Journal of Clinical Medicine

2023

Jump to: 2021, 2020

11 pages, 36960 KiB

Open AccessArticle

Relationship between Muscle Mass, Bone Density and Vascular Calcifications in Elderly People with SARS-CoV-2 Pneumonia

by Rossella Del Toro, Francesco Palmese, Francesco Feletti, Gianluca Zani, Maria Teresa Minguzzi, Ernesto Maddaloni, Nicola Napoli, Giorgio Bedogni and Marco Domenicali

J. Clin. Med. 2023, 12(6), 2372; https://doi.org/10.3390/jcm12062372 - 19 Mar 2023

Cited by 1 | Viewed by 1691

Abstract

Background: Little is known about the changes in organs and tissues that may make elder patients more vulnerable to acute stressors such as SARS-CoV-2 infection. Methods: In 80 consecutive elderly patients with SARS-CoV-2 infection, we evaluated the association between the descending thoracic aorta [...] Read more.

Background: Little is known about the changes in organs and tissues that may make elder patients more vulnerable to acute stressors such as SARS-CoV-2 infection. Methods: In 80 consecutive elderly patients with SARS-CoV-2 infection, we evaluated the association between the descending thoracic aorta calcium score, L1 bone density and T12 skeletal muscle density measured on the same scan by high-resolution computed tomography. Results: At median regression, the ln-transformed DTA calcium score was inversely associated with L1 bone density (−0.02, 95%CI −0.04 to −0.01 ln-Agatston units for an increase of 1 HU) and with T12 muscle density (−0.03, −0.06 to −0.001 ln-Agatston units for an increase of 1 HU). At penalized logistic regression, an increase of 1 ln-Agatston unit of DTA calcium score was associated with an OR of death of 1.480 (1.022 to 2.145), one of 1 HU of bone density with an OR of 0.981 (0.966 to 0.996) and one of 1 HU of muscle density with an OR of 0.973 (0.948 to 0.999). These relationships disappeared after correction for age and age was the stronger predictor of body composition and death. Conclusions: Age has a big effect on the relationship between vascular calcifications, L1 bone density and T12 muscle density and on their relationship with the odds of dying. Full article

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2021

Jump to: 2023, 2020

12 pages, 5141 KiB

Open AccessReview

Sarcopenia’s Prognostic Impact on Patients Treated with Immune Checkpoint Inhibitors: A Systematic Review and Meta-Analysis

by Donggun Lee, Na Won Kim, Jong Yeob Kim, Joo Hyung Lee, Ji Hyun Noh, Haejun Lee, Jin Woon Jeong, Seungeun Lee and Jeonghyun Kang

J. Clin. Med. 2021, 10(22), 5329; https://doi.org/10.3390/jcm10225329 - 16 Nov 2021

Cited by 7 | Viewed by 2043

Abstract

Background: Although sarcopenia has been reported to predict survival in cancer patients, its impact on patients who received immune checkpoint inhibitors (ICIs) has not been thoroughly investigated. This systematic review aimed to assess the long-term oncologic impact of sarcopenia on patients who received [...] Read more.

Background: Although sarcopenia has been reported to predict survival in cancer patients, its impact on patients who received immune checkpoint inhibitors (ICIs) has not been thoroughly investigated. This systematic review aimed to assess the long-term oncologic impact of sarcopenia on patients who received ICIs. Methods: A systematic review of studies indexed in the PubMed, Embase, and Cochrane databases, up to April 1, 2021, was conducted. Studies that reported hazard ratios (HRs) for overall survival (OS) and progression-free survival (PFS) based on sarcopenia in patients treated with ICIs were included. The inverse variance method was used with a random-effects model for data analysis. Results: A total of 1284 patients from 14 studies were included. Among the patients who received ICIs, patients with sarcopenia had a significant increase in overall mortality compared to patients without sarcopenia in univariate analyses (HR = 1.66, 95% CI = 1.20–2.29, p = 0.002) and in adjusted HRs (HR = 1.55, 95% CI = 1.15–2.10, p = 0.004). The same results were obtained for PFS by both univariate analysis (HR = 1.75, 95% CI = 1.37–2.23, p < 0.001) and adjusted HRs (HR = 1.63, 95% CI 1.28–2.09, p < 0.001). Conclusions: Sarcopenia appears to be an effective biomarker for predicting long-term oncologic outcomes in patients receiving ICI therapy and hence plays an important role when making treatment decisions. However, the fundamental role of this association with survival should be further investigated in large cohorts and clinical trials. Full article

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13 pages, 538 KiB

Open AccessArticle

Sarcopenia, Obesity, and Sarcopenic Obesity: Relationship with Skeletal Muscle Phenotypes and Single Nucleotide Polymorphisms

by Praval Khanal, Alun G. Williams, Lingxiao He, Georgina K. Stebbings, Gladys L. Onambele-Pearson, Martine Thomis, Hans Degens and Christopher I. Morse

J. Clin. Med. 2021, 10(21), 4933; https://doi.org/10.3390/jcm10214933 - 25 Oct 2021

Cited by 15 | Viewed by 4309

Abstract

Obesity may aggravate the effects of sarcopenia on skeletal muscle structure and function in the elderly, but no study has attempted to identify the gene variants associated with sarcopenia in obese women. Therefore, the aims of the present study were to: (1) describe [...] Read more.

Obesity may aggravate the effects of sarcopenia on skeletal muscle structure and function in the elderly, but no study has attempted to identify the gene variants associated with sarcopenia in obese women. Therefore, the aims of the present study were to: (1) describe neuromuscular function in sarcopenic and non-sarcopenic women with or without obesity; (2) identify gene variants associated with sarcopenia in older obese women. In 307 Caucasian women (71 ± 6 years, 66.3 ± 11.3 kg), skeletal muscle mass was estimated using bioelectric impedance, and function was tested with a 30 s one-leg standing-balance test. Biceps brachii thickness and vastus lateralis cross-sectional area (VL_ACSA) were measured with B-mode ultrasonography. Handgrip strength, maximum voluntary contraction elbow flexion (MVC_EF), and knee extension torque (MVC_KE) were measured by dynamometry, and MVC_KE/VL_ACSA was calculated. Genotyping was performed for 24 single-nucleotide polymorphisms (SNPs), selected based on their previous associations with muscle-related phenotypes. Based on sarcopenia and obesity thresholds, groups were classified as sarcopenic obese, non-sarcopenic obese, sarcopenic non-obese, or non-sarcopenic non-obese. A two-way analysis of covariance was used to assess the main effects of sarcopenia and obesity on muscle-related phenotypes and binary logistic regression was performed for each SNP to investigate associations with sarcopenia in obesity. There were no significant obesity * sarcopenic status interactions for any of the investigated muscle-related phenotypic parameters. Neither sarcopenia nor obesity had a significant effect on biceps brachii thickness, but sarcopenia was associated with lower VL_ACSA (p = 0.003). Obesity was associated with lower MVC_EF (p = 0.032), MVC_KE (p = 0.047), and MVC_KE/VL_ACSA (p = 0.012) with no significant effect of sarcopenia. Adjusted for age and height, three SNPs (ACTN3 rs1815739, MTHFR rs1801131, and MTHFR rs1537516) were associated with sarcopenia in obese participants. Sarcopenia was associated with a smaller muscle size, while obesity resulted in a lower muscle quality irrespective of sarcopenia. Three gene variants (ACTN3 rs1815739, MTHFR rs1801131, and MTHFR rs1537516) suspected to affect muscle function, homocysteine metabolism, or DNA methylation, respectively, were associated with sarcopenia in obese elderly women. Understanding the skeletal muscle features affected by sarcopenia and obesity, and identification of genes related to sarcopenia in obese women, may facilitate early detection of individuals at particular risk of sarcopenic obesity. Full article

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12 pages, 1699 KiB

Open AccessArticle

Sarcopenia and Myosteatosis as Prognostic Markers in Patients with Advanced Cholangiocarcinoma Undergoing Palliative Treatment

by Markus S. Jördens, Linda Wittig, Lisa Heinrichs, Verena Keitel, Maximilian Schulze-Hagen, Gerald Antoch, Wolfram T. Knoefel, Georg Fluegen, Tom Luedde, Christina Loberg, Christoph Roderburg and Sven H. Loosen

J. Clin. Med. 2021, 10(19), 4340; https://doi.org/10.3390/jcm10194340 - 23 Sep 2021

Cited by 7 | Viewed by 1957

Abstract

Background: Cholangiocarcinoma (CCA) represents the second most common primary liver cancer and is characterized by a very poor outcome, but reliable prognostic markers are largely missing. Sarcopenia, the progressive loss of muscle mass and strength, as well as myosteatosis have been associated with [...] Read more.

Background: Cholangiocarcinoma (CCA) represents the second most common primary liver cancer and is characterized by a very poor outcome, but reliable prognostic markers are largely missing. Sarcopenia, the progressive loss of muscle mass and strength, as well as myosteatosis have been associated with an unfavorable outcome in several clinical conditions, including cancer. Here, we evaluated the prognostic relevance of sarcopenia and myosteatosis using routine abdominal CT (computed tomography) scans in advanced stage CCA patients undergoing palliative treatment. Methods: Routine abdominal CT scans were used to assess the skeletal muscle and the psoas muscle index (L3SMI/L3PMI) at the level of the third lumbar vertebra as radiological indices for sarcopenia as well as the mean skeletal muscle attenuation (MMA) as a surrogate for myosteatosis. Results were correlated with clinical data and outcomes. Results: Using a calculated optimal cut-off value of 71.95 mm²/cm, CCA patients with an L3SMI value below this cut-off showed a significantly reduced median overall survival (OS) of only 250 days compared to 450 days in patients with a higher L3SMI. Moreover, the median OS of CCA patients with an L3PMI above 6345 mm²/cm was 552 days compared to 252 days in patients with a lower L3PMI. Finally, CCA patients with an MMA above 30.51 Hounsfield Units survived significantly longer (median OS: 430 days) compared to patients with an MMA value below this ideal cut-off (median OS: 215 days). The prognostic relevance of L3SMI, L3PMI, and MMA was confirmed in uni- and multivariate Cox regression analyses. Conclusion: Routine abdominal CT scans represent a unique opportunity to evaluate sarcopenia as well as myosteatosis in advanced CCA patients. We identified the L3SMI/L3PMI as well as the MMA as negative prognostic factors in CCA patients undergoing palliative therapy, arguing that the “opportunistic” evaluation of these parameters might yield important clinical information in daily routine. Full article

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12 pages, 857 KiB

Open AccessArticle

The Assessment of Muscle Mass and Function in Patients with Long-Standing Rheumatoid Arthritis

by Hye-Won Yun, Chun-Ja Kim, Ji-Won Kim, Hyoun-Ah Kim, Chang-Hee Suh and Ju-Yang Jung

J. Clin. Med. 2021, 10(16), 3458; https://doi.org/10.3390/jcm10163458 - 4 Aug 2021

Cited by 10 | Viewed by 2275

Abstract

Muscular dysfunction in rheumatoid arthritis (RA) can affect the quality of life and comorbidities. We enrolled 320 patients with RA, and evaluated their muscle mass, grip strength, and physical performance. Seven (2.2%) and 21 RA patients (6.6%) had sarcopenia, as defined by the [...] Read more.

Muscular dysfunction in rheumatoid arthritis (RA) can affect the quality of life and comorbidities. We enrolled 320 patients with RA, and evaluated their muscle mass, grip strength, and physical performance. Seven (2.2%) and 21 RA patients (6.6%) had sarcopenia, as defined by the European and Asian Working Group for Sarcopenia (EWGS and AWGS), respectively; 54 patients (16.9%) were determined to have low muscle mass with normal muscle function, as defined by the EWGS; 38 patients (11.9%) reported sarcopenia by SARC-F questionnaire. Male sex (odds ratio (OR) 140.65), low body mass index (BMI) (OR 0.41), and use of tumor necrosis factor (TNF) inhibitors (OR 4.84) were associated with a low muscle mass as defined by the EWGS, while male sex, old age, and low BMI were associated with sarcopenia as defined by the AWGS. Old age (OR 1.11), high BMI (OR 1.13), and a high Disease Activity Score 28 (OR 1.95) were associated with sarcopenia as reported on the SARC-F. Male, low BMI, and use of TNF inhibitors were associated with a low muscle mass, while male sex, old age, and low BMI were associated with sarcopenia in patients with long-standing RA. Full article

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11 pages, 833 KiB

Open AccessArticle

Utility of the SARC-F Questionnaire for Sarcopenia Screening in Patients with Chronic Liver Disease: A Multicenter Cross-Sectional Study in Japan

by Tatsunori Hanai, Atsushi Hiraoka, Makoto Shiraki, Ryosuke Sugimoto, Nobuhito Taniki, Akira Hiramatsu, Nobuhiro Nakamoto, Motoh Iwasa, Kazuaki Chayama and Masahito Shimizu

J. Clin. Med. 2021, 10(15), 3448; https://doi.org/10.3390/jcm10153448 - 3 Aug 2021

Cited by 12 | Viewed by 2913

Abstract

Diagnosing sarcopenia is challenging. This multicenter cross-sectional study aimed to evaluate the utility of the SARC-F score system for identifying sarcopenia in patients with chronic liver disease (CLD). We enrolled 717 patients from five participating centers who completed the SARC-F between November 2019 [...] Read more.

Diagnosing sarcopenia is challenging. This multicenter cross-sectional study aimed to evaluate the utility of the SARC-F score system for identifying sarcopenia in patients with chronic liver disease (CLD). We enrolled 717 patients from five participating centers who completed the SARC-F between November 2019 and March 2021. Sarcopenia was diagnosed based on the Japan Society of Hepatology Working Group on Sarcopenia in Liver Disease Consensus. Muscle strength was estimated using a grip dynamometer, and muscle mass was assessed using computed tomography or bioelectrical impedance analysis. The association between SARC-F and sarcopenia was analyzed using a logistic regression model. The optimal SARC-F cutoff value for identifying sarcopenia was determined using receiver operating characteristic (ROC) curve analysis. Of the 676 eligible patients, 15% were diagnosed with sarcopenia. The SARC-F distribution was 0 points in 63% of patients, 1 point in 17%, 2 points in 7%, 3 points in 4%, and ≥4 points in 8%. The SARC-F items of “Strength” (odds ratio (OR), 1.98; 95% confidence interval (CI), 1.03–3.80) and “Falls” (OR, 2.44; 95% CI, 1.48–4.03) were significantly associated with sarcopenia. The SARC-F value of 1 point showed a higher discriminative ability for identifying sarcopenia than the 4 points that are conventionally used (p < 0.001), with an area under the ROC curve of 0.68, sensitivity of 0.65, specificity of 0.68, positive predictive value of 0.27, and negative predictive value of 0.92. SARC-F is useful for identifying patients with CLD who are at risk of sarcopenia. Full article

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10 pages, 856 KiB

Open AccessArticle

Ultrasound Evaluation of the Rectus Femoris for Sarcopenia in Patients with Early Subacute Stroke

by Yongmin Choi, Sun Im and Geun-Young Park

J. Clin. Med. 2021, 10(14), 3010; https://doi.org/10.3390/jcm10143010 - 6 Jul 2021

Cited by 9 | Viewed by 3306

Abstract

We investigated the ultrasound characteristics of the rectus femoris for sarcopenia detected by dual-energy X-ray absorptiometry (DEXA) in the early subacute stroke phase. Physical features (age, sex, body mass index, and circumference of thigh) and performances (modified Barthel index in Korean, functional ambulation [...] Read more.

We investigated the ultrasound characteristics of the rectus femoris for sarcopenia detected by dual-energy X-ray absorptiometry (DEXA) in the early subacute stroke phase. Physical features (age, sex, body mass index, and circumference of thigh) and performances (modified Barthel index in Korean, functional ambulation categories, and mini-mental state examination in Korean) were measured. The thickness of the fat layer, the thickness of the rectus femoris (TRF), echo intensity (EI), EI to TRF ratio, and strain ratio of elastography (SRE) were measured by ultrasound in 30 patients with first-ever stroke (male: n = 20). Appendicular lean body mass was measured by DEXA. Sarcopenia was defined according to the Foundation for the National Institutes of Health Sarcopenia Project. In total, 14 patients were in the sarcopenia group, and 16 were in the non-sarcopenia group. Clinical characteristics were similar between the two groups. In the sarcopenia group, TRF was significantly decreased in the paretic (p < 0.026) and non-paretic sides (p < 0.01), and the EI to TRF ratio on the paretic side was significantly increased (p < 0.049). Multivariate binary logistic regression showed that TRF on the non-paretic side was independently and significantly associated with sarcopenia (OR = 0.616, 95% CI: 0.381–0.996). The EI and SRE were not significant between the two groups. In the early subacute stroke phase, TRF on the non-paretic side is a key factor for quantitative evaluation of sarcopenia, and the EI to TRF ratio on the paretic side is also a meaningful qualitative evaluation of sarcopenia. Full article

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15 pages, 2936 KiB

Open AccessArticle

An Inverse Relation between Hyperglycemia and Skeletal Muscle Mass Predicted by Using a Machine Learning Approach in Middle-Aged and Older Adults in Large Cohorts

by Xuangao Wu and Sunmin Park

J. Clin. Med. 2021, 10(10), 2133; https://doi.org/10.3390/jcm10102133 - 14 May 2021

Cited by 21 | Viewed by 2501

Abstract

Background: Skeletal muscle mass (SMM) and fat mass (FM) are essentially required for health and quality of life in older adults. Objective: To generate the best SMM and FM prediction models using machine learning models incorporating socioeconomic, lifestyle, and biochemical parameters and the [...] Read more.

Background: Skeletal muscle mass (SMM) and fat mass (FM) are essentially required for health and quality of life in older adults. Objective: To generate the best SMM and FM prediction models using machine learning models incorporating socioeconomic, lifestyle, and biochemical parameters and the urban hospital-based Ansan/Ansung cohort, and to determine relations between SMM and FM and metabolic syndrome and its components in this cohort. Methods: SMM and FM data measured using an Inbody 4.0 unit in 90% of Ansan/Ansung cohort participants were used to train seven machine learning algorithms. The ten most essential predictors from 1411 variables were selected by: (1) Manually filtering out 48 variables, (2) generating best models by random grid mode in a training set, and (3) comparing the accuracy of the models in a test set. The seven trained models’ accuracy was evaluated using mean-square errors (MSE), mean absolute errors (MAE), and R² values in 10% of the test set. SMM and FM of the 31,025 participants in the Ansan/Ansung cohort were predicted using the best prediction models (XGBoost for SMM and artificial neural network for FM). Metabolic syndrome and its components were compared between four groups categorized by 50 percentiles of predicted SMM and FM values in the cohort. Results: The best prediction models for SMM and FM were constructed using XGBoost (R2 = 0.82) and artificial neural network (ANN; R2 = 0.89) algorithms, respectively; both models had a low MSE. Serum platelet concentrations and GFR were identified as new biomarkers of SMM, and serum platelet and bilirubin concentrations were found to predict FM. Predicted SMM and FM values were significantly and positively correlated with grip strength (r = 0.726) and BMI (r = 0.915, p < 0.05), respectively. Grip strengths in the high-SMM groups of both genders were significantly higher than in low-SMM groups (p < 0.05), and blood glucose and hemoglobin A1c in high-FM groups were higher than in low-FM groups for both genders (p < 0.05). Conclusion: The models generated by XGBoost and ANN algorithms exhibited good accuracy for estimating SMM and FM, respectively. The prediction models take into account the actual clinical use since they included a small number of required features, and the features can be obtained in outpatients. SMM and FM predicted using the two models well represented the risk of low SMM and high fat in a clinical setting. Full article

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12 pages, 7712 KiB

Open AccessArticle

Progressive Sarcopenia Correlates with Poor Response and Outcome to Immune Checkpoint Inhibitor Therapy

by Sven H. Loosen, Vincent van den Bosch, Joao Gorgulho, Maximilian Schulze-Hagen, Jennis Kandler, Markus S. Jördens, Frank Tacke, Christina Loberg, Gerald Antoch, Tim Brümmendorf, Ulf P. Neumann, Christiane Kuhl, Tom Luedde and Christoph Roderburg

J. Clin. Med. 2021, 10(7), 1361; https://doi.org/10.3390/jcm10071361 - 25 Mar 2021

Cited by 21 | Viewed by 3181

Abstract

Background: Immune checkpoint inhibitors (ICIs) represent a new therapeutic standard for an increasing number of tumor entities. Nevertheless, individual response and outcome to ICI is very heterogeneous, and the identification of the ideal ICI candidate has remained one of the major issues. Sarcopenia [...] Read more.

Background: Immune checkpoint inhibitors (ICIs) represent a new therapeutic standard for an increasing number of tumor entities. Nevertheless, individual response and outcome to ICI is very heterogeneous, and the identification of the ideal ICI candidate has remained one of the major issues. Sarcopenia and the progressive loss of muscle mass and strength, as well as muscular fat deposition, have been established as negative prognostic factors for a variety of diseases, but their role in the context of ICI therapy is not fully understood. Here, we have evaluated skeletal muscle composition as a novel prognostic marker in patients undergoing ICI therapy for solid malignancies. Methods: We analyzed patients with metastasized cancers receiving ICI therapy according to the recommendation of the specific tumor board. Routine CT scans before treatment initialization and during ICI therapy were used to assess the skeletal muscle index (L3SMI) as well as the mean skeletal muscle attenuation (MMA) in n = 88 patients receiving ICI therapy. Results: While baseline L3SMI and MMA values were unsuitable for predicting the individual response and outcome to ICI therapy, longitudinal changes of the L3SMI and MMA (∆L3SMI, ∆MMA) during ICI therapy turned out to be a relevant marker of therapy response and overall survival. Patients who responded to ICI therapy at three months had a significantly higher ∆L3SMI compared to non-responders (−3.20 mm²/cm vs. 1.73 mm²/cm, p = 0.002). Moreover, overall survival (OS) was significantly lower in patients who had a strongly decreasing ∆L3SMI (<−6.18 mm²/cm) or a strongly decreasing ∆MMA (<−0.4 mm²/cm) during the first three month of ICI therapy. Median OS was only 127 days in patients with a ∆L3SMI of below −6.18 mm²/cm, compared to 547 days in patients with only mildly decreasing or even increasing ∆L3SMI values (p < 0.001). Conclusion: Both progressive sarcopenia and an increasing skeletal muscle fat deposition are associated with poor response and outcome to ICI therapy, which might help to guide treatment decisions during ICI therapy. Full article

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15 pages, 1000 KiB

Open AccessArticle

Non-Invasive Biomarkers of Musculoskeletal Health with High Discriminant Ability for Age and Gender

by Sandra Agyapong-Badu, Martin B. Warner, Dinesh Samuel, Vasiliki Koutra and Maria Stokes

J. Clin. Med. 2021, 10(7), 1352; https://doi.org/10.3390/jcm10071352 - 25 Mar 2021

Cited by 5 | Viewed by 2976

Abstract

A novel approach to ageing studies assessed the discriminatory ability of a combination of routine physical function tests and novel measures, notably muscle mechanical properties and thigh composition (ultrasound imaging) to classify healthy individuals according to age and gender. The cross-sectional study included [...] Read more.

A novel approach to ageing studies assessed the discriminatory ability of a combination of routine physical function tests and novel measures, notably muscle mechanical properties and thigh composition (ultrasound imaging) to classify healthy individuals according to age and gender. The cross-sectional study included 138 community-dwelling, self-reported healthy males and females (65 young, mean age ± SD = 25.7 ± 4.8 years; 73 older, 74.9 ± 5.9 years). Handgrip strength; quadriceps strength; respiratory peak flow; timed up and go; stair climbing time; anterior thigh tissue thickness; muscle stiffness, tone, elasticity (Myoton technology), and self-reported health related quality of life (SF36) were assessed. Stepwise feature selection using cross-validation with linear discriminant analysis was used to classify cases based on criterion variable derived from known effects of age on physical function. A model was trained and features selected using 126 cases with 0.92 accuracy (95% CI = 0.86–0.96; Kappa = 0.89). The final model included five features (peak flow, timed up and go, biceps brachii elasticity, anterior thigh muscle thickness, and percentage thigh muscle) with high sensitivity (0.82–0.96) and specificity (0.94–0.99). The most sensitive novel biomarkers require no volition, highlighting potentially useful tests for screening and monitoring effects of interventions on musculoskeletal health for vulnerable older people with pain or cognitive impairment. Full article

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15 pages, 3090 KiB

Open AccessReview

The Prevalence of Sarcopenia and Its Impact on Clinical Outcomes in Lumbar Degenerative Spine Disease—A Systematic Review and Meta-Analysis

by Wei-Ting Wu, Tsung-Min Lee, Der-Sheng Han and Ke-Vin Chang

J. Clin. Med. 2021, 10(4), 773; https://doi.org/10.3390/jcm10040773 - 15 Feb 2021

Cited by 28 | Viewed by 4436

Abstract

The association of sarcopenia with poor clinical outcomes has been identified in various medical conditions, although there is a lack of quantitative analysis to validate the influence of sarcopenia on patients with lumbar degenerative spine disease (LDSD) from the available literature. Therefore, this [...] Read more.

The association of sarcopenia with poor clinical outcomes has been identified in various medical conditions, although there is a lack of quantitative analysis to validate the influence of sarcopenia on patients with lumbar degenerative spine disease (LDSD) from the available literature. Therefore, this systematic review and meta-analysis aimed to summarize the prevalence of sarcopenia in patients with LDSD and examine its impact on clinical outcomes. The electronic databases (PubMed and Embase) were systematically searched from inception through December 2020 for clinical studies investigating the association of sarcopenia with clinical outcomes in patients with LDSD. A random-effects model meta-analysis was carried out for data synthesis. This meta-analysis included 14 studies, comprising 1953 participants. The overall prevalence of sarcopenia among patients with LDSD was 24.8% (95% confidence interval [CI], 17.3%–34.3%). The relative risk of sarcopenia was not significantly increased in patients with LDSD compared with controls (risk ratio, 1.605; 95% CI, 0.321–8.022). The patients with sarcopenia did not experience an increase in low back and leg pain. However, lower quality of life (SMD, −0.627; 95% CI, −0.844–−0.410) were identified postoperatively. Sarcopenia did not lead to an elevated rate of complications after lumbar surgeries. Sarcopenia accounts for approximately one-quarter of the population with LDSD. The clinical manifestations are less influenced by sarcopenia, whereas sarcopenia is associated with poorer quality of life after lumbar surgeries. The current evidence is still insufficient to support sarcopenia as a predictor of postoperative complications. Full article

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2020

Jump to: 2023, 2021

12 pages, 482 KiB

Open AccessArticle

Increased Omega-3 Fatty Acid Intake is Inversely Associated with Sarcopenic Obesity in Women but not in Men, Based on the 2014–2018 Korean National Health and Nutrition Examination Survey

by Woojung Yang, Jae-woo Lee, Yonghwan Kim, Jong Hun Lee and Hee-Taik Kang

J. Clin. Med. 2020, 9(12), 3856; https://doi.org/10.3390/jcm9123856 - 27 Nov 2020

Cited by 6 | Viewed by 2906

Abstract

(1) Background: Omega-3 fatty acids (ω3FAs) are known to improve protein anabolism, increase the sensitivity to anabolic stimuli, decrease lipogenesis, and stimulate lipid oxidation. We aim to investigate whether ω3FAs are associated with the prevalence of sarcopenic obesity (SO). (2) Methods: Data were [...] Read more.

(1) Background: Omega-3 fatty acids (ω3FAs) are known to improve protein anabolism, increase the sensitivity to anabolic stimuli, decrease lipogenesis, and stimulate lipid oxidation. We aim to investigate whether ω3FAs are associated with the prevalence of sarcopenic obesity (SO). (2) Methods: Data were obtained from the 2014–2018 Korean National Health and Nutrition Examination Survey. The ratio of daily ω3FA intake to energy intake (ω3FA ratio) was categorized into four quartile groups. (3) Results: The prevalence of SO from Q1 to Q4 was 8.9%, 11.3%, 11.0%, and 9.8% respectively, in men and 17.4%, 14.0%, 13.9%, and 10.1% respectively, in women. The ω3FA ratio in individuals with and without SO were 1.0% and 0.9% in men (p-value = 0.271) respectively, and 0.8% and 1.0% in women (p-value = 0.017), respectively. Compared with Q1, odds ratios (95% confidence intervals) of Q2, Q3, and Q4 of ω3FA ratios were 1.563 (0.802–3.047), 1.246 (0.611–2.542), and 0.924 (0.458–1.864) respectively, in men and 0.663 (0.379–1.160), 0.640 (0.372–1.102), and 0.246 (0.113–0.534) respectively, in women, after fully adjusting for confounding factors. (4) Conclusions: The ω3FA ratio was significantly higher in older females without SO than in older females with SO. The ω3FA ratio was associated with the prevalence of SO in elderly females. Full article

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16 pages, 4143 KiB

Open AccessArticle

A Novel Bioengineered Functional Motor Unit Platform to Study Neuromuscular Interaction

by Jasdeep Saini, Alessandro Faroni, Adam J. Reid, Kamel Mamchaoui, Vincent Mouly, Gillian Butler-Browne, Adam P. Lightfoot, Jamie S. McPhee, Hans Degens and Nasser Al-Shanti

J. Clin. Med. 2020, 9(10), 3238; https://doi.org/10.3390/jcm9103238 - 10 Oct 2020

Cited by 4 | Viewed by 3544

Abstract

Background: In many neurodegenerative and muscular disorders, and loss of innervation in sarcopenia, improper reinnervation of muscle and dysfunction of the motor unit (MU) are key pathogenic features. In vivo studies of MUs are constrained due to difficulties isolating and extracting functional MUs, [...] Read more.

Background: In many neurodegenerative and muscular disorders, and loss of innervation in sarcopenia, improper reinnervation of muscle and dysfunction of the motor unit (MU) are key pathogenic features. In vivo studies of MUs are constrained due to difficulties isolating and extracting functional MUs, so there is a need for a simplified and reproducible system of engineered in vitro MUs. Objective: to develop and characterise a functional MU model in vitro, permitting the analysis of MU development and function. Methods: an immortalised human myoblast cell line was co-cultured with rat embryo spinal cord explants in a serum-free/growth fact media. MUs developed and the morphology of their components (neuromuscular junction (NMJ), myotubes and motor neurons) were characterised using immunocytochemistry, phase contrast and confocal microscopy. The function of the MU was evaluated through live observations and videography of spontaneous myotube contractions after challenge with cholinergic antagonists and glutamatergic agonists. Results: blocking acetylcholine receptors with α-bungarotoxin resulted in complete, cessation of myotube contractions, which was reversible with tubocurarine. Furthermore, myotube activity was significantly higher with the application of L-glutamic acid. All these observations indicate the formed MU are functional. Conclusion: a functional nerve-muscle co-culture model was established that has potential for drug screening and pathophysiological studies of neuromuscular interactions. Full article

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12 pages, 892 KiB

Open AccessArticle

Frailty and Sarcopenia Assessment upon Hospital Admission to Internal Medicine Predicts Length of Hospital Stay and Re-Admission: A Prospective Study of 980 Patients

by Sapir Anani, Gal Goldhaber, Adi Brom, Nir Lasman, Natia Turpashvili, Gilat Shenhav-saltzman, Chen Avaky, Liat Negru, Muhamad Agbaria, Sigalit Ariam, Doron Portal, Yishay Wasserstrum and Gad Segal

J. Clin. Med. 2020, 9(8), 2659; https://doi.org/10.3390/jcm9082659 - 17 Aug 2020

Cited by 21 | Viewed by 2638

Abstract

Background: Frailty and sarcopenia are associated with frequent hospitalizations and poor clinical outcomes in geriatric patients. Ascertaining this association for younger patients hospitalized in internal medicine departments could help better prognosticate patients in the realm of internal medicine. Methods: During a 1-year prospective [...] Read more.

Background: Frailty and sarcopenia are associated with frequent hospitalizations and poor clinical outcomes in geriatric patients. Ascertaining this association for younger patients hospitalized in internal medicine departments could help better prognosticate patients in the realm of internal medicine. Methods: During a 1-year prospective study in an internal medicine department, we evaluated patients upon admission for sarcopenia and frailty. We used the FRAIL questionnaire, blood alanine-amino transferase (ALT) activity, and mid-arm muscle circumference (MAMC) measurements. Results: We recruited 980 consecutive patients upon hospital admission (median age 72 years (IQR 65–79); 56.8% males). According to the FRAIL questionnaire, 106 (10.8%) patients were robust, 368 (37.5%) pre-frail, and 506 (51.7%) were frail. The median ALT value was 19IU/L (IQR 14–28). The median MAMC value was 27.8 (IQR 25.7–30.2). Patients with low ALT activity level (<17IU/L) were frailer according to their FRAIL score (3 (IQR 2–4) vs. 2 (IQR 1–3); p < 0.001). Higher MAMC values were associated with higher ALT activity, both representing robustness. The rate of 30 days readmission in the whole cohort was 17.4%. Frail patients, according to the FRAIL score (FS), had a higher risk for 30 days readmission (for FS > 2, HR = 1.99; 95CI = 1.29–3.08; p = 0.002). Frail patients, according to low ALT activity, also had a significantly higher risk for 30 days readmission (HR = 2.22; 95CI = 1.26–3.91; p = 0.006). After excluding patients whose length of stay (LOS) was ≥10 days, 252 (27.5%) stayed in-hospital for 4 days or longer. Frail patients according to FS had a higher risk for LOS ≥4 days (for FS > 2, HR = 1.87; 95CI = 1.39–2.52; p < 0.001). Frail patients, according to low ALT activity, were also at higher risk for LOS ≥4 days (HR = 1.87; 95CI = 1.39–2.52; p < 0.001). MAMC values were not correlated with patients’ LOS or risk for re-admission. Conclusion: Frailty and sarcopenia upon admission to internal medicine departments are associated with longer hospitalization and increased risk for re-admission. Full article

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11 pages, 996 KiB

Open AccessArticle

Selecting Appropriate Sarcopenia Screening Methods for Asian Populations

by Yu-Ching Lin, Yi-Chien Lu, Fang-Ping Chen, Ying Chin Lin, Yun-Chung Cheung and Wing P. Chan

J. Clin. Med. 2020, 9(8), 2333; https://doi.org/10.3390/jcm9082333 - 22 Jul 2020

Cited by 2 | Viewed by 1930

Abstract

We aimed to determine the most appropriate sarcopenia screening method for Asian populations. We retrospectively studied the physiological differences between the sexes in healthy individuals and prospectively compared using skeletal muscle mass versus handgrip strength (HS) to screen for sarcopenia in a community-based [...] Read more.

We aimed to determine the most appropriate sarcopenia screening method for Asian populations. We retrospectively studied the physiological differences between the sexes in healthy individuals and prospectively compared using skeletal muscle mass versus handgrip strength (HS) to screen for sarcopenia in a community-based population. Skeletal muscle mass was determined using dual-energy X-ray absorptiometry. Of 5881 healthy individuals recruited, 101 were from urban populations and 349 from a community-based population. The sexes were comparable in total lean muscle mass declines after peaking around 20 years of age. An age-dependent decline in total fat mass was found only among men;a persistent increase in total fat mass was observed only among women. The prevalence of low skeletal muscle mass significantly increased with age in both sexes only when applying the weight-adjusted skeletal muscle index (wSMI); it was significant only among men when applying the height-adjusted skeletal muscle index (hSMI). Using HS resulted in a much higher prevalence of sarcopenia in both sexes. A significant age-dependent increase in fat mass in women showed that the most appropriate adjustment method is wSMI for women and hSMI for men. Nevertheless, a primary HS survey is recommended for both sexes in Asian populations. Full article

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12 pages, 1217 KiB

Open AccessArticle

Glucose Levels as a Mediator of the Detrimental Effect of Abdominal Obesity on Relative Handgrip Strength in Older Adults

by Miguel Ángel Pérez-Sousa, Jesús del Pozo-Cruz, Carlos A. Cano-Gutiérrez, Atilio J. Ferrebuz, Carolina Sandoval-Cuellar, Mikel Izquierdo, Paula A. Hernández-Quiñonez and Robinson Ramírez-Vélez

J. Clin. Med. 2020, 9(8), 2323; https://doi.org/10.3390/jcm9082323 - 22 Jul 2020

Cited by 8 | Viewed by 3466

Abstract

Excess central adiposity accelerates the decline of muscle strength in older people. Additionally, hyperglycemia, independent of associated comorbidities, is related to the loss of muscle mass and strength, and contributes to functional impairment in older adults. We studied the mediation effect of glucose [...] Read more.

Excess central adiposity accelerates the decline of muscle strength in older people. Additionally, hyperglycemia, independent of associated comorbidities, is related to the loss of muscle mass and strength, and contributes to functional impairment in older adults. We studied the mediation effect of glucose levels, in the relationship between abdominal obesity and relative handgrip strength (HGS). A total of 1571 participants (60.0% women, mean age 69.1 ± 7.0 years) from 86 municipalities were selected following a multistage area probability sampling design. Measurements included demographic and anthropometric/adiposity markers (weight, height, body mass index, and waist circumference). HGS was measured using a digital dynamometer for three sets and the mean value was recorded. The values were normalized to body weight (relative HGS). Fasting glucose was analyzed by enzymatic colorimetric methods. Mediation analyses were performed to identify associations between the independent variable (abdominal obesity) and outcomes (relative HGS), as well as to determine whether fasting glucose levels mediated the relationship between excess adiposity and relative HGS. A total of 1239 (78.8%) had abdominal obesity. Abdominal obesity had a negative effect on fasting glucose (β = 9.04, 95%CI = 5.87 to 12.21); while fasting glucose to relative HGS was inversely related (β = −0.003, 95%CI = −0.005 to −0.001), p < 0.001. The direct effect of abdominal obesity on relative HGS was statistically significant (β = −0.069, 95%CI = −0.082 to −0.057), p < 0.001. Lastly, fasting glucose levels mediates the detrimental effect of abdominal obesity on relative HGS (indirect effect β = −0.002, 95%CI = −0.004 to −0.001), p < 0.001. Our results suggest that the glucose level could worsen the association between abdominal obesity status and lower HGS. Thus, it is plausible to consider fasting glucose levels when assessing older adults with excess adiposity and/or suspected loss of muscle mass. Full article

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19 pages, 1866 KiB

Open AccessArticle

Role of Menopausal Transition and Physical Activity in Loss of Lean and Muscle Mass: A Follow-Up Study in Middle-Aged Finnish Women

by Hanna-Kaarina Juppi, Sarianna Sipilä, Neil J. Cronin, Sira Karvinen, Jari E. Karppinen, Tuija H. Tammelin, Pauliina Aukee, Vuokko Kovanen, Urho M. Kujala and Eija K. Laakkonen

J. Clin. Med. 2020, 9(5), 1588; https://doi.org/10.3390/jcm9051588 - 23 May 2020

Cited by 51 | Viewed by 17116

Abstract

In midlife, women experience hormonal changes due to menopausal transition. A decrease especially in estradiol has been hypothesized to cause loss of muscle mass. This study investigated the effect of menopausal transition on changes in lean and muscle mass, from the total body [...] Read more.

In midlife, women experience hormonal changes due to menopausal transition. A decrease especially in estradiol has been hypothesized to cause loss of muscle mass. This study investigated the effect of menopausal transition on changes in lean and muscle mass, from the total body to the muscle fiber level, among 47–55-year-old women. Data were used from the Estrogenic Regulation of Muscle Apoptosis (ERMA) study, where 234 women were followed from perimenopause to early postmenopause. Hormone levels (estradiol and follicle stimulating hormone), total and regional body composition (dual-energy X-ray absorptiometry (DXA) and computed tomography (CT) scans), physical activity level (self-reported and accelerometer-measured) and muscle fiber properties (muscle biopsy) were assessed at baseline and at early postmenopause. Significant decreases were seen in lean body mass (LBM), lean body mass index (LBMI), appendicular lean mass (ALM), appendicular lean mass index (ALMI), leg lean mass and thigh muscle cross-sectional area (CSA). Menopausal status was a significant predictor for all tested muscle mass variables, while physical activity was an additional significant contributor for LBM, ALM, ALMI, leg lean mass and relative muscle CSA. Menopausal transition was associated with loss of muscle mass at multiple anatomical levels, while physical activity was beneficial for the maintenance of skeletal muscle mass. Full article

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15 pages, 294 KiB

Open AccessArticle

Determinants of Performance in the Timed up-and-go and Six-Minute Walk Tests in Young and Old Healthy Adults

by Gallin Montgomery, Jamie McPhee, Mati Pääsuke, Sarianna Sipilä, Andrea B Maier, Jean-Yves Hogrel and Hans Degens

J. Clin. Med. 2020, 9(5), 1561; https://doi.org/10.3390/jcm9051561 - 21 May 2020

Cited by 23 | Viewed by 4006

Abstract

The aim of this study was to assess associations between performance in the timed up-and-go (TUG) and six-minute walk distance (6MWD) with physiological characteristics in young and old healthy adults. Thereto, we determined TUG, 6MWD, normalised jump power, centre of pressure displacement during [...] Read more.

The aim of this study was to assess associations between performance in the timed up-and-go (TUG) and six-minute walk distance (6MWD) with physiological characteristics in young and old healthy adults. Thereto, we determined TUG, 6MWD, normalised jump power, centre of pressure displacement during 1-leg standing, forced expiratory volume in 1 s, percentage of age-predicted maximal heart rate (HR%) and height in 419 healthy young (men: 23.5 ± 2.8 years, women: 23.2 ± 2.9 years) and old (men: 74.6 ± 3.2 years, women: 74.1 ± 3.2 years) adults. Normalised jump power explained 8% and 19% of TUG in young (p = 0.025) and older men (p < 0.001), respectively. When fat mass percentage and age were added to normalised jump power, 30% of TUG was explained in older men (R²_adj = 0.30, p < 0.001 to 0.106). Appendicular lean muscle mass percentage (ALM%) and age were the best determinants of TUG for older women (R²_adj = 0.16, p < 0.001 to 0.01). HR% explained 17–39% of 6MWD across all groups (R²_adj = 0.17 to 39, p < 0.001). In conclusion, in men, jump power was a key determinant for TUG, while in old women only it was the ALM%. As HR% was the most important determinant of 6MWD, motivational bias needs to be considered in the interpretation of this test. Full article

13 pages, 1906 KiB

Open AccessArticle

Sarcopenia in Neurological Patients: Standard Values for Temporal Muscle Thickness and Muscle Strength Evaluation

by Ariane Steindl, Johannes Leitner, Matthias Schwarz, Karl-Heinz Nenning, Ulrika Asenbaum, Sophie Mayer, Ramona Woitek, Michael Weber, Veronika Schöpf, Anna S. Berghoff, Thomas Berger, Georg Widhalm, Daniela Prayer, Matthias Preusser and Julia Furtner

J. Clin. Med. 2020, 9(5), 1272; https://doi.org/10.3390/jcm9051272 - 28 Apr 2020

Cited by 67 | Viewed by 4786

Abstract

Temporal muscle thickness (TMT) was investigated as a novel surrogate marker on MRI examinations of the brain, to detect patients who may be at risk for sarcopenia. TMT was analyzed in a retrospective, normal collective cohort (n = 624), to establish standard [...] Read more.

Temporal muscle thickness (TMT) was investigated as a novel surrogate marker on MRI examinations of the brain, to detect patients who may be at risk for sarcopenia. TMT was analyzed in a retrospective, normal collective cohort (n = 624), to establish standard reference values. These reference values were correlated with grip strength measurements and body mass index (BMI) in 422 healthy volunteers and validated in a prospective cohort (n = 130) of patients with various neurological disorders. Pearson correlation revealed a strong association between TMT and grip strength (retrospective cohort, ρ = 0.746; p < 0.001; prospective cohort, ρ = 0.649; p < 0.001). A low or no association was found between TMT and age (retrospective cohort, R² correlation coefficient 0.20; p < 0.001; prospective cohort, ρ = −0.199; p = 0.023), or BMI (retrospective cohort, ρ = 0.116; p = 0.042; prospective cohort, ρ = 0.227; p = 0.009), respectively. Male patients with temporal wasting and unintended weight loss, respectively, showed significantly lower TMT values (p = 0.04 and p = 0.015, unpaired t-test). TMT showed a high correlation with muscle strength in healthy individuals and in patients with various neurological disorders. Therefore, TMT should be integrated into the diagnostic workup of neurological patients, to prevent, delay, or treat sarcopenia. Full article

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11 pages, 890 KiB

Open AccessArticle

Relative Handgrip Strength Diminishes the Negative Effects of Excess Adiposity on Dependence in Older Adults: A Moderation Analysis

by Robinson Ramírez-Vélez, Miguel Ángel Pérez-Sousa, Antonio García-Hermoso, Fabrício Zambom-Ferraresi, Nicolás Martínez-Velilla, Mikel L. Sáez de Asteasu, Carlos A. Cano-Gutiérrez, David Rincón-Pabón and Mikel Izquierdo

J. Clin. Med. 2020, 9(4), 1152; https://doi.org/10.3390/jcm9041152 - 17 Apr 2020

Cited by 11 | Viewed by 3965

Abstract

The adverse effects of fat mass on functional dependence might be attenuated or worsened, depending on the level of muscular strength. The aim of this study was to determine (i) the detrimental effect of excess adiposity on dependence in activities of daily living [...] Read more.

The adverse effects of fat mass on functional dependence might be attenuated or worsened, depending on the level of muscular strength. The aim of this study was to determine (i) the detrimental effect of excess adiposity on dependence in activities of daily living (ADL), and (ii) whether relative handgrip strength (HGS) moderates the adverse effect of excess adiposity on dependence, and to provide the threshold of relative HGS from which the adverse effect could be improved or worsened. A total of 4169 participants (69.3 ± 7.0 years old) from 244 municipalities were selected following a multistage area probability sampling design. Measurements included anthropometric/adiposity markers (weight, height, body mass index, waist circumference, and waist-to-height ratio (WHtR)), HGS, sarcopenia “proxy” (calf circumference), and ADL (Barthel Index scale). Moderation analyses were performed to identify associations between the independent variable (WHtR) and outcomes (dependence), as well as to determine whether relative HGS moderates the relationship between excess adiposity and dependence. The present study demonstrated that (i) the adverse effect of having a higher WHtR level on dependence in ADL was moderated by relative HGS, and (ii) two moderation thresholds of relative HGS were estimated: 0.35, below which the adverse effect of WHtR levels on dependency is aggravated, and 0.62, above which the adverse effect of fat on dependency could be improved. Because muscular strength represents a critically important and modifiable predictor of ADL, and the increase in adiposity is inherent in aging, our results underscore the importance of an optimal level of relative HGS in the older adult population. Full article

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22 pages, 2119 KiB

Open AccessArticle

Corticospinal Control of Human Locomotion as a New Determinant of Age-Related Sarcopenia: An Exploratory Study

by Federico Gennaro, Paolo Maino, Alain Kaelin-Lang, Katrien De Bock and Eling D. de Bruin

J. Clin. Med. 2020, 9(3), 720; https://doi.org/10.3390/jcm9030720 - 6 Mar 2020

Cited by 5 | Viewed by 5248

Abstract

Sarcopenia is a muscle disease listed within the ICD-10 classification. Several operational definitions have been created for sarcopenia screening; however, an international consensus is lacking. The Centers for Disease Control and Prevention have recently recognized that sarcopenia detection requires improved diagnosis and screening [...] Read more.

Sarcopenia is a muscle disease listed within the ICD-10 classification. Several operational definitions have been created for sarcopenia screening; however, an international consensus is lacking. The Centers for Disease Control and Prevention have recently recognized that sarcopenia detection requires improved diagnosis and screening measures. Mounting evidence hints towards changes in the corticospinal communication system where corticomuscular coherence (CMC) reflects an effective mechanism of corticospinal interaction. CMC can be assessed during locomotion by means of simultaneously measuring Electroencephalography (EEG) and Electromyography (EMG). The aim of this study was to perform sarcopenia screening in community-dwelling older adults and explore the possibility of using CMC assessed during gait to discriminate between sarcopenic and non-sarcopenic older adults. Receiver Operating Characteristic (ROC) curves showed high sensitivity, precision and accuracy of CMC assessed from EEG Cz sensor and EMG sensors located over Musculus Vastus Medialis [Cz-VM; AUC (95.0%CI): 0.98 (0.92–1.04), sensitivity: 1.00, 1-specificity: 0.89, p < 0.001] and with Musculus Biceps Femoris [Cz-BF; AUC (95.0%CI): 0.86 (0.68–1.03), sensitivity: 1.00, 1-specificity: 0.70, p < 0.001]. These muscles showed significant differences with large magnitude of effect between sarcopenic and non-sarcopenic older adults [Hedge’s g (95.0%CI): 2.2 (1.3–3.1), p = 0.005 and Hedge’s g (95.0%CI): 1.5 (0.7–2.2), p = 0.010; respectively]. The novelty of this exploratory investigation is the hint toward a novel possible determinant of age-related sarcopenia, derived from corticospinal control of locomotion and shown by the observed large differences in CMC when sarcopenic and non-sarcopenic older adults are compared. This, in turn, might represent in future a potential treatment target to counteract sarcopenia as well as a parameter to monitor the progression of the disease and/or the potential recovery following other treatment interventions. Full article

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15 pages, 2617 KiB

Open AccessArticle

Sarcoscore: A Novel Approach for Assessing Sarcopenia and Functional Disability in Older Adults

by Yosuke Osuka, Hunkyung Kim, Hisashi Kawai, Yu Taniguchi, Yuri Yokoyama, Satoshi Seino, Shuichi Obuchi, Akihiko Kitamura and Shoji Shinkai

J. Clin. Med. 2020, 9(3), 692; https://doi.org/10.3390/jcm9030692 - 4 Mar 2020

Cited by 4 | Viewed by 3323

Abstract

Sarcopenia is associated with instrumental activities of daily living (IADL) and basic activities of daily living (BADL) disabilities. We developed an index for assessing sarcopenia degree (sarcoscore) and compared it to the Asian Working Group for Sarcopenia (AWGS) criteria. Principal component analyses of [...] Read more.

Sarcopenia is associated with instrumental activities of daily living (IADL) and basic activities of daily living (BADL) disabilities. We developed an index for assessing sarcopenia degree (sarcoscore) and compared it to the Asian Working Group for Sarcopenia (AWGS) criteria. Principal component analyses of walking speed, handgrip strength, and skeletal muscle index were performed to develop a sarcoscore using 3088 Japanese population-based cross-sectional data. During the nine-year follow-up, 278 of 2571 and 88 of 2341 participants developed IADL and BADL disabilities, respectively. Adjusted Cox proportional hazards regression models showed that the sarcoscore criteria, defined as proportional to the sarcopenia prevalence diagnosed by the AWGS criteria, had higher hazard ratios (HRs) and 95% confidence interval (CI) for disability onset than the AWGS criteria (IADL disability: 2.19 (1.64–2.93) vs. 1.79 (1.32–2.43), BADL disability: 4.28 (2.63–6.96) vs. 3.22 (1.97–5.27)). The adjusted HRs for IADL and BADL disabilities were reduced by 4% and 8% per point increase in the sarcoscore, respectively. The sarcoscore assessed the degree of sarcopenia and had a satisfactory performance for predicting functional disabilities in older Japanese adults, suggesting its usefulness as a complementary composite marker for clinical diagnosis. Full article

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