strength, the primary sarcopenia trait, was found in almost half of the overall population with CKD. Patients on dialysis were more prevalent to low muscle strength and severe sarcopenia. Nephrology professionals should be aware of regularly assessing sarcopenia and its traits in patients with CKD, especially those on dialysis.

Investigating the Contributing Risk Factors toward Sarcopenia Prevalence and its Development in Human Immunodeficiency Virus (HIV) Patients

Background Human Immunodeficiency Virus (HIV) causes immune system impairment, and antiretroviral therapy (ART) given for HIV may increase the risk of morbidity and adverse health outcomes, including sarcopenia. The prevalence of sarcopenia in patients with HIV in non-Asian countries has been well-documented, but not in Asian countries. Objective The study aimed to investigate the prevalence of sarcopenia and its association with HIV in Thai patients. Methods A cross-section study was designed. This study included 114 patients with HIV from a specialized infectious disease hospital aged 20-75 years and receiving ART for more than a year. Gait speed, muscle strength, and muscle mass were measured using the 6-m walking test, handgrip dynamometer, and bioelectrical impedance analysis, respectively. Patient medical records and Global Physical Health Questionnaire scores were assessed. Logistic regression analysis was used to determine the risk of sarcopenia occurrence. Results The prevalence of sarcopenia was 21.93%. Risk factors for sarcopenia included duration of ART (odds ratio [OR]=16.55), advanced age (≥60 years, OR=13.50), duration of living with HIV (OR=9.44), and female sex (OR=3.79). Besides, low physical activity, which is a modifiable behavioral, had an OR of 2.78. Conclusion The prevalence of sarcopenia in people with HIV was 21.93%. The duration of ART was the most prominent risk factor for sarcopenia in patients with HIV. Patients with HIV should increase their physical activity levels to reduce sarcopenia risk.

Prevalence of Sarcopenia in Liver Cirrhosis Patients and Determinants of Survival in Cirrhotic Population: A Prospective Cohort Study

Introduction: Chronic liver diseases are the leading cause of mortality and are associated with a significant reduction in health-related quality of life, as well as being a major complication in cirrhosis. There is a high risk of reduced muscle mass, muscle strength, or function, known as sarcopenia, in patients with liver cirrhosis. Sarcopenia is a major determinant of survival in cirrhosis patients, along with the Child-Turcotte Pugh (CTP) score and the Model for End-stage Liver Disease (MELD) scores. Aim: To study the prevalence of sarcopenia in patients with liver cirrhosis by assessing skeletal muscle mass using the third lumbar level Skeletal Muscle Index (SMI) through Computed Tomography (CT) and to determine the survival analysis of the cohort using a Cox regression model. Materials and Methods: The present study was a prospective cohort study conducted in the Department of Gastroenterology and Hepatology at Sree Gokulam Medical College and Research Foundation in Thiruvananthapuram, Kerala, India South India, from October 2018 to October 2022. A total of 209 patients with cirrhosis were evaluated. Liver biochemical parameters, CTP score, and the MELD score were studied. Age, gender, and aetiology were noted. All subjects were assessed for sarcopenia using CT at the third lumbar vertebrae level SMI, and all subjects were followed up every six months for survival. Survival curves and survival probability were evaluated for all the subjects recruited in the present study. Cumulative survival rates were estimated by the Kaplan-Meier method for sarcopenia, CTP score, and the MELD scores after categorisation into the aetiology of cirrhosis, and the groups were compared using the Log-rank test. Independent factors associated with mortality were identified using Cox proportional hazards models. A p-value &lt;0.05 was considered statistically significant. Results: The mean age±Standard Deviation of the subjects was 58.24±9.9 years. Among the subjects, males accounted for 161 (77%), while 48 (23%) were females. In subjects with sarcopenia (n=77), the survival rate was 53 (68.8%), and in subjects without sarcopenia (n=132), the survival rate was significantly higher at 110 (83.3%) with a p-value &lt;0.05 (p=0.027). Univariate Cox regression analysis indicated that sarcopenia was a statistically significant predictor of survival. The mortality risk was higher in individuals with sarcopenia, with a Hazard Ratio (HR) of 1.9 and a 95% Confidence Interval (CI) ranging from 1.1-1.4. In the Cox regression model, CTP class B/C had a 2.4 times higher risk for mortality than CTP class A (p&lt;0.05). Individuals with sarcopenia had a 1.76 times higher risk of mortality compared to those without (HR=1.765, 95% CI: 0.983-3.17) in the multivariate Cox regression analysis. Aetiology and CTP class scores were independently associated with mortality (p&lt;0.05) after adjusting for multiple prognostic factors in the multivariate Cox regression analysis. Conclusion: Univariate Cox regression analysis indicated that sarcopenia was a statistically significant predictor of survival, with a higher mortality risk in individuals with sarcopenia. The multivariate Cox regression model for survival concluded that CTP class B/C posed a higher risk for mortality compared to CTP class A.

New specific skeletal muscle mass index cut-offs for the assessment of sarcopenia in patients with severe obesity.

Bioelectrical impedance analysis (BIA) is the most used tool in clinical practice to evaluate body composition in patients with obesity. The skeletal muscle index (SMI) defined by BIA has been proposed for the identification of sarcopenia, but there are currently no univocal cutoffs for this condition. In this study, we aimed: 1) to determine the prevalence of sarcopenia in patients with severe obesity using the current cutoffs of SMI; 2) to define new specific cutoffs; 3) to validate the new cutoffs; and 4) to re-determine the prevalence of sarcopenia. A total of 300 patients, 74% women and 26% men (mean age = 42.6 ±; 9 years), with morbid obesity (mean BMI = 46.7 ±; 6.5 kg/m2) followed by the Unit of Endocrinology from January 2014 to December 2020 were retrospectively evaluated. SMI was calculated as the skeletal muscle mass normalized for squared height through the BIA equation by Janssen etal. The prevalence of sarcopenic obesity calculated using the cutoff points reported by De Rosa etal. (7.3 kg/h2 for women and 9.5 kg/h2 for men) was 2.3%. The prevalence of sarcopenia was calculated using the new cutoffs: with the cutoff obtained from the standard deviation method (8.2 kg/h2 for women and 10.2 kg/h2 for men), a prevalence of 14.7% was observed, whereas the prevalence reached 47.6% when using the cutoff calculated through the K-means unsupervised cluster (9.2 kg/h2 for women and 11.3 kg/h2 for men). The new cutoffs were validated with a second sample consisting of 300 patients with morbid obesity (BMI = 44.9 ±; 6.7 kg/m2): the rate of sarcopenic patients was still higher than that observed in the training cohort (56%). After the matching procedure (by BMI and age), the rates of sarcopenic patients were similar in both groups (50.2% in the validation group and 53% in the training group, p = 0.6). The new cutoffs calculated with cluster analysis could better identify sarcopenia in morbidly obese patients. However, further studies are needed to validate these cutoffs in different patient cohorts.

Comparison of the performance of four screening tools for sarcopenia in patients with chronic liver disease

ObjectivesEarly identification of sarcopenia in patients with chronic liver disease is crucial for patient management and prevention of severe complications. We aimed to assess the effectiveness of Ishii score, Strength, Assistance with Walking, Rise from a Chair, Climb Stairs and Falls (SARC-F), SARC-F and Calf Circumference (SARC-CalF), and Mini Sarcopenia Risk Assessment-7 (MSRA-7) to screen sarcopenia in patients with chronic liver disease. MethodsThis prospective study included patients with chronic liver disease in the infectious department of a tertiary hospital in Sichuan, China. Ishii score, SARC-F, SARC-CalF, and MSRA-7 were used to screen for sarcopenia risk. Sarcopenia was diagnosed according to the Asian Myometriosis Working Group (AWGS) 2019, which was used as the gold standard to compare the performance of the four screening tools. We completed clinical registration on the Chinese Clinical Trial Registration website (ChiCTR2100043910). ResultsA total of 366 patients with chronic liver disease (22.4% women, mean age 48.96 ± 11.88 years) were evaluated. Based on the AWGS 2019 standard, the prevalence of sarcopenia in patients with chronic liver disease was 17.5%. Among all participants, receiver operating characteristic (ROC) produced an area under the curve (AUC) of 0.82 for Ishii score (sensitivity 85.94%, specificity 78.15%), 0.53 for SARC-F (sensitivity 6.25%, specificity 99.34%), 0.64 for SARC-CalF (sensitivity 45.31%, specificity 83.11%), and 0.55 for MSRA-7 (sensitivity 87.50%, specificity 22.85%). Based on AUC, decision curve analysis, and calibration curves, we concluded that Ishii score was the most accurate screening tool and was superior to the other tools. ConclusionsIshii score is more suitable for screening sarcopenia in patients with chronic liver disease than the SARC-F, SARC-CalF, and MSRA-7, based on the AWGS 2019 criteria. Nursing professionals can use Ishii score as a clinical tool to screen for sarcopenia in patients with chronic liver disease, providing an indication cue for the final diagnosis of sarcopenia, improving diagnostic efficiency, and enabling early identification and prevention of complications resulting from sarcopenia.

Prevalence of sarcopenia and its determinants in people with type 2 diabetes: Experience from a tertiary care hospital in north India

ObjectivesChanges in skeletal muscle mass and quality are associated with type 2 Diabetes (T2D) and its complications. We evaluated the prevalence of sarcopenia in patients with T2D and its association with various anthropometric and metabolic parameters. MethodsA total of 229 patients with T2D, ≥20–60 years, were screened for sarcopenia using handgrip strength (HGS) by dynamometer, physical performance test (by Short Physical and chair stand test), and height-adjusted appendicular skeletal muscle index (ASMI) by Dual Energy X-ray Absorptiometry (DXA) applying Asian Working Group on Sarcopenia (AWGS). Multiple logistic regressions were performed to identify the factors associated with sarcopenia. ResultsThe mean age was 46.2 ± 7.4 years with 55% being women. The prevalence of low HGS, poor physical performance, low ASMI, possible sarcopenia, sarcopenia, and severe sarcopenia was 16.2%, 39.3%, 33%, 43%, 18.8%, and 6.1%, respectively. Age >45 years and use of >2 oral hypoglycaemic agents (OHA's) were risk factors for low HGS (OR:3.51, 95%CI = 1.5–8.3) and low ASMI (OR:2.40, 95%CI = 1.05, 5.49, p-0.04), respectively. Female sex (OR:3.3 1.8–6.1 p < 0.01), age >45 years (OR:2.12, 95% CI = 1.2–3.8 p-0.012) and liver fibrosis (OR: 2.12, 95% CI = 1.01–4.46 p-0.048) were independently associated with poor performance. No association was found with HbA1c, dyslipidaemia, albuminuria, hypertension, or duration of diabetes and sarcopenia. ConclusionSarcopenia is becoming increasingly recognized as a significant complication in younger individuals with T2D, and poor physical performance plays a vital role in its development. The prevalence of sarcopenia rises with advancing age, underscoring the importance of early intervention to address this condition.

Sarcopenia predicts cardiovascular disease in chronic kidney disease at advanced stage and associated risks.

Chronic kidney disease (CKD) has been associated with a higher risk of cardiovascular disease (CVD), and sarcopenia is a new risk factor for CKD. However, whether sarcopenia predicts CVD in CKD remains to be determined. Sarcopenia would predict CVD in CKD at advanced stage. This analysis included 101 patients with CKD at stage 3 or over to determine the prevalence of sarcopenia and cardiovascular disease in patients with CKD at stage 3 or over in our center. The patients were further categorized into sarcopenia group (N = 19) and non-sarcopenia group (N = 82) according to the diagnostic criteria for sarcopenia. Data on demographics, laboratory tests, and measurements of extracardiac adipose tissue thickness (EAT) was collected. The prevalence of sarcopenia in patients with CKD at stage ≥ 3 was 19%. Compared with non-sarcopenia group, patients from the sarcopenia group were older (P = .005), and presented longer disease durations (P = .002). The serum level of albumin was significantly decreased, (P = .047), and high-sensitivity C-reactive protein level (CRP) was significantly increased (P = .003) in sarcopenia group. In addition, the EAT was thicker in the sarcopenia group compared with non-sarcopenia group (P = .032). Furthermore, the le-stratified atherosclerotic cardiovascular disease (ASCVD) risk scores were positively correlated with inflammation, nutrition, body mass index (BMI) and disease duration of CKD in sarcopenia group (P < .001). Patients with CKD are prone to have sacropenia, which is associated with inflammation and malnutrition. Presence of sarcopenia in CKD patients predicts the risk of ASCVD.