Sarcopenia In Elderly Patients Research Articles

Use of 3D-CT-derived psoas major muscle volume in defining sarcopenia in colorectal cancer

BackgroundSarcopenia is characterized by reduced skeletal muscle volume and is a condition that is prevalent among elderly patients and associated with poor prognosis as a comorbidity in malignancies. Given the aging population over 80 years old in Japan, an understanding of malignancies, including colorectal cancer (CRC), complicated by sarcopenia is increasingly important. Therefore, the focus of this study is on a novel and practical diagnostic approach of assessment of psoas major muscle volume (PV) using 3-dimensional computed tomography (3D-CT) in diagnosis of sarcopenia in patients with CRC.MethodsThe subjects were 150 patients aged ≥ 80 years with CRC who underwent primary tumor resection at Juntendo University Hospital between 2004 and 2017. 3D-CT measurement of PV and conventional CT measurement of the psoas major muscle cross-sectional area (PA) were used to identify sarcopenia (group S) and non-sarcopenia (group nS) cases. Clinicopathological characteristics, operative results, postoperative complications, and prognosis were compared between these groups.ResultsThe S:nS ratios were 15:135 for the PV method and 52:98 for the PA method. There was a strong positive correlation (r = 0.66, p < 0.01) between PVI (psoas major muscle volume index) and PAI (psoas major muscle cross-sectional area index), which were calculated by dividing PV or PA by the square of height. Surgical results and postoperative complications did not differ significantly in the S and nS groups defined using each method. Overall survival was worse in group S compared to group nS identified by PV (p < 0.01), but not significantly different in groups S and nS identified by PA (p = 0.77). A Cox proportional hazards model for OS identified group S by PV as an independent predictor of a poor prognosis (p < 0.05), whereas group S by PA was not a predictor of prognosis (p = 0.60).ConclusionsThe PV method for identifying sarcopenia in elderly patients with CRC is more practical and sensitive for prediction of a poor prognosis compared to the conventional method.

TRENDS IN THE PREVALENCE OF POSSIBLE SARCOPENIA IN PEOPLE AGED 45 YEARS AND OLDER IN CHINA FROM 2011 TO 2015-BASED ON DATA FROM THE CHINA HEALTH AND RETIREMENT LONGITUDINAL STUDY

Objective: To compare the prevalence of possible sarcopenia in people aged 45 years old and above in China from 2011 to 2015, to increase the epidemiological evidence of possible sarcopenia for early detection and targeted intervention of sarcopenia, and to provide a partial reference basis for the prevention and treatment of sarcopenia in China in the future. Design and method: Based on CHARLS data for 2011,2013 and 2015, we analyzed the possible prevalence of sarcopenia in our 45-year-old middle-aged and elderly population using the diagnostic criteria of AWGS 2019. Results: The overall prevalence of possible sarcopenia in China was 16.6%,16.6%, and 20.3% in 2011,2013, and 2015, respectively, and was higher in 2015 than in 2011 and 2013 (P&lt;0.05). The prevalence increased with age, and was significantly higher in the elderly population aged 60 years and older than in the middle-aged population aged 45 to 59 years (P&lt; 0.05). The comparison of prevalence between different regions was west &gt; central &gt; east &gt; northeast in both 2011 and 2015, with prevalence decreasing and then increasing in central and west from 2011 to 2015, and the opposite in east and northeast (all P&lt;0.05). Conclusions: The detection rate of possible sarcopenia in elderly patients in China was high from 2011 to 2015, and the prevalence varied among different age groups and regions. Awareness of possible sarcopenia should be improved, and timely intervention, early screening, and targeted preventive measures should be provided for specific groups.

Impact of sarcopenia in elderly patients undergoing elective total hip arthroplasty on postoperative outcomes: a propensity score-matched study

ObjectiveFrailty poses a crucial risk for postoperative complications in the elderly, with sarcopenia being a key component. The impact of sarcopenia on postoperative outcomes after total hip arthroplasty (THA) is still unclear. This study investigated the potential link between sarcopenia and postoperative outcomes among elderly THA patients.MethodsTotally 198 older patients were enrolled in this study. Sarcopenia in this group was determined by assessing the skeletal muscle index, which was measured using computed tomography at the 12th thoracic vertebra and analyzed semi-automatically with MATLAB R2020a. Propensity score matching (PSM) was employed to evaluate postoperative complications of grade II and above (POCIIs).ResultsThe variables balanced using PSM contained age, sex and comorbidities including hypertension, diabetes, hyperlipidemia and COPD. Before PSM, sarcopenic patients with reduced BMI (24.02 ± 0.24 vs. 27.11 ± 0.66, P < 0.001) showed higher POCIIs rates (48.31% vs. 15%, P = 0.009) and more walking-assisted discharge instances (85.96% vs. 60%, P = 0.017) compared with non-sarcopenia patients. After PSM, this group maintained reduced BMI (23.47 ± 0.85 vs. 27.11 ± 0.66, P = 0.002), with increased POCIIs rates (54.41% vs. 15%, P = 0.002) and heightened reliance on walking assistance at discharge (86.96% vs. 60%, P = 0.008).ConclusionSarcopenia patients exhibited a higher incidence of POCIIs and poorer physical function at discharge. Sarcopenia could serve as a valuable prognostic indicator for elderly patients undergoing elective THA.

Sonographic methods to predict type 2 diabetes patients with sarcopenia: B mode ultrasound and shear wave elastography.

Type 2 diabetes accelerates the loss of muscle mass and strength. Sarcopenia is also one of the chronic complications of diabetes. To investigate the clinical value of B mode ultrasound (BMUS) and shear wave elastography (SWE) for predicting type 2 diabetic sarcopenia. We recorded Skeletal Muscle Mass Index (ASMI), grip strength, muscle thickness (MT), pinna angle (PA), fascicle length (FL), and the difference of Young's modulus in the relaxed states and tense states (ΔSWE). The correlations between clinical indicators and ultrasound characteristics were compared. A diagnostic model of sarcopenia was developed to assess the independent correlates and evaluate the diagnostic efficacy of sarcopenia. ASMI was significantly and positively correlated with MT and ΔSWE (r = 0.826, 0.765, P < 0.01), and grip strength was significantly and positively correlated with MT and ΔSWE (r = 0.797, 0.818, P < 0.01). MT was the most significant predictor of sarcopenia (OR = 4.576, P < 0.001), and the cut-off value of MT was 11.4 mm (AUC: 0.952). BMUS and SWE can quantitatively assess muscle mass and strength, and are effective methods to predict the occurrence of sarcopenia in elderly patients with type 2 diabetes.

Evaluation of sarcopenia and phase angle in elderly patients with Parkinson’s Disease

Purpose To investigate sarcopenia and related factors and to determine the disease-specific phase angle (PhA) cut-off score in detecting sarcopenia in elderly patients with Parkinson’s Disease (PD). Methods This cross-sectional study was conducted with 89 participants. The Mini-Nutritional Assessment (MNA), the Eating Attitude Test-10 (EAT-10), the Physical Activity Scale for The Elderly (PASE) questionnaire and the Hoehn-Yahr scale have been used. Additionally, anthropometric measurements were performed. The diagnosis of sarcopenia was based on the new consensus published by the European Working Group on Sarcopenia in Older People 2 (EWGSOP2). PhA has been performed by Bioelectrical Impedance Analysis (BIA) with Tanita MC 780®. Results The mean age was of the participants 68.9 ± 6.4 years, and 57.3% were male. The prevalence of sarcopenia was 12.3%. PhA, malnutrition, age, disease severity, low calf circumference (CC), low body mass index (BMI), the difference between the pre-diagnosis and current weight loss, dopaminergic treatment, and low PASE score were associated with sarcopenia. The cut-off value of the PhA in terms of the ability to identify sarcopenia was <4.5o with a sensitivity of 53.3% and a specificity of 93.2% (p = 0.001). When we grouped the PhA of the patients according to this cut-off score, it was seen that 14.6% of them were sarcopenic. Age, disease severity, PASE score and hand grip strength were significantly related to both sarcopenia and PhA. Conclusion It is important to be aware of sarcopenia and related factors at an early stage in Parkinson’s patients. Because of disease-related symptoms, it may be more appropriate to use a disease-specific PhA cut-off score in the definition of sarcopenia.

Frequency and Overlap of Cachexia, Malnutrition, and Sarcopenia in Elderly Patients with Diabetes Mellitus: A Study Using AWGC, GLIM, and AWGS2019.

This study aimed to estimate the frequency and overlap of cachexia, malnutrition, and sarcopenia in elderly patients with diabetes mellitus. Patients who were aged at least 65 years, had diabetes mellitus, and were regularly visiting the Ise Red Cross Hospital on an outpatient basis were included. The patients were assessed to determine whether they had cachexia, malnutrition, and sarcopenia according to the Asian Working Group for Cachexia criteria, the Global Leadership Initiative on Malnutrition criteria, and the Asian Working Group for Sarcopenia 2019 criteria. A total of 510 patients (310 men and 200 women) were analyzed in this study. Sarcopenia, cachexia, and malnutrition were found in 84 patients (16.4%), 40 patients (7.8%) (17.8% among patients with chronic diseases), and 110 patients (21.5%), respectively. Among patients with sarcopenia, the frequencies of cachexia and malnutrition were 30% and 71.4%, respectively. Among patients with cachexia, the frequencies of sarcopenia and malnutrition were 65% and 90%, respectively, and among those with malnutrition, the frequencies of sarcopenia and cachexia were 54% and 32.7%, respectively. The overlap among cachexia, malnutrition, and sarcopenia appears to be an important factor to be considered in the treatment of elderly patients with diabetes mellitus.

Pathogenesis and comprehensive treatment strategies of sarcopenia in elderly patients with type 2 diabetes mellitus.

Sarcopenia and diabetes are two age-related diseases that are common in the elderly population, and have a serious effect on their general health and quality of life. Sarcopenia refers to the progressive loss of muscle mass, strength and function, whereas diabetes is a chronic disease characterized by elevated blood sugar levels. The comorbidity of sarcopenia and diabetes is particularly concerning, as people with diabetes have a higher risk of developing sarcopenia due to the combination of insulin resistance, chronic inflammation and reduced physical activity. In contrast, sarcopenia destroyed blood sugar control and exacerbated the development of people with diabetes, leading to the occurrence of a variety of complications. Fortunately, there are a number of effective treatment strategies for sarcopenia in people with diabetes. Physical exercise and a balanced diet with enough protein and nutrients have been proved to enhance the muscular quality and strength of this population. Additionally, pharmacological therapies and lifestyle changes can optimize blood sugar control, which can prevent further muscle loss and improve overall health outcomes. This review aims to summarize the pathogenesis and comprehensive treatment strategies of sarcopenia in elderly patients with type 2 diabetes, which help healthcare professionals recognize their intimate connection and provide a new vision for the treatment of diabetes and its complications in this population. Through early identification and comprehensive treatment, it is possible to improve the muscle function and general quality of life of elderly with diabetes and sarcopenia.

Relevance of sarcopenia in elderly patients undergoing surgery for oral squamous cell carcinoma

In the elderly population there is increasing evidence that frailty predicts adverse outcomes better than chronological age. Sarcopenia is an important component of frailty. This study aimed to establish the relevance of sarcopenia in elderly patients with oral squamous cell carcinoma (OSCC) undergoing surgery. This retrospective, single-centre, cohort study included patients over the age of 75 years who were diagnosed with OSCC between 2007 and 2016. Cross-sectional imaging of the neck was used to predict the Skeletal Muscle Index (SMI) using validated equations. Based on established thresholds, patients were categorised as having either a normal or low SMI, indicative of sarcopenia. Sixty-nine patients met the inclusion criteria. Patients with a low SMI had a longer length of stay (16.9 days vs 9.8 days, p = 0.030); they had more severe complications, defined as Clavien-Dindo grade IIIb or higher (17.6% vs 4.0%, p = 0.042); and their mean Comprehensive Complication Index (CCI) was also higher (14.1 vs 4.7, p = 0.051). Furthermore, 2/34 patients in the low SMI group died within 30 days of surgery compared with none in the normal SMI group (5.9% vs 0%, p = 0.503). Whilst patients with a low SMI who underwent surgery had lower five-year overall survival, the difference was not statistically significant. This study shows that sarcopenia negatively influences surgical outcomes in elderly patients. Routine measurement of SMI could be an indication for a comprehensive geriatric assessment (CGA).

Cross-Sectional Study on the Association between Dietary Patterns and Sarcopenia in Elderly Patients with Chronic Kidney Disease Receiving Conservative Treatment

Sarcopenia is a poor prognostic factor in patients with chronic kidney disease (CKD). Adequate dietary patterns are important for preventing sarcopenia; however, evidence regarding the underlying association between sarcopenia and diet is insufficient. Therefore, in this study, we aimed to investigate the association between sarcopenia and dietary patterns in CKD patients receiving conservative treatment. In this cross-sectional study, 441 patients with conservative CKD were examined using the Asian Working Group for Sarcopenia diagnostic criteria. CKD was defined as an eGFR of &lt;60 mL/min/1.73 m2 present for &gt;3 months. The participants were divided into sarcopenia and non-sarcopenia groups, and dietary patterns were compared between the two groups using the dietary variety score, a simple dietary survey method that investigates the weekly frequency of consumption of 10 food groups. Logistic regression analysis for CKD G3 showed that female sex (odds ratio (OR): 0.166, 95% confidence interval (CI): 0.086–0.320), increased body mass index (OR: 0.663, 95% CI: 0.590–0.745), and almost daily consumption of green/yellow vegetables (OR: 0.350, 95% CI: 0.176–0.695) were positively associated with non-sarcopenia. Although further prospective studies are required, the results suggest that low frequent consumption of vegetables is associated with sarcopenia in patients with CKD.

Changes and correlation analysis of intestinal microflora composition, inflammatory index, and skeletal muscle mass in elderly patients with sarcopenia.

This study aimed to explore the alterations in characteristics of intestinal flora, inflammatory factors and skeletal muscle mass in elderly patients affected by sarcopenia, as well as the correlation among the three, in order to provide a reference for the early identification, intervention, and treatment of sarcopenia in elderly patients. A total of 206 elderly patients (≥60 years old) admitted to the Geriatric Outpatient Department of China Resources Wugang General Hospital were included in this study as the research participants. The differences in the general data, laboratory examination and intestinal flora in patients between the two groups were statistically analyzed, and the correlation between intestinal flora composition and skeletal muscle mass index, grip and inflammatory factors was also determined. The normal group and sarcopenia group exhibited a significant difference in the composition of the intestinal flora (P < 0.05). The abundance of Escherichia-Shigella between the two groups was negatively correlated with the patient's relative skeletal muscle mass index and positively correlated with the interleukin-6 (IL-6) level; moreover, Lacchnospira abundance was positively correlated with relative skeletal muscle mass index; Lactobacillus and Roseburia abundance were negatively correlated with IL-6; and Lactobacillus, Lachnospira, and Eubacterium_rectale_group were positively correlated with grip, and the differences were statistically significant (P < 0.05). Overall, it was found that elderly patients with sarcopenia have intestinal flora disorders, and the abundance of such flora was negatively correlated with the relative skeletal muscle mass index, which was positively correlated with the IL-6 level. Geriatr Gerontol Int 2024; 24: 140-146.

Are thyroid hormone levels and sarcopenia in elderly patients associated with type 2 diabetes mellitus and euthyroidism?

Aim to study the relationship between thyroid function parameters (free T3 (FT3), free T4 (FT4), FT3/FT4 ratio), thyroid-stimulating hormone (TSH) and parameters characterizing sarcopenia (muscle mass and strength, physical performance) in patients with type 2 diabetes mellitus (T2DM) and euthyroidism.&#x0D; Material and methods. The study included 312 elderly patients with T2DM in a state of euthyroidism (mean age 65.39 2.28 years). In all participants the following parameters were measured: anthropometric parameters, thyroid hormones (FT3, FT4), TSH, fasting blood glucose, glycated hemoglobin (HbA1c), fasting C-peptide and insulin, lipid profile, body composition, handgrip strength, walking speed.&#x0D; Results. Sarcopenia was prevalent in 26.9% of T2DM patients with euthyroidism. A binary logistic regression analysis adjusted for age, gender, smoking and alcohol consumption, T2DM duration, hypertension, HbA1c level, eGFR, TG, HDL and fat mass fraction showed that the high-normal FT3 level (OR = 0.522, 95% CI: 0.3040.895, p = 0.018), a low-normal FT4 level (OR = 1.126, 95% CI: 1.0091.258, p = 0.034) and an increased FT3/FT4 ratio (OR = 0.923, 95% CI: 0.8790.969, p = 0.001) were associated with a low prevalence of sarcopenia. FT3 concentration was positively associated with muscle strength (OR = 0.525, 95% CI: 0.3050.902, p = 0.020) and walking speed (OR = 0.443, 95% CI: 0.2590.758, p = 0.003), while FT4 concentration was negatively associated with muscle mass (OR = 1.114, 95% CI: 1.0091.232, p = 0.036). The FT3/FT4 ratio was positively associated with muscle mass (OR = 0.943, 95% CI: 0.9050.981, p = 0.006), muscle strength (OR = 0.945, 95% CI: 0.9010.992, p = 0.021), and walking speed (OR = 0.934, 95% CI: 0.8940.975, p = 0.002). TSH levels were not associated with sarcopenia.&#x0D; Conclusion. The high FT3/FT4 ratio is significantly associated with a low risk of sarcopenia in T2DM patients with euthyroidism.

Analysis of the incidence and influencing factors of sarcopenia in elderly patients with radiation enteritis

Analysis of the incidence and influencing factors of sarcopenia in elderly patients with radiation enteritis

Perbedaan Kadar Insulin-Like Growth Factor-1 dan Tumor Necrosis Factor-α Serum pada Berbagai Derajat Sarkopenia Pasien Lanjut Usia: Studi Potong Lintang

Introduction. Sarcopenia is a phenomenon of progressive decline in muscle function that occurs due to the aging process. Insulin-like growth factor-1 (IGF-1) and tumor necrosis factor-α (TNF-α) have an important role in the occurrence of sarcopenia as a positive and negative regulator of muscle mass. Research shows differences in IGF-1 and TNF-α levels between sarcopenia and non-sarcopenia groups, but research on differences in severity of sarcopenia remains unclear. The purpose of this study was to determine the difference in levels of IGF-1 and TNF-α in various degrees of sarcopenia in elderly patients. Methods. This was an analytical observational study with a cross-sectional approach involving 45 subjects of elderly patients who came to the internal outpatient clinic of RSUP dr. M. Djamil Padang and met the criteria for inclusion and exclusion. Subjects were grouped into possible sarcopenia, sarcopenia, and severe sarcopenia. Then, serum IGF-1 and TNF-α examinations were performed using the enzyme linked immunosorbent assay (ELISA) method. Data was analyzed using SPSS 26.0. Results. Median of serum IGF-1 levels in the total sample were 41.36 ng/mL. The highest levels of IGF-1 were found in the possible sarcopenia group (55.28 ng/mL), while the lowest level was in the severe sarcopenia group (31 ng/mL). Median of serum TNF-α levels in the total sample were 157.63 ng/L with the lowest was found in the possible sarcopenia group (111.41 ng/L) and the highest was in the severe sarcopenia group (241.1 ng/L). There was a significant difference in serum levels of IGF-1 and TNF-α in the three sarcopenia groups (p= 0.001). IGF-1 levels decreased according to the severity of sarcopenia, while TNF-α levels increased according to the severity of sarcopenia. Conclusions. There are differences in serum levels of IGF-1 and TNF-α between possible sarcopenia, sarcopenia, and severe elderly sarcopenia.

Acceleration of sarcopenia in elderly patients who develop asymptomatic pneumonia shadow within one year after surgery for early gastric cancer

BackgroundAlthough early gastric cancer is curable with local treatment, the overall survival in elderly patients did not reach 80% at five years after surgery. The major cause of death in elderly patients with early gastric cancer is not cancer itself but is related to postoperative sarcopenia. Elderly patients frequently develop postoperative asymptomatic pneumonia shadow, which is associated with a poor prognosis. However, why asymptomatic pneumonia shadow worsens the prognosis remains unclear. We investigated whether sarcopenia is accelerated in patients who developed asymptomatic pneumonia shadow.MethodsWe retrospectively examined patients of > 75 years of age who underwent R0 gastrectomy for gastric cancer and were diagnosed with T1 disease at National Cancer Center Hospital between 2005 and 2012. The diagnosis of asymptomatic pneumonia shadow was defined by diagnostic findings of pneumonia (consolidation type, reticular type, and nodular type) which were newly observed on chest computed tomography performed one year after surgery in comparison to preoperative computed tomography. Postoperative muscle loss was assessed by a computed tomography-based analysis using the L3 skeletal muscle index before and two years after surgery and the rate of decrease was calculated. Patients were classified into two groups according to the rate of decrease (cut-off value: 10%).ResultsOf the 3412 patients who underwent gastrectomy in our hospital during the study period, 142 were included in this study. Asymptomatic pneumonia shadow was found in 26 patients (18%). Patients who developed asymptomatic pneumonia shadow showed a significantly greater loss of muscle volume in comparison to patients who did not develop asymptomatic pneumonia shadow. In the multivariate analysis, total gastrectomy and asymptomatic pneumonia shadow were the independent risk factors for severe muscle loss. However, there was no significant difference in prognosis between the two groups.ConclusionsSarcopenia was accelerated in elderly patients who developed asymptomatic pneumonia shadow after surgery for early gastric cancer. However, the poor prognosis in these patients may not be related to accelerated sarcopenia.

Sarcopenia in elderly patients with type 2 diabetes: risk factors

Aim to determine the risk factors for sarcopenia in elderly patients with type 2 diabetes (T2DM).&#x0D; Material and methods. The study included 395 elderly patients with T2DM (mean age 65.1 2.7 years). The probable sarcopenia group (n = 185) included participants with low muscle strength, the control group (n = 210) included participants without sarcopenia. In all participants we registered the anthropometric indicators; fasting blood glucose; glycated hemoglobin (HbA1c); albumen; creatinine; body composition; handgrip strength. The food diary was used to calculate total daily calories, the amount of carbohydrates, proteins and fats eaten per day, as well as the proportion of calories provided by these macronutrients.&#x0D; Results. Compared with the controls, the male and female patients with probable sarcopenia were older (p0.001) and had lower waist-to-hip ratio (p=0.038 and p=0.018, respectively) and BMI (p=0.001 and p0.001 respectively), eGFR (p=0.030 and p=0.018, respectively), bone mineral content (p0.001), basal metabolic rate (p=0.016 and p0.001, respectively), appendicular skeletal muscle mass (p=0.043 and p0.001, respectively), appendicular musculoskeletal mass index (p=0.002 and p0.001, respectively) and muscle quality (p0.001), high fasting plasma glucose (p=0.017 and p=0.007, respectively) and HbA1c (p0.001 and p=0.004, respectively). In men with probable sarcopenia, the percentage of calories provided by carbohydrates was lower (p=0.041), while the percentage provided by fats (p= 0.012) was higher than in the control group.&#x0D; Conclusion. The multivariate logistic regression analysis showed that age (OR = 1.517, 95% CI: 1.127-2.043, p=0.006), male sex (OR = 0.196, 95% CI: 0.142-0.271, p0.001), BMI 28 kg/m2 (OR = 0.683, 95% CI: 0.467-0.998, p=0.049), HbA1c level 10% (OR = 1.396, 95% CI: 1.018-1.915, p=0.038), diabetic nephropathy (OR = 1.439, 95% CI: 1.033-2.006, p=0.031) and decreased serum albumin (OR = 0.917, 95% CI: 0.883-0.953, p0.001) were risk factors associated with low muscle strength in patients with type 2 diabetes type.

Chinese expert consensus on prevention and intervention for elderly with sarcopenia (2023).

Sarcopenia is the age-related loss of skeletal muscle mass and muscle strength or physical function. It is most common in elderly individuals. Due to its high incidence, insidious onset, and extensive impact on the body, it has a huge impact on the family medical burden and the social public health expenditure in China. The understanding of sarcopenia in China is still lacking, and the recommendations for prevention, control, and intervention are not clear and unified. The purpose of this consensus report is to standardize the prevention, control, and intervention methods for sarcopenia in elderly patients in China; improve the efficacy of intervention; reduce complications during the intervention process; and reduce the risk of falls, fractures, disability, hospitalization, and even death in elderly individuals.

The association between glucose fluctuation with sarcopenia in elderly patients with type 2 diabetes mellitus.

Growing evidence shows that sarcopenia is more prevalent in patients with type 2 diabetes mellitus (T2DM) than in the normal population. However, currently, data on the relationship between blood glucose fluctuation and sarcopenia in elderly patients with T2DM are still limited. In this study, 280 patients ≥ 60 years with T2DM were divided into sarcopenic group and non-sarcopenic group, according to the diagnostic criteria of the 2019 Asian Working Group for Sarcopenia. They wore MeiQi to acquire the indexes including time in range (TIR), time above range (TAR), time below range (TBR), mean amplitude of glycemic excursion (MAGE), coefficient of Variation (CV), blood glucose standard deviation (SD), largest amplitude of glycemic excursions (LAGE) and mean glucose (MG). The prevalence rate of sarcopenia was statistically analyzed and the different indicators of glucose fluctuation between the two groups were compared. We analyzed the indexes of glucose fluctuation and appendicular skeletal muscle mass index (ASMI), handgrip strength, the time of five times sit to stand test (FTSST) with Spearman's correlation analysis. Logistic regression was used to analyze the influence factors for sarcopenia. The prevalence of sarcopenia was 15.36%. TIR, MG and TAR were correlated with ASMI, handgrip strength, the time of FTSST. MG and TAR were risk factors for sarcopenia, while TIR was the protective factor of sarcopenia. After adjusting mixing factors, logistic regression analysis showed that TIR was an independent protective factor. The result of the Chi-square test showed that the incidence of sarcopenia in different TIR ranges was different: the proportion of patients with sarcopenia was 40.48% (TIR ≤50%), 20.41% (50%<TIR≤70%) and 8.47% (TIR >70%). TIR is associated with sarcopenia in elderly T2DM patients. Furtherly, the incidence rate of sarcopenia decreases with the increase of TIR.

25-Hydroxyvitamin D: A potential marker of the incidence of osteoporosis and sarcopenia in diabetic mellitus patients

Purpose: To investigate the feasibility of using the 25-hydroxyvitamin D (25(OH)D) levels in assessing osteoporosis (OP) and sarcopenia in elderly patients with diabetes mellitus (DM).&#x0D; Methods: One hundred and forty elderly patients with DM were allocated to DM (n = 40), OP (n = 50), and DM + OP (n = 50) groups. Their clinical data were collected, and muscle function assessed. The levels of fasting insulin, glycated hemoglobin (HbAlc), t-P1NP, and 25(OH)D were determined by chemiluminescent microparticle immunoassay, high-pressure liquid chromatography, electrochemical immunoassay, and liquid chromatography-tandem mass spectrometry, respectively.&#x0D; Results: The 25(OH)D levels were lowest in DM + OP group, followed by the OP group, and highest in the DM group (p &lt; 0.05). The DM + OP group showed significantly lower gait speed and grip strength than the OP and DM groups (p &lt; 0.05). The diagnostic AUC of 25(OH)D for OP and sarcopenia were 0.9733 (95 % CI: 0.9274 - 1.000, p &lt; 0.001) and 0.9866 (95 % CI: 0.9632 - 1.000, p &lt; 0.001). Patients with sarcopenia had significantly lower 25(OH)D and t-PINP levels than patients without sarcopenia (p &lt; 0.05). Logistic regression analysis revealed that the 25(OH)D level, duration of DM, and age were independent risk factors for sarcopenia (p &lt; 0.05).&#x0D; Conclusion: Patients with DM and OP exhibit increase in the incidence of sarcopenia. Serum 25(OH)D may be used as a potential marker for the incidence of OP and sarcopenia in DM patients.

Alternative skeletal muscle index for sarcopenia diagnosis in elderly patients with type 2 diabetes mellitus: A pilot study.

To determine an alternative skeletal muscle index (a-SMI), easy diagnosis of sarcopenia in elderly patients with type 2 diabetes mellitus (T2DM). This cross-sectional study included 223 inpatients with T2DM (100 males, age range 60-89; 123 females, age range 60-87). Screening for grip strength and gait speed, measuring SMI by dual-energy X-ray absorptiometry (d-SMI) for sarcopenia diagnosis, according to the Asian Working Group for Sarcopenia (AWGS) 2019 consensus. The a-SMI was established by binary logistic regression analysis with positive screening population. To assess the conformance of the new diagnostic approach with the AWGS 2019. Sarcopenia was present in 36.3% of the study population. 59 had normal d-SMI and 81 had low d-SMI in screening patients with probable sarcopenia. In univariate analyses for all positive screening population, body mass index (BMI), 25-hydroxyvitamin D (25 - (OH) VitD), high density lipoprotein cholesterol (HDL-C), hypertension (HTN), and gender were correlates of d-SMI. Binary logistic regression analysis revealed that male (B = 2.463, 95%CI: 3.640 ~ 37.883, p = 0.000), HTN (B = 1.404, 95%CI: 1.599 ~ 10.371, p = 0.003), BMI (B = -0.344, 95%CI: 0.598 ~ 0.839, p = 0.000), 25-(OH) VitD (B = -0.058, 95%CI: 0.907 ~ 0.982, p = 0.004) were independent factors for d-SMI detection. Based on the extracted four correlates, the a-SMI was determined. The area under receiver operating characteristic (ROC) curve was 0.842, sensitivity and specificity for the new diagnostic approach were 84.0% and 84.5%. In a statistical measure of agreement between the AWGS 2019 and the new diagnostic approach, the kappa coefficient was 0.669 (p < 0.001). The a-SMI - based on gender, obesity status, 25-(OH) VitD, and HTN history - can be used in the absence of the d-SMI to supplement the algorithm for sarcopenia diagnosis in elderly patients with T2DM.

Value of conventional ultrasound and shear wave elastography in the assessment of muscle mass and function in elderly people with type 2 diabetes.

We assessed muscle mass and function using ultrasound (US) and shear wave elastography (SWE) for sarcopenia in elderly patients with type 2 diabetes. There were 84 patients with type 2 diabetes enrolled in this study; of these, 30 had sarcopenia and 54 did not. We measured appendicular skeletal muscle mass index (ASMI), handgrip strength, calf circumference, 6-m walking speed, and 5-time chair stand test. All patients were in the supine position with their knees in straight and bent poses in turn. The US-derived thickness (Tstraight, Tbent), cross-sectional area (CSAstraight, CSAbent), and SWE (SWEstraight, SWEbent) of the rectus femoris muscle (RFM) were measured and the differences (ΔT, ΔCSA, ΔSWE) were calculated. We assessed the correlations of clinical indicators with US and SWE features. We then compared the clinical indicators and US and SWE features between patients with and without sarcopenia to determine independent predictors. Diagnostic models were established based on these independent predictors. The ASMI was correlated with Tbent (r = 0.57, p < 0.001) and CSAbent (r = 0.50, p < 0.001). Handgrip strength was correlated with Tbent (r = 0.53, p < 0.001) and CSAbent (r = 0.51, p < 0.001). Between patients with and without sarcopenia, the indicators of age, ΔCSA, and ΔSWE were statically different (all p ≤ 0.001). Based on these results, a diagnostic model for sarcopenia was established with 83.3% sensitivity, 83.3% specificity, and 83.3% accuracy. In elderly people with type 2 diabetes, sarcopenia patients had smaller muscle CSA and less stiffness than non-sarcopenia patients. US and SWE might be useful to screen them. • Sarcopenia is common in elderly people with type 2 diabetes. • Ultrasound and shear wave elastography might be useful methods for quantitatively assessing muscle mass and strength. • Ultrasound and shear wave elastography might be useful methods for screening sarcopenia in elderly patients with type 2 diabetes.