Sarcopenic Individuals Research Articles

PLASMA PROTEOMIC SIGNATURE OF DEVELOPMENT AND PROGNOSIS OF SARCOPENIA

Abstract Sarcopenia, characterized by muscle loss and functional decline, poses a significant health concern in aging populations. Understanding the proteomic signatures associated with the development and prognosis of sarcopenia is crucial for targeted management. Data from 52,689 participants (aged 39-70 years) in the UK Biobank were analyzed, with 2,920 proteins assayed using Olink. We used the multinomial logistic regression to identify proteins cross-sectionally associated with sarcopenia at baseline; Cox regression was used to examine proteins associated with all-cause mortality among 2,886 individuals who were sarcopenic at baseline. Subsequently, we used the LASSO regression to screen for important proteins for predicting death among sarcopenic persons and the light gradient boosting machine model to determine relative importance of these proteins. Pathway analysis was performed using Enrichr. A total of 738 proteins were cross-sectionally associated with sarcopenia at baseline, while 627 proteins were significantly associated with mortality among initially sarcopenic individuals (Bonferroni-corrected p-value < 0.05). LASSO regression identified 306 and 65 proteins associated with sarcopenia status and death, respectively. Among the 34 overlapping proteins, GDF15, WFDC2, EDA2R, and CHRDL1 were the top signals. The prediction model with these 34 proteins had a C-statistic=0.81 and performed better than a base model with key socio-demographic variables (net reclassification index=0.27). Differential expression analysis revealed enrichment of proteins in cellular signaling, extracellular matrix remodeling, cancer initiation and progression, and metabolic regulation pathways. Identification of proteomic signatures of sarcopenia provides insights into its pathogenesis and prognosis. The refined predictive models offer potential clinical utility in personalized management strategies for sarcopenia.

Multi-channel EMG manifestations of upper-extremity muscle coordination imbalance among community-dwelling sarcopenic seniors

BackgroundSarcopenia is an age-related, insidious, crippling but curable degenerative disease if diagnosed and treated early. However, no accessible and accurate early screening method is available for community settings that does not require specialized personnel. One of the hallmarks of sarcopenia is the pathological changes of muscle fiber type composition and motor unit firing patterns. Surface electromyography (sEMG) may serve as an effective tool for detecting differences between healthy and sarcopenic individuals due to its superior wearability and accessibility compared to other screening methods such as medical imaging and bioimpedance measurements, making it ideal for community-based sarcopenic screening. Our study aims to explore sEMG biomarkers that can be used for screening or diagnosis of sarcopenia.ResultsWe collected multi-channel sEMG signals from six forearm muscles of 98 healthy and 55 sarcopenic community-dwelling older adults. Participants performed grasp tasks at 20% and 50% of maximum voluntary contraction (MVC). Hexagons created by various EMG features, normalized with respect to respective MVC, and symmetry analyses were performed to estimate multi-muscle coordination patterns. An innovative index, namely incenter–circumcenter distance of muscle coordination (ICDMC), is proposed to discriminate between the healthy and sarcopenic groups. We utilized non-parametric tests to compare the ICDMC between the two groups, considering a p-value less than 0.05 statistically significant. The results showed that at 20% MVC, ICDMCs from root mean square (RMS), mean absolute value (MAV), slope sign changes (SSC) and wavelength (WL) showed statistically significant differences. More insights of this sEMG manifestation of sarcopenia were revealed by gender- and age-stratifications analyses.ConclusionsOur results demonstrated that there are clear sEMG manifestations of altered muscle coordination in sarcopenic patients. More consistent force generation patterns were observed in the sarcopenic group, especially at lower contraction intensities. The novel ICDMC can quantify differences between sarcopenic and healthy muscle. These results warrant further research to further develop more accessible sarcopenia screening strategies in community settings based on electrophysiological measurements such as sEMG.

Bioelectrical Impedance Vectors Analysis of Sarcopenic Older Adults Submitted to a Resistance Training Program.

The objective of the present study is to analyze the changes in bioimpedance vector analysis (BIVA) and phase angle (PhA) in sarcopenic older people submitted to a 12-week resistance training (RT) program according to classic and specific analyses. To this end, 20 sarcopenic older adults of both sexes, invited through media, underwent bioimpedance analysis before and after the RT carried out three times a week, for 12 weeks. The mean impedance vectors of the groups established for the confidence ellipses (95% of the confidence ellipse) are compared using Hotelling's T2 test. The distance D from Mahalanobis is also calculated. Classic and Specific BIVA are presented. The resistance values for the classical analyses (R/H) decreased across all groups (whole group, women and men, p < 0.05), with approximate decreases ranging from 9.4% to 10%, while the classic reactance (Xc/H) decreased (p < 0.05) only for the whole group (5.9%) and men (7.7%). For the specific BIVA, trends are verified for the whole sample, with a decrease in resistance (R.sp) and an increase in reactance (Xc.sp). In conclusion, the RT program in sarcopenic individuals promoted a reduction in resistance values in classical analyses, indicating a possible increase in hydration status and, consequently, musculoskeletal mass.

Characterizing the skeletal muscle immune microenvironment for sarcopenia: insights from transcriptome analysis and histological validation.

Sarcopenia is a condition characterized by the age-related loss of skeletal muscle mass and function. The pathogenesis of the disease is influenced by chronic low-grade inflammation. However, the specific changes in the immune landscape changes of sarcopenic muscle are not yet fully understood. To gain insights into the immune cell composition and interactions, we combined single-nucleus RNA sequencing data, bulk RNA sequencing dataset, and comprehensive bioinformatic analyses on the skeletal muscle samples from young, aged, and sarcopenic individuals. Histological staining was then performed on skeletal muscles to validate the distribution of immune cells in clinical samples. We analyzed the transcriptomes of 101,862 single nuclei, revealing a total of 10 major cell types and 6 subclusters of immune cell types within the human skeletal muscle tissues. Notable variations were identified in the immune microenvironment between young and aged skeletal muscle. Among the immune cells from skeletal muscle microenvironment, macrophages constituted the largest fraction. A specific marker gene LYVE1 for skeletal muscle resident macrophages was further identified. Cellular subclasses included four distinct groups of resident macrophages, which play different roles in physiological or non-physiological conditions. Utilizing bulk RNA sequencing data, we observed a significant enrichment of macrophage-rich inflammation in sarcopenia. Our findings demonstrate age-related changes in the composition and cross-talk of immune cells in human skeletal muscle microenvironment, which contribute to chronic inflammation in aged or sarcopenia muscle. Furthermore, macrophages emerge as a potential therapeutic target, thus advancing our understanding of the pathogenesis of sarcopenia.

Trend in prevalence, associated risk factors, and longitudinal outcomes of sarcopenia in China: A national cohort study.

To estimate the contemporary trend in the prevalence of sarcopenia and evaluate its risk factors and the longitudinal associations with multiple chronic conditions and mortality among Chinese middle-aged and older adults. This was a nationwide, prospective cohort study using data from the China Health and Retirement Longitudinal Study. The definition of sarcopenia was based on the Asian Working Group for Sarcopenia 2019 algorithm. In the cross-sectional analysis, we estimated the trend in the weighted prevalence of sarcopenia from 2011 to 2015 and examined the associated risk factors for sarcopenia severity in 2011. In the longitudinal analysis, we assessed the longitudinal associations between sarcopenia and 14 chronic conditions and mortality during a 9-year follow-up. The weighted prevalence of sarcopenia remained consistently high in the overall population from 2011 (15.9%, 95% confidence intervals [CI]: 15.1, 16.6) to 2015 (15.0%, 95% CI: 14.3, 15.6; p for trend=0.075). A range of risk factors were independently associated with the severity of sarcopenia, including older age, female sex, lower socioeconomic status, smoking status, malnutrition, and several chronic conditions. Possible sarcopenic and sarcopenic individuals had higher odds of several chronic conditions (i.e., heart disease, chronic lung disease, and memory-related disease) and increased risks of mortality (possible sarcopenia: odds ratios (OR): 1.66, 95% CI: 1.37, 2.00; sarcopenia: OR: 1.69, 95% CI: 1.36, 2.11) in 9 years of follow-up. The prevalence of sarcopenia remained consistently high in the investigated population. Various risk factors were significantly associated with a higher prevalence of sarcopenia. Sarcopenic individuals had higher odds of several chronic conditions and increased risks of mortality, highlighting that the urgent need for dedicated efforts to improve the management of sarcopenic patients.

P34: The prognostic value of pre-treatment sarcopenia in overall survival in head and neck cancer patients: A systematic review

Abstract Background This study aims to determine the prognostic value of pre-treatment sarcopenia, defined radiologically at the cervical (C3) or lumbar (L3) region, in head and neck (HNC) adult patient population undergoing treatment with curative intention. Methods A systematic search in the PubMed and Scopus databases was performed before February 2022. The inclusion criteria applied were adult patients with locally advanced HNC, sarcopenia defined radiologically at the C3 and/or L3 level, and patients receiving primary treatment with curative intent. The certainty of study evidence was assessed using the ROBINS-I scale, the Cochrane method for assessing bias in non-randomised trials. Results Twenty-six studies were included in this review, totalling 6395 adult patients with HNC. It was evident that pre-treatment sarcopenia was associated with worse overall survival outcomes in 22 out of 26 (85%) studies across all the treatment modalities with curative intent. In addition, the gender-specific skeletal muscle index (SMI) sarcopenic cut-off value of &amp;lt;52.4 cm2/m2 for men and &amp;lt;38.5 cm2/m2 for women, was significantly associated with worse OS compared to other cut-off values seen in a minority of studies. Conclusions Despite the retrospective design of the studies and inconsistency in SMI cut-off values, these findings suggest that sarcopenia is a strong prognostic factor of overall survival in HNC patients undergoing primary curative treatment. The clinical implications of these findings suggest that sarcopenia evaluation is a good prognostic marker in the HNC population. Future nutritional interventional studies might focus on reversing the muscle loss and improving the overall outcomes in identified sarcopenic individuals.

Sarcopenic patients “get even”: The impact of COVID-19 vaccination on mortality

BackgroundCoronavirus Disease-2019 (COVID-19), driven by the SARS-CoV-2 virus, has disproportionately affected the elderly, with comorbidities like sarcopenia worsening prognosis. Considering the significant impact of RNA vaccines on survival rates in this population, our objective is to investigate the impact of vaccination on the survival of hospitalized elderly patients with COVID-19, considering the presence or absence of sarcopenia. MethodsProspective study conducted on 159 patients aged>65 years from September 2021 to March 2022. Data about clinical and body composition, and mortality at 12-months after discharge were recorded. Sarcopenia was diagnosed according to the 2019 European Consensus criteria. ResultsAt the twelfth month post-discharge, vaccinated sarcopenic individuals exhibited a mortality risk similar to vaccinated non-sarcopenic individuals, and lower than unvaccinated non-sarcopenic patients. Cox regression analysis, adjusted for age, gender, comorbidity, functional and vaccinal status, showed that the presence of sarcopenia did not significantly impact the risk of death within 12-months post-discharge. DiscussionVaccination emerges as a protective measure for sarcopenic patients, countering the potential adverse effects of sarcopenia on COVID-19 outcomes, underscoring the importance of immunization in the frail elderly with a call for meticulous monitoring of its benefits. ConclusionsOur study represents the first attempt to analyze the vaccine's effect on survival in sarcopenic hospitalized older adults with COVID-19. The administration of vaccination to sarcopenic patients proves pivotal, as its omission could lead to notably unfavorable outcomes within this specific population.

Muscle ultrasound to diagnose sarcopenia in chronic kidney disease: a systematic review and bayesian bivariate meta-analysis

ObjectiveThe aim of this systematic review was to assess the diagnostic test accuracy of muscle ultrasound for sarcopenia among chronic kidney disease (CKD) populations.BackgroundSarcopenia has become a worldwide health issue, especially for CKD patients. Conventional techniques of muscle mass assessment often prove limited, thus prompts increasing interest in ultrasound suitability.MethodsWe searched the Cochrane Library, PubMed and Embase for literature published up to June 2023. Ultrasound diagnosis of sarcopenia in CKD patients was included. Two independent investigators used the Quality Assessment Tool for Diagnosis Accuracy Studies (QUADAS-2) to assess the quality. We extracted valuable information from eligible studies. Using a Bayesian bivariate model, we pooled sensitivity and specificity values and summary receiver operating characteristic (SROC) curves.ResultsFive articles, involving 428 participants at various stages of CKD were included. Three studies diagnosed by the cross-sectional area (CSA) of the rectus femoris, while two others by muscle thickness (MT) and shear wave elastography (SWE) from the same muscle, separately. Overall, CSA or SWE had a pooled sensitivity of 0.95 (95% CrI, 0.80, 1.00), and the specificity was 0.73 (95% CrI, 0.55, 0.88) for diagnosing sarcopenia in CKD patients.ConclusionsUltrasound measurements of CSA and SWE were more sensitive for diagnosing sarcopenia in the CKD population than in the general population. Ultrasound assessment from a single peripheral skeletal muscle site may serve as a rapid screening tool for identifying sarcopenic individuals within the CKD population, if a specific cut-off value could be determined.

Effects of inspiratory muscle training on inspiratory muscle strength, diaphragm thickness, and exercise capacity in sarcopenic individuals

Effects of inspiratory muscle training on inspiratory muscle strength, diaphragm thickness, and exercise capacity in sarcopenic individuals

Effect of whole-body vibration stimulation on plasma soluble TNF receptors in elderly with sarcopenia: a randomized controlled trial.

Sarcopenia is a pathology resulting from a progressive and severe loss of muscle mass, strength, and function in the course of aging, which has deleterious consequences on quality of life. Among the most widespread studies on the issue are those focused on the effect of different types of physical exercise on patients with sarcopenia. This randomized controlled study aimed to compare the effects of a whole-body vibration exercise (WBV) session on the inflammatory parameters of non-sarcopenic (NSG, n=22) and sarcopenic elderly (SG, n=22). NSG and SG participants were randomly divided into two protocols: intervention (squat with WBV) and control (squat without WBV). After a one-week washout period, participants switched protocols, so that everyone performed both protocols. Body composition was assessed by dual-energy radiological absorptiometry (DXA) and function through the six-minute walk test (6MWD) and Short Physical Performance Battery (SPPB). Plasma soluble tumor necrosis factor receptors (sTNFR) were determined by enzyme-linked immunosorbent assay (ELISA) and measured before and immediately after each protocol. After exercise with WBV, there was an increase in sTNFR2 levels in the NSG (P<0.01; d=-0.69 (-1.30; -0.08) and SG (P<0.01, d=-0.95 (-1.57; -0.32) groups. In conclusion, an acute session of WBV influenced sTNFr2 levels, with sarcopenic individuals showing a greater effect. This suggested that WBV had a more pronounced impact on sTNFr2 in those with loss of muscle strength and/or physical performance. Additionally, WBV is gaining recognition as an efficient strategy for those with persistent health issues.

PREDICTIVE VALUE OF NUTRITIONAL INDICES FOR SARCOPENIA TRANSITIONS IN MIDDLE-AGED AND OLDER ADULTS

Abstract Since malnutrition plays an important role in sarcopenia development, we aimed to investigate sarcopenia’s transitional dynamics and explore value of nutritional indices for predicting state transitions in middle-aged and older Asian adults. We analyzed data from 1910 participants in the WCHAT study who had complete information at baseline (2018) and at least one follow-up between 2019-2022. We defined the normal, sarcopenia, and intermediate subclinical states. Using a continuous-time multistate Markov model, we calculated transition probabilities and examined associations between nutritional indices and transitions. The probabilities of remaining stable versus progressing to the subclinical state in normal individuals were 53.4% versus 42.1% and 40.6% versus 49.0% at 2 and 4 years. In the subclinical population, their 2- and 4-year chances were 60.2% and 51.2% for keeping stable, 11.8% and 16.2% for developing sarcopenia, 28.0% and 32.6% for reverting to normal. For sarcopenic individuals, their likelihood of staying stable versus retrogressing to the subclinical state was 67.0% versus 26.3% and 48.3% versus 36.3% at 2 and 4 years. Increased albumin, BMI, calf circumference (CC), geriatric nutrition risk index (GNRI), mid-arm circumference (MAC), prealbumin, and triceps skinfold thickness (TST) was predictive for reversion to earlier states. Conversely, decreased BMI, CC, GNRI, MAC, and TST was associated with progression to sarcopenia. Vitamin D was not significantly associated with any transitions. This study reveals how sarcopenia changes over time and highlights usefulness of simple and cost-effective nutritional indices for predicting state transitions, which can help identify individuals at risk of sarcopenia and guide targeted interventions.

Interleukin-6: Unravelling its role in sarcopenia pathogenesis and exploring therapeutic avenues

This review explores the intricate relationship between interleukin-6 (IL-6) and sarcopenia, a prevalent condition characterized by progressive skeletal muscle loss, particularly in aging populations. Emphasizing the rising prevalence and health challenges posed by sarcopenia, the paper delves into the multifunctional roles of IL-6 in immune response, inflammation and inflammaging associated with sarcopenia. Significantly elevated in sarcopenic individuals, IL-6 prompts an exploration of its molecular impact on muscle wasting. The review critically assesses IL-6 as a potential biomarker for sarcopenia diagnosis and prognosis while also examining therapeutic interventions targeting IL-6 signaling pathways, offering a foundation for future research and the development of targeted therapeutic strategies to alleviate the impact of this debilitating condition.

Abstract 11656: Relation Between Method of Indexation for Normal Chamber Dimensions and Association With Functional Measures: The Multi-Ethnic Study of Atherosclerosis

Background: Normalization of echocardiographic chamber measurements for body surface area (BSA) may result in biased estimation of dimensions in obese or sarcopenic individuals. While alternative scaling systems that circumvent this issue have been proposed, there remains a dearth of information on normal values indexed to scaling parameters other than BSA and whether they vary by sex or race/ethnicity. Methods: Of 3032 individuals who underwent echocardiography at Exam 6 in the Multi-Ethnic Study of Atherosclerosis (MESA), we identified 608 without apparent cardiopulmonary or cardiometabolic disease (69.5 ± 7.0 years, 46.2% male, 47.5% White). Normal values for left and right heart variables across a variety of ratiometric (BSA, body mass index [BMI], height) and allometric (height 1.6 , and height 2.7 ) scaling systems were defined as the mean value ± 1.96 standard deviations and compared across sex and race/ethnicity categories. In the broader cohort (N = 3032), we evaluated the correlation of indexed parameters and functional measures (NT-proBNP, 6-minute walk distance (6MWD), and Kansas City Cardiomyopathy Questionnaire [KCCQ]). Results: Height 2.7 had the best overall mean correlation with functional measures (mean correlation -0.12 ± 0.04 with KCCQ; mean correlation -0.15 ± 0.08 with 6MWD) and was superior to BSA for KCCQ and 6MWD (both p &lt; 0.001) but not NT-proBNP (both p &gt; 0.05). Mean correlations for allometric scaling were greater than ratiometric scaling for KCCQ and 6MWD (both p &lt; 0.001) but not NT-proBNP (both p &gt; 0.05). For 6MWD, mean correlations for allometric scaling (p = 0.001) but not ratiometric scaling (p = 0.8) were more negative (suggestive of impaired function) than unindexed measures. Conclusions: In this a multi-ethnic cohort of community-dwelling older adults free from apparent cardiopulmonary or cardiometabolic diseases, we provide normative indexed values for commonly measured echocardiographic parameters across a variety of indexation methods and show that they differ across sex and race/ethnicity categories. Allometric height 2.7 correlated best with functional measures and was superior to BSA. Current chamber quantification guidelines should be updated to reflect normative data on scaled parameters.

ACE I/D genotype associates with strength in sarcopenic men but not with response to ACE inhibitor therapy in older adults with sarcopenia: Results from the LACE trial.

Angiotensin II (AII), has been suggested to promote muscle loss. Reducing AII synthesis, by inhibiting angiotensin converting enzyme (ACE) activity has been proposed as a method to inhibit muscle loss. The LACE clinical trial was designed to determine whether ACE inhibition would reduce further muscle loss in individuals with sarcopenia but suffered from low recruitment and returned a negative result. Polymorphic variation in the ACE promoter (I/D alleles) has been associated with differences in ACE activity and muscle physiology in a range of clinical conditions. This aim of this analysis was to determine whether I/D polymorphic variation is associated with muscle mass, strength, in sarcopenia or contributed to the lack of response to treatment in the LACE study. Sarcopenic individuals were recruited into a 2x2 factorial multicentre double-blind study of the effects of perindopril and/or leucine versus placebo on physical performance and muscle mass. DNA extracted from blood samples (n = 130 72 women and 58 men) was genotyped by PCR for the ACE I/D polymorphism. Genotypes were then compared with body composition measured by DXA, hand grip and quadriceps strength before and after 12 months' treatment with leucine and/or perindopril in a cross-sectional analysis of the influence of genotype on these variables. Allele frequencies for the normal UK population were extracted from 13 previous studies (I = 0.473, D = 0.527). In the LACE cohort the D allele was over-represented (I = 0.412, D = 0.588, p = 0.046). This over-representation was present in men (I = 0.353, D = 0.647, p = 0.010) but not women (I = 0.458, D = 0.532, p = 0.708). In men but not women, individuals with the I allele had greater leg strength (II/ID = 18.00 kg (14.50, 21.60) vs DD = 13.20 kg (10.50, 15.90), p = 0.028). Over the 12 months individuals with the DD genotype increased in quadriceps strength but those with the II or ID genotype did not. Perindopril did not increase muscle strength or mass in any polymorphism group relative to placebo. Our results suggest that although ACE genotype was not associated with response to ACE inhibitor therapy in the LACE trial population, sarcopenic men with the ACE DD genotype may be weaker than those with the ACE I/D or II genotype.

High-throughput sequencing analysis of the characteristics of the gut microbiota in aged patients with sarcopenia

BackgroundThe gut microbiota is a complex microbial community that changes in response to various intestinal diseases, including aging-related diseases such as sarcopenia. Several studies have shown that the metabolites of the gut microbiota affect the dynamic balance of the skeletal muscle. However, the effect of gut microbiota imbalance on sarcopenia is still largely unknown. MethodsWe collected the baseline characteristics and fecal samples of 14 patients with sarcopenia and 21 patients without sarcopenia, and used the 16S rRNA sequencing technology to analyze the differences in the gut microbiota in the two groups. α-diversity and β-diversity were employed to assess the abundance and diversity of species and variations in microflora composition, respectively. Moreover, Tax4Fun was employed to predict the functional capacities of the microbial communities. ResultsIn the sarcopenia group, the abundances of beneficial bacteria such as Bacteroides, Faecalibacterium, Fusobacterium, and Prevotella were reduced, whereas those of pathogenic bacteria, such as Escherichia-Shigella and Klebsiella, were increased. The genera and species of the family Enterobacteriaceae were the main pathogenic bacteria in patients with sarcopenia, and Escherichia-Shigella and Klebsiella could be used as key biomarkers of sarcopenia. The defective protein processing and amino acid synthesis pathways in patients with sarcopenia indicated that protein synthesis and nutrient transport may be damaged. Moreover, the abundances of Escherichia-Shigella and Enterobacteriaceae have been found to have a negative correlation with muscle mass and were the main parameters predicting the change in muscle mass. ConclusionsIn this study, we have identified changes in the gut microbiota of sarcopenic individuals, which were linked to the loss of muscle mass and function. Escherichia-Shigella is a conditional pathogen of sarcopenic patients, and its levels are found to have a significant negative correlation with muscle mass.

Transitional Dynamics of Sarcopenia and Associations of Nutritional Indices with State Transitions in Chinese aged ≥ 50.

Sarcopenia's temporal profile can be regarded as a dynamic process with distinct states, in which malnutrition plays an important role. This study aimed to address two research gaps: sarcopenia's transitional dynamics and associations of nutritional indices with state transitions in community-dwelling Chinese adults aged 50 and older. A prospective population-based cohort study. Community-based setting in western China. The analytic sample included data from 1910 participants aged ≥ 50 in the West China Health and Aging Trend study between 2018-2022. We defined three states: the initial normal state (normal muscle strength, physical performance and muscle mass), the worst sarcopenia state (low muscle mass plus low muscle strength and/or low physical performance) and the intermediate subclinical state (the other scenarios). The relevant measurement methods and cut-off points were based on the 2019 AWGS consensus. Using a continuous-time multistate Markov model, we calculated probabilities of transitions between different states over 1, 2 and 4 years; we also examined associations between nutritional indices and transitions, including body mass index (BMI), calf circumference (CC), mid-arm circumference (MAC), triceps skinfold thickness (TST), albumin (ALB), geriatric nutrition risk index (GNRI), vitamin D (VitD) and prealbumin (PA). For individuals in the normal state, their probabilities of remaining stable versus progressing to a subclinical state were 53.4% versus 42.1% at 2 years, and 40.6% versus 49.0% at 4 years. In the subclinical population, their 2- and 4-year chances were 60.2% and 51.2% for maintaining this state, 11.8% and 16.2% for developing sarcopenia, 28.0% and 32.6% for reverting to normal. For sarcopenic individuals, the likelihood of staying stable versus retrogressing to the subclinical state were 67.0% versus 26.3% at 2 years, and 48.3% versus 36.3% at 4 years. Increased BMI, CC, MAC, TST, ALB, GNRI and PA correlated with reversion from the subclinical state, among which increased TST, ALB and PA were also paralleled with reversion from sarcopenia, while decreased BMI, CC, MAC, TST and GNRI were associated with progression to sarcopenia. VitD was not significantly associated with any transitions. This study reveals how sarcopenia changes over time in a Chinese population. It also highlights the usefulness of simple and cost-effective nutritional status indices for indicating state transitions, which can help identify individuals at risk of sarcopenia and guide targeted interventions within the optimal time window.

Current Research on Vitamin D Supplementation against Sarcopenia: A Review of Clinical Trials.

Vitamin D plays an important role in skeletal muscle function and metabolism. The aim of this review was A) to discuss the clinical evidence of vitamin D supplementation either alone or combined with other strategies in the prevention of sarcopenia in non-sarcopenic individuals and B) to critically discuss the clinical evidence on the effect of vitamin D combined with other strategies on muscle strength, mass and function in sarcopenic individuals without vitamin D deficiency. Sparse clinical data on non-sarcopenic individuals indicate that vitamin D alone has a subtle beneficial effect on knee extensor strength at doses 880-1600 IU/day without improving handgrip strength or muscle mass. When co-administered with other supplements such as protein, mixed effects appear to prevent the decline of muscle mass, possibly delaying the onset of sarcopenia in non-sarcopenic individuals, at doses of 800-1,000 IU/day over 6-12 weeks. In sarcopenic individuals, vitamin D 100-1,000 IU/day co-supplementation with protein results in increased handgrip strength between 9.8-40.5%. However, there is no strong clinical evidence that vitamin D dosage correlates with changes in muscle strength or mass. Potential sources of discrepancy among studies are discussed. Future studies with appropriate experimental design are essential to dissect the net effect of vitamin D on sarcopenia.

Can Nutrition Contribute to a Reduction in Sarcopenia, Frailty, and Comorbidities in a Super-Aged Society?

Many countries are facing the advent of super-aging societies, where sarcopenia and frailty will become pertinent problems. The prevalence of comorbidities is a major problem in countries with aged populations as elderly people suffer from various diseases, such as diabetes, heart failure, chronic kidney disease and dementia. All of these diseases are associated with sarcopenia and frailty, and they frequently cause falls, fractures, and a decline in activities of daily living. Fractures in the elderly people are associated with bone fragility, which is influenced by diabetes and chronic kidney disease. Nutritional support for chronic disease patients and sarcopenic individuals with adequate energy and protein intake, vitamin D supplementation, blood glucose level management for individuals with diabetes, obesity prevention, nutritional education for healthy individuals, and the enlightenment of society could be crucial to solve the health-related problems in super-aging societies.

A Narrative Review of Non-Pharmacological Strategies for Managing Sarcopenia in Older Adults with Cardiovascular and Metabolic Diseases.

This narrative review examines the mechanisms underlying the development of cardiovascular disease (CVD) and metabolic diseases (MDs), along with their association with sarcopenia. Furthermore, non-pharmacological interventions to address sarcopenia in patients with these conditions are suggested. The significance of combined training in managing metabolic disease and secondary sarcopenia in type II diabetes mellitus is emphasized. Additionally, the potential benefits of resistance and aerobic training are explored. This review emphasises the role of nutrition in addressing sarcopenia in patients with CVD or MDs, focusing on strategies such as optimising protein intake, promoting plant-based protein sources, incorporating antioxidant-rich foods and omega-3 fatty acids and ensuring sufficient vitamin D levels. Moreover, the potential benefits of targeting gut microbiota through probiotics and prebiotic fibres in sarcopenic individuals are considered. Multidisciplinary approaches that integrate behavioural science are explored to enhance the uptake and sustainability of behaviour-based sarcopenia interventions. Future research should prioritise high-quality randomized controlled trials to refine exercise and nutritional interventions and investigate the incorporation of behavioural science into routine practices. Ultimately, a comprehensive and multifaceted approach is essential to improve health outcomes, well-being and quality of life in older adults with sarcopenia and coexisting cardiovascular and metabolic diseases.

Impact of Sarcopenia on Head and Neck Cancer Treatment: A Review of Literature

AbstractThe overall outcome of head and neck cancer (HNC) patients undergoing any treatment modality may significantly depend upon their general nutritional condition. Poor nutritional status leading to sarcopenia may be a negative prognostic factor in determining the outcome of HNC patients. PubMed database was searched to identify studies published between 2015 and 2022. All studies reporting the index for sarcopenia as well as its effect on HNC were included. This narrative review was conducted to specifically evaluate the impact of sarcopenia on HNC patients undergoing surgery/ free flap reconstruction/ adjuvant treatment. In oncology, computed tomography assessment of skeletal mass at C3 and L3 is the most suitable index to detect sarcopenia. From the articles yielded, the prevalence rate of sarcopenia ranges from 6 to 70% worldwide. Indian population presents with a significantly higher rate of 31.5% sarcopenia HNC patients. Sarcopenic patients have an increased propensity for surgical site infections, as high as 24.6% owing to the reduced skeletal muscle mass. These patients are also prone to have frequent breaks during radiation treatment of more than 1 week and increased chemotherapy-related toxicities. Further, sarcopenic individuals tend to have higher Ryle's tube dependency of more than 90 days. Sarcopenic patients undergoing surgery have a poor overall survival (OS) and disease-free survival (DFS). In terms of hazards ratio, sarcopenic patients have 1.96 times poor OS and 2.00 times poor DFS when compared to normal individuals who undergo HNC surgery. Sarcopenia is an indispensable part of cancer ailment and it is an independent factor negatively influencing DFS and OS. Thus, nutritional strategy needs to be developed to mitigate sarcopenic effects, especially in the Indian population in preoperative setting.