It is unclear how knee biomechanics in individuals with Sarcopenic Obesity and osteoarthritis (OA-SO) affect ambulation relative to those with knee osteoarthritis (OA) without SO. The primary objective of this study was to compare the knee kinematics and spatio-temporal gait parameters during treadmill walking using simulated terrain modifications in individuals with end-stage knee OA awaiting total knee arthroplasty (TKA) with SO and obesity (OA-SO group) versus those with knee OA without SO (OA group).

We performed a cross-sectional analysis of individuals with knee OA (with or without SO) awaiting TKA. Gait assessments using Computer-Assisted Rehabilitation Environment (CAREN) occurred within one month before TKA; each participant was asked to perform two trials of self-selected treadmill speed for each of the following six walking conditions: (1) level; (2) uphill; (3) downhill; (4) cross slope with the affected body side elevated; (5) cross slope with the unaffected side elevated; and (6) medial-lateral walking surface translations. Data analyses compared demographics, gait kinematics, spatio-temporal, and clinical outcome measures between the groups using a two-tailed independent t-test for continuous measures and Chi Square tests for categorical data.

The groups were similar in age and sex distribution (P = 0.90 and 0.37, respectively). Of the 18 participants with knee OA, eight were classified as with and ten without SO. On the affected side, the group-level knee flexion-extension range was significantly larger in the OA group compared to OA-SO group for all six walking conditions during the full gait cycle. The OA group walked significantly faster than the OA-SO group for all walking conditions. The stride length and step length were significantly longer in the OA group than in the OA-SO group during four of the six walking conditions.

Gait assessment for different walking conditions adds important information to level walking assessments. Individuals with knee OA and SO have less knee range of motion, are slower, and less stride and step length, compared to individuals with OA only. This study may indicate the need for preoperative and postoperative rehabilitation programs to address the needs of individuals with knee OA and SO.

Standard assessment of physical function commonly involves evaluation of gait speed, balance, duration of repetitive sit-to-stand movements using the 5-times chair-rise test (CRT-5), and handgrip strength (HGS). However, reports involving longer versions of stand-alone sit-to-stand tests to evaluate functional fitness in older adults are hard to find in literature.

To investigate the strength of within-group relationships between duration, power and velocity using a 30-s chair-rise test (CRT-30) and physical performance, and to assess between-group differences in these relationships, in a large cohort of older adults.

Study participants (n = 73; age-range: 28-93 years; females: 50 males: 23) performed a longer protocol (CRT-30) at maximum voluntary speed. Chair-rise power (CRP), sit-to-stand (concentric) and stand-to-sit (eccentric) velocities were measured during trials. Anthropometric, Short Physical Performance Battery (SPPB) and HGS data collected with CRT-30 variables were analyzed in participants divided into three subsets (<50, 50-70 & >70 years).

Between-group differences significantly varied between CRT-30 measurements. CRT-30 duration, power and velocities demonstrated strong within-group correlations with SPPB and HGS measures, especially in the >70-year age-group (p < 0.01). CRT-30 and physical performance variables also showed significant between-group differences, especially for the >70 years age group.

CRT variables such as duration, power, sit-to-stand and stand-to-sit velocities exhibit stronger relationships with markers of physical function, especially in older adults.

Sarcopenia is a multifaceted condition affecting between 10 and 16% of the global population, and although multiple classification algorithms exist, no prevalence has been reported for a representative sample of the Slovenian population. Furthermore, multiple behavioural factors, such as malnutrition, physical inactivity, sedentary lifestyle and lower cognitive function, can contribute to the risk of sarcopenia. This study aims to: a) determine sarcopenia prevalence among Slovenian older adults according to different classification algorithms, b) compare the agreement among the algorithms and c) evaluate the relationship between proposed risk factors and sarcopenia.

654 participants (≥60 years, 30.4% males) have been classified into sarcopenia groups according to eight algorithms, and agreement (Fleiss K) between them was calculated. Additionally, age, sex, nutritional status, physical activity, sedentary levels and cognitive function were assessed as sarcopenia risk/protective factors.

The prevalence of sarcopenia according to EWGSOP2 was 4.1%, ranging from 2.1% to 15.3%, when classified by all eight algorithms. Overall agreement between algorithms was weak (K=.429; 95% CI .414 to .444) with 0.6% of participants classified as sarcopenic by all eight algorithms. Adequate nutrition and physical activity were identified as protective factors, while age, lower cognitive function and sedentary lifestyle were considered risk factors.

Sarcopenia prevalence among the Slovenian general population was lower than in the global population. We can conclude that different sarcopenia algorithms lead to a different prevalence of sarcopenia. It is of great importance to be cautious when comparing prevalences among studies and to further validate the classification algorithms.

The Global Leadership Initiative on Sarcopenia (GLIS) was proposed recently by creating a widely recognized conceptual definition of sarcopenia, however, the diagnostic framework of GLIS in cancer patients remains unclear. This study aims to evaluate the potential framework of GLIS based on muscle mass and/or strength in cancer patients.

We performed a multicenter cohort study spanning from November 2012 to May 2020. Potential covariates were identified through univariate and multivariate analyses. The association between low muscle mass (LMM) and/or low muscle strength (LMS) with survival was estimated using Kaplan-Meier curves and Cox models. LMM was identified by lean mass index (LMI) or calf circumference (CC) while LMS was identified by hand grip strength (HGS).

A total of 6471 cancer patients were included, with a median follow-up of 50.0 months. Both LMM-LMI or LMS (HR = 1.56; 95%CI: 1.42, 1.71; p < 0.001) and LMM-LMI plus LMS (HR = 2.01; 95%CI: 1.65, 2.44; p < 0.001) were associated with a lower overall survival (OS) compared with patients without sarcopenia. Similarly, both LMM-CC or LMS group (HR = 1.51; 95%CI: 1.37, 1.67; p < 0.001) and LMM-CC plus LMS group (HR = 1.45; 95%CI: 1.28, 1.63; p < 0.001) were associated with a lower OS. Age, alcohol, Nutritional Risk Screening 2002 (NRS2002) score, Karnofsky Performance Status (KPS) score, Tumor Node Metastasis (TNM) stage, cancer category, albumin, direct bilirubin, anticancer therapy plus sex were introduced as covariates in fully-adjusted Cox model. Multivariable-adjusted Cox models revealed that LMM-LMI or LMS was an independent prognosis factor for cancer patients (HR = 1.18; 95%CI: 1.07, 1.31; p = 0.001). LMM-LMI plus LMS also was an independent predictor for survival among cancer patients (HR = 1.58; 95 % CI: 1.30, 1.94; p < 0.001).

The potential framework of GLIS based on muscle mass and/or strength was associated with survival in Chinese cancer patients. This research provides a simplified, clinically outcome-driven potential framework of sarcopenia, and offers new insights for the development of an operational definition of GLIS in the future.

Chronic kidney disease (CKD) leads to the accumulation of uremic toxins such as indoxyl sulfate (IS), which has been linked to myopathy. Iron is essential for muscle growth and differentiation, with ferrous iron (Fe2+) contributing to intracellular oxidative stress. Although IS is known to affect muscle differentiation and regeneration, the underlying mechanisms remain poorly understood. Both iron overload and deficiency can negatively impact muscle growth. We hypothesized that IS impairs myoblast differentiation by disrupting the balance between intracellular oxidative stress and iron metabolism. To test this, we exposed C2C12 myoblasts and primary human skeletal muscle myoblasts to IS during the proliferation phase and maintained IS exposure throughout the differentiation process. IS treatment reduced both intracellular reactive oxygen species (ROS) and free Fe2+ levels during differentiation. It also altered intracellular iron metabolism and upregulated the gene expression and activity of antioxidant-related enzymes, maintaining the cells in a high-antioxidant state and establishing a new oxidative balance. Unexpectedly, Fe2+ (FeSO4) supplementation, with or without IS, significantly increased ROS levels and further exacerbated the inhibition of myoblast differentiation induced by IS, suggesting that cellular redox homeostasis was disrupted. These findings reveal that IS induces an imbalance in cellular iron metabolism and oxidative stress, providing new insights into an alternative mechanism by which IS inhibits muscle differentiation and regeneration.

Currently, the proportion of haemodialysis patients with combined sarcopenia is as high as 13.7%, and the prevalence of sarcopenia in patients over 60 years of age is 33.3%. At present, the pathogenesis of combined sarcopenia in dialysis patients and the intervention strategies are still unclear, and the aim of this paper is to explore the pathogenesis of sarcopenia in haemodialysis patients and the clinical management strategies to improve the patients' prognosis and quality of life.

The relationship between sarcopenia and microinflammation and protein metabolic imbalance was analysed and the effects of nutritional supplementation, exercise and pharmacological treatment were assessed.

The management of sarcopenia, which is critical for improving quality of life in haemodialysis patients, is associated with multiple factors, including microinflammation, reduced protein synthesis, and hormonal dysregulation. This article proposes an integrated management strategy of diet, exercise and pharmacotherapy and explores new therapeutic targets such as methylglyoxal to improve patient prognosis.

We highlighted sarcopenia's association with psychiatric disorders, including generalized anxiety disorder (GAD), and aimed to explore correlations between the detection and prevention of GAD using population-based data of middle-aged and older Korean adults. This cross-sectional study data was collected through standardized surveys and physical examinations including GAD assessment survey and sarcopenia examination through muscle strength and mass assessments. We used logistic regression analysis to examine the association between sarcopenia and GAD, adjusting for relevant confounders. Data from the 2022 Korea National Health and Nutrition Examination Survey (KNHANES) were analyzed for sarcopenia and GAD in individuals aged ≥40 years, employing the 2019 Asian Working Group for Sarcopenia criteria and GAD-7 scale, respectively. Overall, 2960 individuals were selected, focusing on sarcopenia and GAD-7 scores, and regression analyses explored sarcopenia and GAD associations. Notably, 3.7% and 14% of participants had sarcopenia and GAD, respectively. The relationships between sarcopenia, possible sarcopenia, and GAD were found for females, suggesting sex-specific risks. In females, after adjusting for marital status and smoking, sarcopenia and possible sarcopenia showed correlation coefficients (β) of 0.145 (95% confidence interval [CI]: 0.025-0.266) and 0.096 (95% CI: 0.004-0.189), respectively, with GAD. After further adjustment for physical activity variables, only sarcopenia remained significantly associated with GAD in females (β=0.132, P = 0.033). Sarcopenia was significantly associated with GAD severity. Individuals with sarcopenia were 1.051 times more likely to experience mild GAD (95% CI: 0.554-1.992) and 2.480 times more likely to experience moderate to severe GAD (95% CI: 1.232-4.990) compared to those without sarcopenia. This study found a significant correlation between sarcopenia and GAD in the examined demographics, emphasizing the importance of integrative physical and mental health interventions. Early detection and management of sarcopenia may contribute to GAD management, advocating a holistic approach to healthcare in aging populations.

The cardiometabolic index (CMI), initially devised as a diagnostic tool for diabetes mellitus, has evolved into a composite biomarker for evaluating metabolic syndrome and cardiovascular disease risk. In order to shed light on any possible interactions between sarcopenia and CMI, this study will look at the relationship between the two.

Data from the 2011-2018 National Health and Nutrition Examination Survey (NHANES) were analyzed to investigate the possible link between sarcopenia and CMI. Among 3,185 eligible participants, the weighted prevalence of sarcopenia was 7.84%. A significant positive association emerged between CMI and sarcopenia risk, with each unit increase in CMI was linked with a 12% greater risk of sarcopenia in the fully adjusted model (OR: 1.12; 95% CI: 1.01-1.26). Moreover, dose-response relationships were evident across CMI tertiles (P for trend < 0.05). Subgroup analyses and interaction tests indicated that the positive correlation between CMI and the risk of sarcopenia differs significantly across subgroups defined by education level, sedentary time and CVD status (all P for interaction < 0.05).

Our findings demonstrate a robust association between elevated CMI levels and increased sarcopenia risk, suggesting CMI's potential utility as a clinical biomarker for sarcopenia risk surveillance. To confirm these results and demonstrate causality, more research is required.

Sarcopenia is a prevalent and debilitating condition among stroke survivors, characterized by the progressive loss of muscle mass and function. This multicenter, randomized controlled trial aims to evaluate the effects of a community-based high-speed power training (HSPT) program tailored for individuals with post-stroke sarcopenia. The intervention bridges the gap between hospital-based rehabilitation and long-term community reintegration by offering physician-supervised, progressive resistance training sessions conducted twice weekly for eight weeks. Participants are assessed on muscle strength, physical performance, balance, body composition, and gait before and after the intervention. The study utilizes validated tools such as handgrip dynamometry, dual-energy X-ray absorptiometry (DXA), short physical performance battery (SPPB), and timed up and go (TUG) to comprehensively evaluate outcomes. Through stratified randomization and a double-blind design, the trial seeks to minimize bias and maximize clinical relevance. The results from this protocol are expected to inform evidence-based guidelines for stroke rehabilitation and support scalable community-based exercise programs aimed at improving functional recovery and quality of life in this population.

BACKGROUND. CT muscle metrics hold promise for opportunistic sarcopenia screening and individualized clinical risk stratification, but reference values applicable across broad populations are lacking. OBJECTIVE. To estimate reference cutoff values for CT skeletal muscle metrics using data from populations of healthy young adults. EVIDENCE ACQUISITION. The PubMed, Embase, Cochrane Library, Web of Science, and Scopus databases were searched through January 1, 2025 for studies reporting skeletal muscle index (SMI) and/or skeletal muscle density (SMD) on CT at the L3 vertebral level in healthy young adults (age range, 18-45 years). For SMI and SMD in both men and women, a random effects meta-analysis was used to estimate interstudy SD (as a measure of variance among studies) and mean values for a theoretic global population of healthy young adults. Presence of significant heterogeneity among individual study means was assessed using the Q statistic. Cutoff values for the theoretic global population corresponding with a T-score of -2 (i.e., values ≥ 2 SDs below the population's mean value) were calculated, incorporating the meta-analysis results and pooled intrastudy variance. EVIDENCE SYNTHESIS. The meta-analysis included 14 studies (16,958 individuals; 11,819 men, 5139 women) reporting SMI, of which seven studies (11,175 individuals; 8372 men, 2803 women) also reported SMD. The estimated global mean value for SMI was 54.6 in men and 42.4 in women and for SMD was 47.4 HU in men and 43.6 HU in women. The interstudy SD for SMI was 5.4 in men and 4.3 in women and for SMD was 1.9 in men versus 3.2 in women; significant heterogeneity was present among individual study means for both SMI and SMD in both men and women (all p<.001). The cutoff value corresponding with a T-score of -2 for SMI was 36.3 in men and 27.5 in women and for SMD was 36.4 HU in men and 28.1 HU in women. CONCLUSION. This meta-analysis of studies performed in healthy young adults provides reference mean values and standardized cutoffs analogous to a T-score of -2 for SMI and SMD at the L3 level on abdominal CT. CLINICAL IMPACT. These results can aid opportunistic screening for sarcopenia.

Sarcopenia is recognized as a complex and multifactorial disorder that includes nutritional deficiency, inactivity, proinflammatory status, hormonal changes, neurological degeneration, and metabolic disturbances. It's pathogenesis is not fully understood. Therefore, identifying specific biomarkers of sarcopenia will help us understand its pathophysiology. The most frequently reported blood-derived biomarkers of sarcopenia are growth factors, neuromuscular junctions, endocrine systems, mitochondrial dysfunction, inflammation-mediated and redox processes, muscle protein turnover, blood metabolomics, and behavior-mediated biomarkers. Here, we address the implications of sarcopenia biomarkers based on our research experience with Korean Frailty and Aging Cohort Study cohort data. It includes free testosterone, myostatin, fibroblast growth factor 21 (FGF-21), growth differentiation factor 15 (GDF-15), procollagen type III N-terminal peptide (P3NP), creatinine-based biomarkers, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), brain-derived neurotrophic factor (BDNF), metabolites (proline, alanine, tryptophan), and multi-biomarker risk score. We attempted to explain the paradoxical findings of myostatin and FGF-21 levels in relation to sarcopenia. GDF-15 levels were associated with sarcopenia prevalence but not its incidence. Plasma P3NP and BDNF levels may be biomarkers of muscle quality rather than quantity. Lower erythrocyte eicosapentaenoic acid (EPA) and docosahexaenoic acid levels were associated with slow gait speed, and erythrocyte EPA levels were associated with low handgrip strength. We developed a multi-biomarker risk score for sarcopenia and found that its accuracy in diagnosing sarcopenia was higher than that of any single biomarker.

The association between vitamin D and sarcopenia in patients with chronic liver disease (CLD) has yet to be conclusively established, particularly in Western populations. We investigated the association between serum 25(OH)D levels and sarcopenia in adult CLD patients in the USA. We conducted a cross-sectional study using data from the National Health and Nutrition Examination Survey III. Weighted logistic regression was used to determine the association between sarcopenia and serum 25(OH)D in participants with CLD. CLD was defined as chronic hepatitis B or C, non-alcoholic fatty liver disease, alcohol-related liver disease, and other liver diseases. A serum 25(OH)D level of less than 75 nmol/L was defined as vitamin D insufficiency. This study included 1402 participants with CLD. The serum 25(OH)D concentration was significantly lower in the sarcopenia group (45.3 nmol/l) compared to the non-sarcopenia group (50.6 nmol/l). The prevalence of vitamin D insufficiency was as high as 91.3% in participants with CLD, and the proportion of vitamin D insufficiency was higher in those with sarcopenia. In the full multivariate model, each 10-nmol/L increase in 25(OH)D concentration was significantly associated with a decreased risk of sarcopenia (OR 0.89; 95%CI 0.79-0.99). Conversely, participants with insufficient vitamin D levels had a significantly increased risk of sarcopenia (OR, 2.07; 95% CI 1.08-4.00). Subgroup analyses suggested a sex difference in the association between vitamin D levels and sarcopenia, with a significant association only observed in females. Restricted cubic spline curves indicated a linear inverse association between serum 25(OH)D concentration and risk of sarcopenia in all participants and in females. Low serum 25(OH)D levels were significantly associated with an increased risk of sarcopenia in individuals with CLD, with the observed gender differences in this association warranting further validation in future studies.

Sarcopenia, a progressive loss of muscle mass and function, increases health risks in older adults, especially in rapidly ageing populations like Korea. Computed tomography (CT) imaging at the third lumbar vertebra (L3) level is a gold standard for assessing skeletal muscle area (SMA) and indices (SMIs), yet age- and sex-specific reference values are limited. This multicentre study aimed to establish these values for improved sarcopenia diagnosis.

We conducted a retrospective study with 2637 healthy Korean adults (1366 men, 1271 women) aged 20 and older, using abdominal CT scans from routine health check-ups at four centres. SMA and SMIs were measured at L3, and T-scores were calculated by comparing participants' values with a healthy young reference group (ages 20-39). Sarcopenia was classified into Classes I and II using standardised cutoffs.

An age-related SMA decline was observed in both sexes, with a more significant reduction in men. Sarcopenia prevalence was higher in men based on the SMA index, while SMA/body mass index (BMI) was more sensitive in women. Class I sarcopenia ranged from 10.1% to 21.3% in men and 10.6% to 23.6% in women, with Class II prevalence between 1.0% and 5.5% in men and 1.3% and 8.3% in women.

This study establishes CT-based reference values for SMA and SMIs, supporting early sarcopenia detection, with the SMA/BMI index proving valuable for both men and women.

Objective: To investigate the cross-sectional association between skeletal muscle mass and lifestyles including exercise, mealtime, and sleep habits in adult men aged under 64. Materials and Methods: A total of 101 Japanese men aged under 64 who underwent "Anti-aging Health Checkups" were enrolled in the study. Cross-sectional analyses were conducted using the subjects' data such as body mass index, skeletal muscle mass index (SMI), and self-reported lifestyle information. The physical activity (PA) value of habitual exercise per week (metabolic equivalent hr/week) was categorized into three groups. Mealtime combination of breakfast and dinner time was categorized into five groups. A multiple regression analysis demonstrated how each PA group has an association with SMI. Moreover, an analysis of covariance was performed to investigate the association between "mealtime combined with PA" and SMI levels by comparison and to investigate the association between "sleep duration or satisfaction combined with PA" and SMI levels, respectively. Results: The subjects with "breakfast before 8 a.m." had a significant positive association between SMI and PA levels; in addition, among the subjects from the "dinner before 8 p.m." group, as the PA level was higher, the SMI level increased. Consequently, the SMI level increased as the PA level was higher among the subjects who had "breakfast before 8 a.m. and dinner before 8 p.m." Furthermore, sufficient sleep such as more than 6 hr and satisfied sleep had positive associations with SMI as PA levels increased. Conclusion: These findings suggest a potential benefit of habitual exercise with breakfast before 8 a.m., dinner before 8 p.m., and sufficient sleep for maintaining skeletal muscle mass among middle-aged men.

Although bariatric and metabolic surgery (BS) has proved effective in the treatment of obesity based on the reduction in fat mass and the remission of comorbidities, there is also loss of lean mass after BS which could compromise muscle functionality. According to the European Working Group on Sarcopenia in Older People (EWGSOP), sarcopenia is a disease associated with loss of muscle mass, strength, and function. Through a comprehensive review of the literature, we identified a range of studies focusing on evaluating sarcopenia-related parameters according to the EWGSOP2 consensus criteria, before and after BS. Although most studies reported reductions in skeletal muscle mass and absolute muscle strength after surgery, improvements in muscle functionality were generally achieved, independent of the type of BS.

Investigating relationships between nutritional and clinical biochemistry biomarkers and skeletal muscle mass, strength and function (sarcopenic indices) may 1) highlight micronutrients of interest for potential preventive or treatment strategies for sarcopenia, or 2) highlight biomarkers that may be useful for identifying individuals at risk of sarcopenia.

Investigate associations between nutritional biomarkers (vitamin D, vitamin B12, folate, magnesium, potassium, calcium, and iron), clinical biomarkers (hemoglobin, ferritin, albumin, creatinine, and hemoglobin A1c: HbA1c), and sarcopenic indices (appendicular lean mass: ALM); height-adjusted ALM: ALMht; fat-free mass as a percentage of total body weight; extended short physical performance battery score: extSPPB; height-adjusted hand grip strength: HGSht; height-adjusted knee extension concentric strength, and; height-adjusted knee extension isometric strength) in males and females.

Using multivariable linear regression analysis, we investigated cross-sectional associations between biomarkers and sarcopenic indices in data collected from 1761 participants (age 22-103 y) from the Baltimore Longitudinal Study of Aging.

Hemoglobin was positively associated with ALM (β = 0.20, P = 0.021), HGSht (β = 0.25, P = 0.001), and extSPPB (β = 0.13, P = 0.024) in males, and with extSPPB in females (β = 0.15, P = 0.019). In males, serum iron was positively associated with ALMht (β = 0.0021, P = 0.038) and extSPPB (β = 0.0043, P = 0.045). In females, ferritin was positively associated with knee-extension strength measurements. Serum creatinine was positively associated with lean mass measures in males and females and with muscle strength and function measures in males with normal renal function (estimated glomerular filtration rate ≥60 mL/min/1.73 m2). In males, high HbA1c was associated with lower ALMht (β = -0.21, P = 0.023), extSPPB (β = -0.40, P = 0.027), and HGSht (β = -0.56, P = 0.031). In males and females, magnesium was positively associated with extSPPB, and potassium was positively associated with measures of knee-extension strength.

The associations found between measures of iron status and creatinine and sarcopenic indices, in males in particular, indicate potential importance for muscle health. Future longitudinal and intervention studies are warranted to confirm these findings.

Malnutrition is a common phenomenon, particularly in those at an increased risk of muscle mass and function losses. In this systematic review and meta-analysis, we aimed to explore the association of malnutrition with sarcopenia in middle-aged and older adults and the prognostic association of malnutrition and sarcopenia compared with sarcopenia alone on all-cause mortality. PubMed, Scopus, Web of Science, and Cochrane Library were searched from inception until January 2024. A meta-analysis using a random-effect model was employed, utilizing the Mini Nutritional Assessment malnutrition tool as a continuous and categorical variable. The study protocol was registered in the International Prospective Register of Systematic Reviews (CRD42024501521). Malnutrition was significantly associated with a greater risk of sarcopenia [continuous: k = 12, odds ratio (OR): 1.38, 95% confidence interval (CI): 1.18, 1.61, I2 = 94.8%, P < 0.01; categorical: k = 37, OR: 2.99, 95% CI: 2.26, 3.96, I2 = 78.3%, P < 0.01]. Sarcopenia and malnutrition were associated with a higher risk of mortality compared with sarcopenia alone (k = 5, hazard ratio: 4.04, 95% CI: 1.36, 11.94, I2 = 92.8%, P < 0.01). Metaregression showed age, sex, and number of adjustments did not explain heterogeneity among studies. The included studies had a moderate risk of bias. Malnutrition is associated with higher odds of sarcopenia and their combined presence is a better predictor of all-cause mortality compared with sarcopenia alone, further highlighting the importance of applying interventions to counteract these two closely related phenomena.

Sarcopenia is an aging process characterized by the loss of skeletal muscle mass and function. Although this condition primarily affects older adults, it is also associated with various diseases, physical inactivity, and nutritional deficiencies. Effective preventive measures include regular exercise, and adequate nutrition and protein intake to mitigate muscle atrophy. In this study, we investigated the effects of alanine on muscle tissue. Alanine supplementation increases physical performance and muscle function during physiological exercise in humans. To further explore its potential, we synthesized a D-alanine analog, D-Ala-Oi-pr-HCl, which demonstrated the ability to prevent muscle atrophy and increase muscle mass by downregulating myostatin expression both in vitro and in vivo. Furthermore, D-Ala-Oi-pr-HCl promoted the phosphorylation of Akt and ERK, both of which are associated with cell proliferation. However, the underlying mechanisms remain unclear. Notably, myostatin was inhibited by a D-alanine analog. These findings suggest that D-alanine analogs may serve as new therapeutic agents for muscle atrophy, providing valuable insights for future biomedical applications.

Head and neck cancers, including cancers of the mouth, throat, voice box, salivary glands, and nose, are a significant global health issue. Radiotherapy and surgery are commonly used treatments. However, due to treatment resistance and disease recurrence, new approaches such as immunotherapy are being explored. Immune checkpoint inhibitors (ICIs) have shown promise, but patient responses vary, necessitating predictive markers to guide appropriate treatment selection. This study investigates the potential of non-invasive biomarkers found in saliva, oral rinses, and tumor-derived exosomes to predict ICI response in head and neck cancer patients. The tumor microenvironment significantly impacts immunotherapy efficacy. Oral biomarkers can provide valuable information on composition, such as immune cell presence and checkpoint expression. Elevated tumor mutation load is also associated with heightened immunogenicity and ICI responsiveness. Furthermore, the oral microbiota may influence treatment outcomes. Current research aims to identify predictive salivary biomarkers. Initial studies indicate that tumor-derived exosomes and miRNAs present in saliva could identify immunosuppressive pathways and predict ICI response. While tissue-based markers like PD-L1 have limitations, combining multiple oral fluid biomarkers could create a robust panel to guide treatment decisions and advance personalized immunotherapy for head and neck cancer patients.

Sarcopenia is characterized by a loss of muscle mass and function, with significant implications for the physical performance of the affected people. Although commonly associated with aging, disease-related sarcopenia is of great clinical importance, particularly as it impacts disease progression and outcomes. Individuals with rheumatic diseases (RDs), including rheumatoid arthritis, systemic sclerosis, spondyloarthritides, systemic lupus erythematosus, fibromyalgia, myositis, or vasculitis, exhibit a high prevalence of sarcopenia, which exacerbates their clinical symptoms and contributes to poorer disease outcomes. Chronic inflammation influences muscle tissue degradation, causing a decline in physical performance. Apart from the apparent clinical manifestations, patients with RDs also use pharmacological treatments that negatively impact muscle mass further, increasing the risk of sarcopenia. Nutrition (diet and dietary supplements) and exercise interventions have been recommended as protective measures for sarcopenia as they may mitigate its adverse events. The present narrative review seeks to explore the methods used to assess sarcopenia in patients with RDs, its prevalence among them, and the challenges faced by the affected individuals, while critically assessing the appropriateness and limitations of current sarcopenia assessment tools in the context of RDs.

Low muscle mass is a critical indicator of frailty and adverse health outcomes. However, the potential link between systemic oxidative stress and low muscle mass remains underexplored. This study aims to investigate the association between the Oxidative Balance Score (OBS) and low muscle mass in U.S. adults.

In this cross-sectional study, data from 4096 adults aged 20 to 59 years from National Health and Nutritional Examination Survey (NHANES) 2011 to 2018 were analyzed. Low muscle mass, the primary outcome, was evaluated utilizing the Foundation for the National Institutes of Health (FNIH) definition. Analysis involved the application of restricted cubic splines and weighted multivariate regression techniques.

A nonlinear association was observed between OBS and low muscle mass (p for nonlinearity < 0.0049). Compared to the lowest OBS quartile, individuals in the highest quartile had an adjusted OR of 0.26 (95% CI: 0.14-0.48) for low muscle mass (P for trend < 0.001). Additionally, the adjusted β value for ALM/BMI was 0.067 (95% CI: 0.053-0.082), P for trend < 0.001. Both dietary and lifestyle OBS also showed negative associations with low muscle mass, with fully adjusted ORs of 0.38 (95% CI: 0.19-0.76) and 0.17 (95% CI: 0.05-0.62), respectively (both P for trends < 0.01). Furthermore, in stratified analyses, this relationship was particularly prominent in the 40-59 years age group (P for interaction = 0.048).

Higher OBS, indicative of greater antioxidant exposure, was robustly associated with a lower risk of low muscle mass, particularly in 40-59 old adults. These findings underscore the potential role of oxidative balance in preserving muscle health and highlight the need for targeted interventions in this demographic. Further longitudinal studies are warranted to confirm these associations and evaluate potential clinical applications.

Parkinson's disease (PD) and sarcopenia are prevalent age-related conditions that often coexist in affected individuals. Sarcopenia is particularly common among PD patients, with severe cases affecting approximately one in five individuals with the disease. Furthermore, sarcopenia is closely linked to the accelerated progression of PD, diminished quality of life, greater susceptibility to falls and fractures, and increased mortality risk. Although the precise mechanisms remain unclear, numerous studies suggest that factors such as the accumulation of α-Synuclein in skeletal muscle, loss of motor neurons, inflammation, phosphate toxicity, hormonal dysregulation, vitamin D deficiency, intestinal flora imbalances, and dysfunction of the gut-muscle-brain axis contribute to sarcopenia in PD. Understanding these mechanisms provides valuable insights into the relationship between PD and sarcopenia and establishes a foundation for future research and therapeutic strategies. This review examines the mechanisms underlying sarcopenia in PD, methods for its screening and assessment, and potential avenues for future research, including strategies for risk reduction and treatment.

Studies comparing different operational definitions of sarcopenia (S) and sarcopenic obesity (SO) defined according to the ''European Society for Clinical Nutrition and Metabolism and the European Association for the Study of Obesity'' (ESPEN/EASO) criteria with functionality are scarce. Our aim is to investigate whether SO or S with different skeletal muscle mass (SMM) adjustments is better associated with functional disability.

This retrospective study was carried out in older individuals ≥ 65 years of age in a geriatric outpatient clinic. Probable and confirmed sarcopenia were evaluated with the revised European Working Group on Sarcopenia in Older People (EWGSOP2) criteria, and SO with ESPEN/EASO consensus steps. For SMM component for both S and SO, different adjustments (weight, body mass index, and height square (W, BMI, H2 respectively)) were used. Functional disability was examined with activities of daily living (ADL), and instrumental ADL (IADL). Receiver operating characteristic (ROC) curves were drawn and area under ROC curve (AUC) were calculated to find which operational definition best predicts disability.

Data from 1477 older adults were screened. 408 participants (median age; 73 (65-101), 65% female) were included. Prevelance of SO was 6.9%. Probable sarcopenia, confirmed sarcopenia BMI-adjusted and confirmed sarcopenia W-adjusted were significantly associated with impaired IADL (p < 0.001), and showed fair accuracy for predicting IADL disability. Sarcopenic obesity did not show significant associations with ADL and IADL disability and didn't predict ADL and IADL disability. Only confirmed sarcopenia by BMI predicted ADL disability with poor accuracy. Among operational definitions of sarcopenia, probable sarcopenia had the highest sensitivity (83.6%) and negative predictive value (NPV) (94.2%) for predicting IADL disability.

We found that probable sarcopenia (with the highest sensitivity and NPV) and confirmed sarcopenia (BMI-adjusted with higher sensitivity and NPV than W-adjusted) were the most relevant for predicting IADL disability, but their diagnostic accuracy was limited. Confirmed sarcopenia by BMI predicted ADL disability with poor accuracy. Other operational definitions, including SO did not predict functional disability in our study. Future studies need to refine the definitions of SO and investigate its distinct impact on functional impairment compared to sarcopenia alone.

In primary care, tailored physical activity and nutritional counselling are scarce for older adults. Several challenges contribute to this issue, the primary obstacle being limited access to expert healthcare providers. The purpose of this study was to propose a quick, easy-to-implement case-finding tool offering straightforward nutritional and physical activity counselling to overcome these barriers.

Cross-sectional, baseline analysis was performed on 277 participants of the Cognitive Function and Amyloid Marker in Frail Older Adults (COGFRAIL) study, aged 70 years and older with mild cognitive impairment (mini-mental state examination score ≥ 20) and autonomy in daily living activities (ADL ≥ 4). Body composition was assessed using dual-energy X-ray absorptiometry, physical function was assessed using the short physical performance battery (SPPB), and nutrition was assessed using the mini nutritional assessment (MNA). A structured dietary interview was conducted to collect data on a typical daily intake pattern. A second database of 725 autonomous frail older adults from the Frailty clinic was used to test the robustness of the findings.

Participants with MNA scores < 24/30 and SPPB scores < 6/12 presented a high percentage of protein (74.1%) and caloric (66.7%) deficiency compared to the other categories. Based on standard daily protein and caloric recommendations, age, and weight, this category had a daily protein-caloric deficit of -19.4 ± 22.7 g and -225.5 ± 430.1 Kcal.

Based on the data, an easy-to-use algorithm using MNA and SPPB scores is suggested. This algorithm could serve as an effective tool for guiding nutritional and physical activity counselling for community-dwelling older adults.

Muscle-specific strength was recently proposed as a component for the definition of sarcopenia. However, no previous study has investigated the association between muscle-specific strength and postoperative outcomes. The present study aims to explore the association between muscle-specific strength and postoperative outcomes in patients undergoing colectomy for colorectal cancer. We also aimed to investigate whether addition of muscle-specific strength to the definition of sarcopenia could lead to an increased prognostic value for postoperative outcomes.

Clinical data of 1252 patients who underwent curative colectomy for colorectal cancer were prospectively collected and retrospectively analyzed. Muscle mass was measured by skeletal muscle index (SMI) determined by the preoperative computed tomography (CT) images at the third vertebra level. Grip strength and 6-m usual gait speed were measured before surgery. Muscle-specific strength was determined by the ratio of grip strength to SMI.

Low muscle-specific strength was associated with a higher incidence of postoperative complications, longer postoperative hospital stays, and more costs. Low muscle-specific strength was an independent predictor for postoperative complications, overall survival (OS) and disease-free survival (DFS). Addition of low muscle-specific strength to low muscle mass and strength led to significant predictive value for postoperative complications, and a higher hazard ratio in predicting OS and DFS.

Low muscle-specific strength could predict adverse postoperative outcomes in patients undergoing curative colectomy for colorectal cancer. Muscle-specific strength added prognostic value to sarcopenia for the prediction of postoperative outcomes, which should be incorporated into the diagnostic criteria of sarcopenia.

Sarcopenia, defined by the gradual decline in skeletal muscle mass and functionality, is a common disorder in the aging population and is linked to an elevated risk of falls and osteoporotic fractures. The contemporary diagnosis of sarcopenia depends on intricate and expensive techniques, such as computed tomography (CT) scans or dual-energy X-ray absorptiometry (DXA), which hinder the timely prevention of sarcopenia.

This study seeks to explore the association between the Body Roundness Index (BRI) and sarcopenia in the older adult cohort, utilizing data from the National Health and Nutrition Examination Survey (NHANES) in the United States.

Our study adopted a cross-sectional design, encompassing 9,411 older individuals, of which 1,147 were diagnosed with sarcopenia. After weighting, the number of individuals with sarcopenia was 23,985,011. The study employed multivariate logistic regression analysis to evaluate the association between BRI and sarcopenia, incorporating stepwise adjustments for potential confounders.

The outcomes of the multivariate logistic regression analysis revealed that, in contrast to individuals without sarcopenia, those with sarcopenia exhibited significantly higher mean BRI values and a greater prevalence of comorbid conditions, including hypertension and diabetes. A significant positive correlation was observed between BRI and the likelihood of developing sarcopenia. Specifically, after controlling for all covariates, each one-unit increase in BRI was linked to a 64% elevation in the risk of sarcopenia (OR = 1.64, 95% CI = 1.58-1.71). Furthermore, the receiver operating characteristic (ROC) curve analysis indicated that BRI is a robust predictor for diagnosing sarcopenia, with an AUC of 0.744.

These findings suggest that, within the U.S. older adult population, an elevated BRI is associated with a heightened risk of sarcopenia. BRI can function as a practical and cost-effective anthropometric index for more precise prediction of sarcopenia risk in older adults.

Aging is associated with a reduction in skeletal muscle fiber size and number, leading to a decline in physical function and structural integrity-a condition known as sarcopenia. This syndrome is further characterized by elevated levels of inflammatory mediators that promote skeletal muscle catabolism and reduce anabolic signaling.Androgens are involved in various biological processes, including the maintenance, homeostasis and trophism of skeletal muscle mass. The decline in androgen levels contributes, indeed, to androgen deficiency in aging people. Such clinical syndrome exacerbates the muscle loss and fosters sarcopenia progression. Nevertheless, the mechanism(s) by which the reduction in androgen levels influences sarcopenia risk and progression remains debated and the therapeutic benefits of androgen-based interventions are still unclear. Given the significant societal and economic impacts of sarcopenia, investigating the androgen/androgen receptor axis in skeletal muscle function is essential to enhance treatment efficacy and reduce healthcare costs.This review summarizes current knowledge on the role of male hormones and their-dependent signaling pathways in sarcopenia. We also highlight the cellular and molecular features of this condition and discuss the mechanisms by which androgens preserve the muscle homeostasis. The pros and cons of clinical strategies and emerging therapies aimed at mitigating muscle degeneration and aging-related decline are also presented.

Possible sarcopenia (PS) and depression are prevalent among middle-aged and older adults. However, few studies have evaluated the causal association between depression and PS, as well as its components. This study conducted both cross-sectional and longitudinal analyses to explore the relationship between PS and depression in a population aged 45 and oledr. We evaluated the association between PS and its components with depression using data from the China Health and Retirement Longitudinal Study (CHARLS). PS was assessed according to the Asian Working Group for sarcopenia gudielines established in 2019 (AWGS 2019). Depression was measured by the validated 10-item Center for Epidemiological Studies Depression Scale (CES-D.10), with a cut-off score of 12 or higher indicating the presence of depression. 10,058 participants included in cross-sectional study and 5,726 participants without depression from the same cohort in 2011 were followed through 2020. Logistic regression and Cox proportional hazards models were employed to assess the association between PS and its components with depression. Restricted cubic spline (RCS) model was utilized to evaluate dose-response relationshipbetween muscle strength and physical performance with depression, and subgroup analyses were performed to validate the robustness of the findings. Cross-sectional analysis revealed that the prevalence of PS among middle-aged and older adults was 32.84% (3,303/10,058). Both PS (OR:1.47,95%CI:1.34-1.63), low muscle strength (LMS) (OR:1.46,95%CI:1.24-1.71) and low physical performance (LPP) (OR:1.45,95%CI:1.31-1.61) exhibited higher odds of depression after adjusting covariates. 1515 cases (26.46%) of incident depression were identified during the 9-years follow-up. Subjects with PS (HR:1.10,95%CI:1.01-1.19), LMS (HR:1.16,95%CI:1.01-1.34) and LPP (HR:1.08,95%CI:1.01-1.18) were at an elevated risk of new-onset depression compared to those without these conditions. The RCS analysis demonstrated a non-linear relationship between muscle strength and physical performance with depression (p > 0.05). Participants aged 50-59, married, with education below middle school, living in rural areas, non-smokers or non-drinkers, sleeping less than 8 hours, and classified as obese exhibited an increased risk in subgroup analysis. (all p <  0.05). PS, LMS and LPP were indentified as independent risk factors for new-onset depression. It is essential to assess muscle strength and physical performance in community-dwelling middle-aged and older adults using simple and feasible objective measures to enhance depression screening.

The global aging population faces a growing prevalence of sarcopenia and musculoskeletal (MSK) pain, two interrelated conditions that diminish physical function, quality of life, and independence in older adults. Sarcopenia, characterized by the loss of muscle strength, mass, and function, often coexists with MSK pain, with emerging evidence suggesting that each condition may contribute to the progression of the other. This perspective explores the bidirectional relationship between sarcopenia and MSK pain, highlighting shared mechanisms, including inactivity, cellular aging, chronic inflammation, gender-related hormonal changes, and psychosocial factors such as depression and social isolation, which underlie the mutual exacerbation between conditions. Through a multidisciplinary framework, the article emphasizes integrating care across specialties to address these interconnected conditions. Practical approaches, including comprehensive screening protocols, tailored resistance exercise, and nutritional support, are discussed alongside innovative hybrid care models combining in-person and telemedicine systems to enhance accessibility and continuity of care. A call to action is presented for clinicians, policymakers, and researchers to adopt collaborative strategies, prioritize investment in integrated healthcare, and bridge critical knowledge gaps. By reframing care delivery and advancing multidisciplinary efforts, this perspective aims to effectively address the complex challenges posed by the intersection of sarcopenia and MSK pain in older adults.

The aim of this study was to investigate risk factors, develop, and assess the predictive nomogram for low appendicular skeletal muscle mass index (ASMI) in middle-aged and elderly populations. A total of 3,209 inpatients were divided into a Training Set (n = 2,407) and a Validation Set (n = 802). A nomogram was developed using R software for internal validation, and external validation was performed using the Validation Set. Gender (male), age, height, weight, triglyceride levels, alanine aminotransferase levels, alcohol consumption, and the triglyceride-glucose index to body-mass index ratio (TyG/BMI) were identified as predictors for the nomogram of low ASMI. In the Training Set, Q1-Q4 subgroups were performed for TyG/BMI, and logistic regression analysis showed that a TyG/BMI ratio greater than 0.37 was significantly associated with an increased risk of developing low ASMI (P < 0.001), with an area under the receiver operating characteristic curve (AUC) of 0.879 for the nomogram. In the Validation Set, the nomogram also demonstrated excellent calibration and discrimination, with an AUC of 0.881. Decision curve analysis (DCA) indicated excellent clinical utility of the nomogram. The study innovatively used TyG/BMI to predict low ASMI, which can reduce the impact of obesity on the diagnosis of sarcopenia. The nomogram can be effectively used to screen for possible sarcopenia in community settings. Due to the cross-sectional study design and unable to obtain complete data on the assessment of muscle strength, the predictive efficacy of our nomogram model requires further confirmation through external validation by large, multicenter prospective studies on sarcopenia population.

Coordinated hand movements used to grasp and manipulate objects are crucial for many daily activities, such as tying shoelaces or opening jars. Recently, the string-pulling task, which involves cyclically reaching, grasping, and pulling a string, has been used to study coordinated hand movements in rodents and humans. Here, we characterize how adult common marmosets perform the string-pulling task and describe changes in performance across the lifespan. Marmosets (n = 15, 7 females) performed a string-pulling task for a food reward using an instrumented apparatus attached to their home-cage. Movement kinematics were acquired using markerless video tracking and we assessed individual hand movements and bimanual coordination using standard metrics. Marmosets oriented their gaze toward the string above their hands and readily performed the task regardless of sex or age. The task required little training and animals routinely engaged in multiple pulling trials per session, despite not being under water or food control. All marmosets showed consistent pulling speed and similar hand movements regardless of age. Adult marmosets exhibited a clear hand effect, performing straighter and faster movements with their right hand despite showing idiosyncratic hand preference according to a traditional food retrieval assay. Hand effects were also evident for younger animals but seemed attenuated in the older animals. In terms of bimanual coordination, all adult marmosets demonstrated alternating movement pattern for vertical hand positions. Two younger and two older marmosets exhibited idiosyncratic coordination patterns even after substantial experience. In general, younger and older animals exhibited higher variability in bimanual coordination than adults.NEW & NOTEWORTHY Bimanual coordination is crucial for daily activities. In this study, we characterized how common marmosets performed the string-pulling task without extensive training, regardless of sex or age, and naturally exhibited a cyclical alternating pattern of hand movements. Although the overall behavior was similar across ages, younger and older marmosets demonstrated higher variability in bimanual coordination. These results establish the string-pulling task as a reliable tool for studying bimanual coordination and its underlying neural substrates.

This research examines the replicability and generalizability of the association between purpose in life and grip strength. An individual-participant meta-analysis of 27 samples (total N=115,972) from 24 countries that spanned four continents (Asia, Europe, North and South America) with self-reported purpose in life and dynamometer-assessed grip strength. Purpose in life was associated with stronger grip strength in every sample and aggregated in a random-effects meta-analysis (meta-analytic estimate=.06, p<.001). The association was similar across samples from different world regions and not moderated by methodological factors (e.g., scale content). The association was apparent across age, sex, race, and education and slightly stronger among males and participants with relatively less education. Every standard deviation in purpose was associated with a 23% lower likelihood of weak grip strength (meta-analytic OR=.81, 95% CI=.79-.84, p<.001) based on a standard threshold. Purpose in life is associated with grip strength, a marker of overall musculoskeletal health. The association replicates across diverse locations around the world and generalizes across sociodemographic groups.

Sarcopenia is characterized by progressive muscle loss with reduced physical function and/or reduced muscle strength. Operational definitions of sarcopenia include a measurement of muscle mass, most often from dual-energy X-ray absorptiometry (DXA)-derived appendicular lean mass. Appendicular lean mass can be derived from whole-body dual-DXA scans; however, these scans are performed less commonly than hip and spine scans as part of clinical care. The objective of our study was to develop an algorithm to predict appendicular lean mass index (ALMI) from regional spine and hip dual-energy X-ray absorptiometry (DXA) scans.

We performed a retrospective cross-sectional study using a subset of patients from the Manitoba Bone Mineral Density Registry who had hip, spine, and whole-body DXA scans at the same visit. We developed the algorithm using the following candidate covariates: age, sex, height, weight, DXA-derived spine and hip fat fraction, DXA-derived spine and hip tissue thickness. We internally validated the algorithm using the bootstrap method. Mean bootstrap parameter estimates were used as the final equation.

DXA scans from 676 patients were included in the analytic dataset. Mean ALMI was 6.73 (SD 1.43) kg/m2. The final predictive model included sex, age, height, weight, spine fat fraction and hip fat fraction. Sex also acted as an interaction term on weight and hip fat fraction. After bootstrap validation, model adjusted R2 was 0.863, root mean square error was 0.529 kg/m2, and AUROC to predict low ALMI per the European Working Group on Sarcopenia version 2 was 0.88.

Hip and spine DXA scans can be used to predict appendicular lean mass index. Future studies should test whether these predictions can be used to assess relationships between sarcopenia and other clinical conditions.

Sarcopenia is a progressive muscle disorder that may lead to mobility disability. No pharmaceutical interventions are currently available, and treatment relies on physical exercise and nutrition. The aim of SARA-INT was to investigate whether BIO101 (20-hydroxyecdysone), an activator of the MAS receptor, is safe and improves muscle function and physical performance of community dwelling older sarcopenic patients.

SARA-INT was a randomised three-arm interventional study (BIO101 175 mg bid /350 mg bid/placebo) with a planned 6-month treatment (up to 9 months in 50 subjects). Eligibility criteria for sarcopenia were meeting FNIH criteria for sarcopenia and Short Physical Performance Battery (SPPB) score ≤ 8/12 in men and women aged ≥ 65 years. Primary endpoint was the change from baseline (CFB) in gait speed (GS) measured by 400-m walking test (400MWT), secondary endpoints being CFB in other physical performance tests.

A total of 233 participants were randomised (mean age 75.5 ± 7.12; 54.3% female), of whom 232 and 156 were included in the full analysis set (FAS) and per-protocol (PP) populations, respectively. Due to COVID-19 pandemic, 55% of on-site end-of-treatment efficacy assessments were lost, reducing the studies' power. In the primary analysis (mix of 6/9 months), BIO101 350 mg bid treatment after 6/9 months was associated with an improvement in the 400MWT of 0.07 m/s versus placebo in the FAS population (not significant) and of 0.09 m/s in the PP population (p = 0.008). BIO101 350 mg bid treatment effect on the 400MWT GS was also observed in pre-defined subpopulations at higher risk of mobility disability (0.0474 m/s for slow walkers, 0.0521 m/s for obese and 0.0662 m/s for chair stand sub-score ≤ 2 from SPPB in the FAS population), with a trend for a dose response. BIO101 showed a good safety profile at both doses (number of subjects with related treatment emergent adverse events (TEAEs) of 13 (16.0%), 10 (13.3%) and 10 (13.5%) in the placebo, 175 mg and 350 mg BIO101 groups, respectively).

After 6 to 9 months of treatment, BIO101 350 mg bid showed strong trends consistent with a clinically relevant effect on the 400MWT GS, close to the minimal clinically important difference (MCID) in sarcopenia (0.1 m/s). This was also shown in predefined subpopulations at higher risk of mobility disability. BIO101 showed a good safety profile. Taken together, efficacy and safety data of this Phase 2 trial encourage us to pursue further development of BIO101 for the treatment of sarcopenia.

To undertake a systematic review and meta-analysis to examine the evidence base for the effects of β-hydroxy-β-methylbutyrate (HMB) supplementation in patients with sarcopenia.

Systematic review and meta-analysis.

The literature was searched via the PubMed, MEDLINE, Web of Science, EMBASE, CINAHL, Scopus, WANFANG, CNKI and VIP databases, through 23rd February 2024. The inclusion criteria were: randomized controlled trials (RCTs); patients diagnosed with sarcopenia defined according to well-accepted clinical consensus; HMB as an intervention; outcomes on muscle mass and/or muscle strength and/or physical performance. Data extraction was completed by independent pairs of reviewers. Meta-analyses of continuous outcomes were performed on the extracted data. Standard mean difference (SMD) with 95 % confidence intervals (CIs) between treatment and control group were used to express intervention effect estimates of HMB for each study. Risk of bias was assessed according to Version 2 of the Cochrane tool for assessing risk of bias in randomized trials (ROB 2).

Of 196 records retrieved and screened, five RCTs met the eligibility criteria for qualitative and quantitative analysis, yielding 154, 359 and 359 participants for muscle mass, muscle strength, and physical performance, respectively. For the overall risk of bias, no studies were graded as "high risk of bias", one (20.0 %) as "some concerns", and four (80.0 %) as "low risk of bias" according to the ROB 2. The overall meta-analysis revealed a beneficial effect on muscle mass and strength, as demonstrated by a higher skeletal muscle mass index (SMD = 0.32; 95 % CI: [0.00,0.64]; Z value =1.98; P = 0.048), along with an elevated handgrip strength (SMD = 0.65; 95 % CI: [0.05, 1.25]; Z value = 2.12; P = 0.034) in the HMB intervention groups compared with the control groups. However, there was no evidence of a benefit on physical performance, assessed by gait speed (SMD = 0.19; 95 % CI: [-0.14, 0.53]; Z value = 1.14; P = 0.255).

Overall, although limited and requiring interpretation with utmost caution, current evidence indicates that HMB supplementation is beneficial for improving muscle mass and strength, but there is no evidence of a benefit on physical performance in patients with sarcopenia. In future, more well-designed HMB intervention trials should be conducted that include populations diagnosed with sarcopenia according to well-accepted clinical consensus.

Malnutrition is a condition of deficiency, imbalance, or excess in a person's intake of energy and/or nutrients. Despite being common in patients with cancer, it is rarely diagnosed and managed by oncologists. Weight loss or changes in body mass index may fail to capture nutritional risk in patients with ovarian cancer due to masking ascites. The European Society for Clinical Nutrition and Metabolism and American Society for Parenteral and Enteral Nutrition guidelines recommend that patients with cancer undergo formal malnutrition screening and a full specialist assessment for those identified as high risk, and this recommendation is endorsed by European Society of Gynecologic Oncology and National Comprehensive Cancer Network for patients with ovarian cancer. The goal of this review was to describe the most common screening and assessment tools, studied in patients with ovarian cancer, as they relate to patient outcomes (complications, toxicity, and survival). Several tools have been tested in research and clinical settings, including serum markers, algorithms, scores, and clinical screening and assessment methods. These include but are not limited to pre-operative albumin, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, the Glasgow prognostic score, the prognostic nutritional index, and several clinical questionnaires. There are benefits and limitations to any individual tool as described in the review. Emerging technologies may also prove useful for malnutrition detection. We advocate that gynecologic oncology practices adopt a universal standardized method of screening and assessment for malnutrition in patients with ovarian cancer. Malnutrition can dramatically impact oncologic outcomes and patient well-being. Patients with malnutrition should be offered a nutritional care plan. These patients might also benefit from pre-habilitation, an emerging concept in gynecologic oncology, but evidence on its real impact is still limited. It is imperative that future research focus on strategies to reduce nutritional risk, improve patient overall health, and support resilience to cancer and anticancer treatment.

Gynaecological cancers (GCs) comprise a group of cancers that originate in the female reproductive organs. Each GC is unique, with different signs and symptoms, risk factors and therapeutic strategies. Worldwide, the majority of GCs are still associated with high mortality rates, especially ovarian, due to difficulty in early detection. Despite numerous studies on the underlying pathophysiology, research in the field of GCs poses unique scientific and technological challenges. These challenges require a concerted multi- and inter-disciplinary effort by the clinical, scientific and research communities to accelerate the advancement of prognostic, diagnostic, and therapeutic approaches. Sarcopenia is a multifactorial disease which leads to the systemic loss of skeletal muscle mass and function. It can be caused by malignancies, as well as due to malnutrition, physical inactivity, ageing and neuromuscular, inflammatory, and/or endocrine diseases. Anorexia and systemic inflammation can shift the metabolic balance of patients with cancer cachexia towards catabolism of skeletal muscle, and hence sarcopenia. Therefore, sarcopenia is considered as an indicator of poor general health status, as well as the possible indicator of advanced cancer. There is a growing body of evidence showing the prognostic significance of sarcopenia in various cancers, including GCs. This review will outline the clinical importance of sarcopenia in patients with GCs.

To explore the potential molecular mechanism of Qigu capsule (，QGC) in the treatment of sarcopenia through network pharmacology and to verify it experimentally.

The active compounds of QGC and common targets between QGC and sarcopenia were screened from databases. Then the herbs-compounds-targets network, and protein-protein interaction (PPI) network was constructed. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis were performed by R software. Next, we used a dexamethasone-induced sarcopenia mouse model to evaluate the anti-sarcopenic mechanism of QGC.

A total of 57 common targets of QGC and sarcopenia were obtained. Based on the enrichment analysis of GO and KEGG, we took the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt) signaling pathway as a key target to explore the mechanism of QGC on sarcopenia. Animal experiments showed that QGC could increase muscle strength and inhibit muscle fiber atrophy. In the model group, the expression of muscle ring finger-1 and Atrogin-1 were increased, while myosin heavy chain was decreased, QGC treatment reversed these changes. Moreover, compared with the model group, the expressions of p-PI3K, p-Akt, p-mammalian target of rapamycin and p-Forkhead box O3 in the QGC group were all upregulated.

QGC exerts an anti-sarcopenic effect by activating PI3K/Akt signaling pathway to regulate skeletal muscle protein metabolism.