Osteosarcopenia is suggested to be on the causal pathway to frailty; however, data on this topic is scarce, and it is unclear if osteosarcopenia is associated with frailty risk.

To investigate if osteosarcopenia is associated with frailty risk in community-dwelling older adults.

Retrospective analysis of a prospective cohort study.

I-Lan Longitudinal Aging Study (ILAS).

1779 older adults (≥50 years) at baseline, and 998 participants at follow-up.

Frailty was defined based on the Fried criteria. Osteosarcopenia was defined by the coexistence of osteopenia or osteoporosis (WHO definition) and sarcopenia (Asian Working Group definition). Multinomial logistic regression models were employed to examine the association of osteosarcopenia (at baseline) with frailty risk (at eight years), adjusted for demographic and clinical factors.

Out of 1779 adults (mean age 63.9 ± 9.2 SD, women 53.1 %), 998 (mean age 67.1 ± 7.6 SD, women 52.6 %) completed a follow-up at eight years. At baseline, osteosarcopenia was more prevalent in the frail group (27.5 %) compared to the pre-frail (10.8 %) and non-frail groups (0 %). However, neither osteosarcopenia (Odds Ratio [OR] 2.67, 95 %CI 0.85-8.40, p = 0.094) nor its components (sarcopenia (OR 3.13, 95 %CI 0.64-15.21, p = 0.158); osteopenia (OR 1.33, 95 %CI 0.70-2.53, p = 0.386); osteoporosis (OR 1.71, 95 %CI 0.64-4.59, p = 0.287)) were associated with frailty risk at eight years.

Neither osteosarcopenia nor its components were associated with frailty risk. However, a greater number of older adults with osteosarcopenia and extended follow-up are needed to re-evaluate whether osteosarcopenia is associated with frailty risk.

Osteosarcopenia, a condition characterized by the simultaneous presence of osteoporosis and sarcopenia, is a common geriatric syndrome associated with increased risk of falls and fracture. While there are multiple medications available for the management of osteoporosis, there are currently no approved pharmacological treatments for sarcopenia.

In this secondary analysis of a 2-year, double-blind, placebo-controlled, randomized trial involving 201 men and women with osteoporosis aged ≥65 years who were residents of long-term care communities (LTCCs), we examined the impact of denosumab on various indices of muscle health. Study participants received either denosumab 60 mg every 6 months or a matching placebo. We measured appendicular lean mass (ALM/Height2), lower extremity lean mass (LELM), grip strength, chair stand test performance, gait speed, Short Physical Performance Battery (SPPB), and total hip and spine bone density at baseline and at 6, 12, and 24 months.

Our study involved 78 men and 123 women, with a mean age of 81.5 years. There were no statistically significant differences between the denosumab and placebo groups in terms of changes in appendicular lean mass adjusted for ALM/Height2, LELM, chair stand performance, SPPB scores, or gait speed (all p > 0.05). However, in women, the chair stand test and grip strength showed non-significant greater improvements with denosumab at 18 and 24 months, suggesting a potential positive effect.

We did not find confirmatory evidence that denosumab impacts muscle health in older adults residing in LTCCs, despite its clear advantages for improving bone density. We observed non-significant improvements in grip strength and chair stand test performance in women, which warrant further investigation.

Our study found that in older adults in LTCCs, denosumab did not significantly enhance muscle health indices.

We aimed to elucidate the role of Angiotensin II type 1 receptor (AT1R) blocker usage in muscle wasting and dysfunction related to HIV.

Appendicular skeletal muscle mass, higher and lower limb strength, and physical fitness were determined in people living with HIV (PWH) using AT1R blockers users (n = 33), angiotensin-converting enzyme (ACE) inhibitors (n = 28), or not using antihypertensive drugs (n = 33). Groups had similar age, sex, race, BMI, and time of HIV infection. Muscle biopsies were performed to determine the abundance of AT1R, the relative abundance of selected proteins related to proteolysis, antioxidant enzymes, and oxidative stress. Plasma angiotensin II, IL-6, and TNF-alpha were also determined.

PWH using AT1R blocker presented higher strength, physical fitness, and muscle mass than PWH using ACE inhibitors or not using antihypertensive drugs. Although both PWH using AT1R blockers and ACE inhibitors presented reduced angiotensin II plasma levels, only PWH using AT1R blockers presented lower skeletal muscle AT1R activation, lower plasma oxidative stress markers, lower skeletal muscle oxidative stress (4-HNE), and proteolysis markers (Atrogin-1, Murf-1).

AT1R blocker usage protects against oxidative stress and activated proteolysis, contributing to the prevention of muscle wasting and dysfunction among PWH.

Low muscle mass and chronic lung disease are common among people with HIV (PWH), but whether low muscle mass is associated with a faster decline in lung function in this population remains unknown. We aimed to determine the prevalence and associated factors of low muscle mass, and the association between low muscle mass and lung function decline in PWH.

A prospective study on PWH from the Copenhagen Comorbidity in HIV Infection (COCOMO) study.

Skeletal muscle index (SMI) was assessed with computed tomography and low muscle mass was defined as SMI below the lowest 5% of a healthy population. Lung function was measured as forced expiratory volume in 1 s (FEV 1 ) at baseline and 2-year follow-up. We used logistic regression to investigate potential risk factors for low muscle mass. Using linear mixed models, we investigated if low muscle mass was associated with a faster FEV 1 decline.

We included 509 PWH, and 16% had low muscle mass. Older age, male sex, lower BMI, and high concentrations of interleukin 6 and tumor necrosis factor alpha were associated with low muscle mass. Low muscle mass was not associated with a faster FEV 1 decline (35.9 versus 34.0 ml/year in PWH with and without low muscle mass, respectively; P  = 0.69).

Almost one in six PWH had low muscle mass, mirroring the general population. Traditional risk factors and inflammatory markers were associated with low muscle mass. We found no association between low muscle mass and a faster FEV 1 decline among PWH.

The aim of this cross-sectional study was to develop new regression equations for estimating fat mass (FM) and skeletal muscle mass (SMM) in a heterogeneous Caucasian population, using the phase angle (PhA) as a bioelectrical parameter and DXA as the reference method. We also aimed to cross-validate the new equations, and to compare them with the manufacturers' equations.

The 212 healthy Caucasian participants aged 20-65 years were randomly distributed into two groups: development group (n = 141) and validation group (n = 71). Bioelectrical parameters were obtained with a 50 kHz foot-to-hand phase-sensitive body composition analyzer. The new FM percentage (FM%) and SMM percentage (SMM%) equations were developed by performing multiple forward regression analyses. Agreement between DXA and the different equations was assessed by mean differences, coefficient of determination, standard error of the estimate (SEE), concordance correlation coefficient (CCC), and Bland-Altman plots.

The proposed equations explained 89.2% of the variance in the DXA-derived FM% and 91.8% in the DXA-derived SMM%, with low random errors (SEE = 3.04% and 1.92%, respectively), and a very strong agreement (CCC = 0.93 and 0.94, respectively). In addition, they demonstrated no fixed bias and a relatively low individual variability. However, the manufacturer's equations described a lower percentage of the variance, with higher random errors, obtained fixed bias of -5.77% for FM% and 4.91% for SMM%, as well as higher individual variability.

The new regression equations, which include the PhA as a bioelectrical parameter, can accurately predict DXA-derived FM% and SMM% in a heterogeneous Caucasian population, and are better options than the manufacturer's equations.

Emerging evidence suggests that diminished skeletal muscle mass is associated with lower health-related quality of life (HRQOL) in individuals with cancer. There are no studies that we know of in the literature that use ultrasound system to evaluate muscle mass and its relationship with HRQOL.

The aim of our study was to evaluate the relationship between HRQOL determined by the EuroQol-5D tool and muscle mass determined by an artificial intelligence-based ultrasound system at the rectus femoris (RF) level in outpatients with cancer.

Anthropometric data by bioimpedance (BIA), muscle mass by ultrasound by an artificial intelligence-based at the RF level, biochemistry determination, dynamometry and HRQOL were measured.

A total of 158 patients with cancer were included with a mean age of 70.6 ±9.8 years. The mean body mass index was 24.4 ± 4.1 kg/m2 with a mean body weight of 63.9 ± 11.7 kg (38% females and 62% males). A total of 57 patients had a severe degree of malnutrition (36.1%). The distribution of the location of the tumors was 66 colon-rectum cancer (41.7%), 56 esophageal-stomach cancer (35.4%), 16 pancreatic cancer (10.1%), and 20.2% other locations. A positive correlation cross-sectional area (CSA), muscle thickness (MT), pennation angle, (BIA) parameters, and muscle strength was detected. Patients in the groups below the median for the visual scale and the EuroQol-5D index had lower CSA and MT, BIA, and muscle strength values. CSA (beta 4.25, 95% CI 2.03-6.47) remained in the multivariate model as dependent variable (visual scale) and muscle strength (beta 0.008, 95% CI 0.003-0.14) with EuroQol-5D index. Muscle strength and pennation angle by US were associated with better score in dimensions of mobility, self-care, and daily activities.

CSA, MT, and pennation angle of RF determined by an artificial intelligence-based muscle ultrasound system in outpatients with cancer were related to HRQOL determined by EuroQol-5D.

We developed and evaluated a skeletal muscle deep-learning (SMDL) model using skeletal muscle computed tomography (CT) imaging to predict the survival of patients with gastric cancer (GC).

This multicenter retrospective study included patients who underwent curative resection of GC between April 2008 and December 2020. Preoperative CT images at the third lumbar vertebra were used to develop a Transformer-based SMDL model for predicting recurrence-free survival (RFS) and disease-specific survival (DSS). The predictive performance of the SMDL model was assessed using the area under the curve (AUC) and benchmarked against both alternative artificial intelligence models and conventional body composition parameters. The association between the model score and survival was assessed using Cox regression analysis. An integrated model combining SMDL signature with clinical variables was constructed, and its discrimination and fairness were evaluated.

A total of 1242, 311, and 94 patients were assigned to the training, internal, and external validation cohorts, respectively. The Transformer-based SMDL model yielded AUCs of 0.791-0.943 for predicting RFS and DSS across all three cohorts and significantly outperformed other models and body composition parameters. The model score was a strong independent prognostic factor for survival. Incorporating the SMDL signature into the clinical model resulted in better prognostic prediction performance. The false-negative and false-positive rates of the integrated model were similar across sex and age subgroups, indicating robust fairness.

The Transformer-based SMDL model could accurately predict survival of GC and identify patients at high risk of recurrence or death, thereby assisting clinical decision-making.

Falls become more frequent with ageing. Improving balance and muscle strength has been shown to reduce the risk of falls in older patients, but the importance of muscle power is less investigated.

To evaluate changes in functional Sit-to-Stand muscle power and the association with dynamic balance in older adults following a 12-week exercise program.

A retrospective study including 84 (69 women) with a mean age of 79.3 years were included. Based on the 30s-STS performance, relative muscle power (W*kg-1) and allometric muscle power (W*m-2) was calculated, and the Dynamic Gait Index was used for dynamic balance.

The mean (SD) relative- and allometric power increased significantly (p < 0.001) from 2.3 (0.9) W*kg-1 to 2.9 (0.9) W*kg-1 and 58.4 (22.6) W*m-2 to 76.3 (22.6) W*m-2, respectively. Forty-seven out of 70 patients improved their 30s-STS performances by ≥ 2 repetitions, and 44 out of 68 patients showed an improvement of ≥ 3 points in their DGI scores. Relative- and allometric muscle power was significantly correlated with DGI scores before r = 0.398, (0.188-0.573) and r = 0.381 (0.169-0.560) and after r = 0.439 (0.215-0.62) and r = 0.374 (0.215-0.620) the 12-week program for the whole group. Additionally, 45 % of the patients were at reduced risk of falling according to their DGI values.

Sit-to-stand performance and DGI scores improved in older adults after participating in a 12-week combined balance and strength training program. Estimates of STS muscle power was associated with DGI scores.

The association between the Metabolic Score for Visceral Fat (METS-VF) and sarcopenia remains unclear. This study aims to explore the relationship between METS-VF and sarcopenia in the middle-aged and older adults in China.

Data were collected from 2011 and 2015 of the China Health and Retirement Longitudinal Survey (CHARLS) and 2948 participants were enrolled in this study. METS-VF was calculated using data from CHARLS. Sarcopenia was defined according to the criteria set by the Asian Working Group for Sarcopenia (AWGS) 2019. Potential confounders were identified through the Directed Acyclic Graph (DAG). The association between METS-VF and sarcopenia was then analyzed using multivariate logistic regression and restricted cubic spline (RCS) analysis.

Compared with low METS-VF, high METS-VF (OR = 1.65, 95 % CI = 1.08-2.52) showed a significant association with the occurrence of sarcopenia. Subgroup and interaction analyses revealed that residence (P for interaction = 0.012) influenced the relationship between METS-VF and sarcopenia. Additionally, RCS analysis demonstrated a non-linear relationship between METS-VF and sarcopenia.

There is a positive non-linear correlation between METS-VF and sarcopenia with residence showing an impact on this association. Early identification of patients with possible sarcopenia by METS-VF is of great value for disease prediction, prevention, early diagnosis and timely treatment to reduce the potential disease burden.

Phase angle (PhA), derived from bioelectrical impedance analysis (BIA), is an indicator of cell membrane health. Low PhA values reflect poor cellular function and low muscle mass. However, consensus regarding the appropriate cutoff value of PhA remains insufficient, and its impact on outcomes after esophagectomy in patients with esophageal malignancies is not well studied. We aimed to investigate whether preoperative PhA is associated with postoperative complication risk and survival prognosis and whether PhA decrease during the surgical preparation period is a prognostic factor in patients with esophageal cancer.

This retrospective cohort study analyzed data from 194 patients who had undergone esophagectomy for esophageal malignancies. A PhA measured several days before surgery, with cutoff values of 5.0° for men and 4.2° for women, was used. The relationship between postoperative pneumonia and clinicopathological factors and between low PhA and postoperative outcomes and survival prognosis was investigated. The preoperative PhA decline and survival prognosis were analyzed in 134 patients whose PhA was measured twice before surgery.

Overall, 93 and 101 patients were classified into the low and high PhA groups, respectively. A multivariate analysis showed that a serum albumin level lower than 3.5 g/dL and low PhA were independent risk factors for pneumonia (odds ratio [OR] = 3.40, P = 0.03; OR = 3.42, P = 0.03, respectively). The low PhA group exhibited significantly higher intraoperative fluid balance (6.7 versus 6.0 mL/kg/h, P = 0.01) and a higher proportion of patients who failed to achieve early mobilization on the first postoperative day (46 versus 32%, P = 0.04) than did the high PhA group. Multivariate analysis using a Cox proportional hazards model revealed that low PhA was a poor survival prognostic factor, independent of the clinical stage of esophageal cancer (hazard ratio = 2.61, P < 0.01). In patients whose PhA was measured twice preoperatively, a decrease in PhA during the preoperative period was a significant indicator of poor survival (hazard ratio = 2.59, P < 0.01). The group with a decrease in PhA during the preoperative period had significantly fewer steps than the group with an increase in PhA (6220 ± 2880 versus 8200 ± 2850, P < 0.01).

Low PhA was a risk factor for postoperative pneumonia in patients who had undergone esophagectomy and was associated with poor survival prognosis. A decrease in PhA during the preoperative period was a significant poor prognostic factor. Increasing physical activity before surgery may lead to an increase in PhA. Thus, it is important to measure and evaluate PhA changes sequentially in patients with esophageal cancer.

There is scarce evidence about which probiotic, prebiotic, or synbiotic supplementation is the most appropriate to improve sarcopenia parameters, and this presents a challenge.

The effects of consumption of probiotics, prebiotics, and synbiotics on sarcopenia, muscle strength, muscle mass, and physical performance and function were assessed in this study. In addition, another aim of the study was to determine the best probiotic, prebiotic, and/or synbiotic for the management of sarcopenia in older adults.

A systematic search was conducted in the MEDLINE/PubMed, Cochrane Library, SCOPUS databases, and other sources (eg, references obtained from articles identified in databases).

The search was limited from 2000 to 2023 and was based on sarcopenia parameters, and probiotics, prebiotics, or synbiotics supplementation. The quality of each included study also was assessed.

A meta-analysis was performed with the Review Manager program and publication bias and sensitivity analysis were performed.

Eight randomized controlled trials (RCTs) were included in the systematic review and 4 in the meta-analysis. Results showed that probiotics supplementation improved muscle strength and physical performance and function and suggested a beneficial effect on muscle mass. Prebiotics are suggested to be effective on muscle strength. The meta-analysis also determined that probiotic interventions were effective in increasing muscle strength by handgrip strength (mean difference [MD], 2.50 kg [95% CI, 1.33-3.66]; P < .0001) and physical performance and function by gait speed (MD, 0.10 m/s [95% CI, 1.33-3.66]; P < .0001) and physical performance and function by gait speed (MD, 0.10 m/s [95%CI, 0.03-0.16]; P = .003), but when sensitivity analysis was applied, the effectiveness was only maintained for gait speed.

Nutritional strategies based on probiotic supplementation seem to improve muscle strength and physical function. More robust research is needed with high-quality RCTs to confirm probiotics' effects. There is still limited evidence about prebiotic and synbiotic strategies, and more evidence is needed to elucidate their effects on sarcopenia parameters.

PROSPERO registration no. CRD42022360514.

Sarcopenia is a prevalent age-related disorder characterized by progressive loss of muscle mass, strength, and physical performance. While genome-wide association studies (GWAS) have explored isolated traits, the multifactorial genetic architecture underlying sarcopenia remains poorly defined. In this study, we constructed a comprehensive genetic factor to explain the genetic architecture of sarcopenia, and explore causal associations, genetic comorbidities, and mediating pathways linking sarcopenia to 30 urological diseases.

Based on the European Working Group on Sarcopenia in Older People (EWGSOP) criteria, six sarcopenia-related phenotypes were selected. A multivariate GWAS framework using genomic structural equation modeling (genomic SEM) was constructed, with an effective sample size of 651,820 individuals. Bidirectional Mendelian randomization (MR) was employed to assess causal relationships between sarcopenia and 30 urological diseases. Genetic correlation, tissue-specific heritability enrichment, shared risk genes, and gene set enrichment analyses were conducted to dissect genetic comorbidities between sarcopenia and urological diseases. Multi-omic mediation analysis was conducted to identify potential pathways mediated by blood proteins, metabolites, and immune traits.

Multivariate GWAS identified 215 loci and 30,869 single-nucleotide polymorphisms (SNPs) associated with polygenic architecture of sarcopenia. Bidirectional Mendelian randomization revealed causal links between sarcopenia and urological diseases, notably hyperplasia of prostate (BPH; OR = 1.17, P = 0.043) and acute tubulointerstitial nephritis (ATIN; OR = 1.14, P = 0.028). Genetic comorbidity analyses identified local genetic correlations between sarcopenia and BPH, and highlighted tissue-specific heritability enrichment in Cells Cultured fibroblasts tissue for both traits, while no genetic correlation was found with ATIN. We identified 75 shared risk genes for sarcopenia and BPH, which were enriched in cellular component biogenesis, RNA binding, and metabolic pathways. Multi-omic mediation analyses prioritized 17 metabolites and proteins linking sarcopenia to BPH and ATIN, though no significant immune mediators were identified.

These findings unveil a shared genetic architecture between sarcopenia and urological diseases, especially BPH, with heritability enrichment in fibroblast tissue and metabolic dysfunction emerging as the significant overlapping pathway.

Aging-associated body composition changes lead to a decrease in muscle mass and strength, affecting the functionality of older adults. Myostatin and musclin are myokines that regulate muscle metabolism and may modulate muscle changes during aging. Our objective was to determine the relationship between myostatin, musclin, and nutritional status with physical functionality in older adults.

This was a cross-sectional study of a subsample of a stratified random sampling population survey in community-dwelling 60-90-year-old adults of both sexes. Serum myostatin and musclin concentrations were measured using MILLIPLEX technology (Merck Millipore, USA). Trained personnel recorded body mass index (BMI), and waist (WC), calf (CC), and arm (AC) circumferences as indicators of nutritional status. Functionality tests included handgrip strength (GS), walking speed (WS), and Advanced Activities of Daily Living.

Of 101 participants, 55.4% were women, 56.4% were between 60 and 69 years old, 53.5% had abdominal obesity, 23.8% had dynapenia, and 33.7% had low WS. Neither myostatin nor musclin showed significant changes from 60 to 90 years. In a multiple lineal regression model, myostatin showed an inverse correlation with BMI, CC, and AC in men (P < 0.05) but did not explain GS or WS. In a similar analysis, musclin and WC showed an inverse correlation with GS (P < 0.05). Moreover, myostatin was lower in the more physically active men (P < 0.05) but musclin did not show any relationship with the Advanced Activities of Daily Living scale.

Myostatin and musclin do not decrease with aging and are associated with nutritional and metabolic status. Musclin is associated with dynapenic obesity in older adults.

Transcatheter tricuspid valve repair (TTVR) might be an alternative option to reduce tricuspid regurgitation (TR) in patients with sarcopenia. Psoas muscle area (PMA) measured using computed tomography (CT) is known as a marker of sarcopenia. We investigated the association of PMA with procedural and clinical outcomes following TTVR. We retrospectively measured left and right PMA using pre-procedural CT in patients undergoing TTVR. Low PMA was defined as the total PMA < 20.3 cm2 for men and < 11.8 cm2 for women. The primary outcome was a composite of all-cause mortality and heart failure hospitalization within one year after TTVR. Of 163 patients, 47 (29%) were considered as having low PMA. Procedural success, defined as residual TR of ≤ 2 + at discharge, and in-hospital mortality were comparable between patients with low and high PMA. Patients with low PMA had a higher incidence of the composite outcome than those with high PMA (49% vs. 21%; p = 0.001) This association was consistent after adjusting for baseline characteristics (adjusted hazard ratio 0.43; 95% confidence interval: 0.23-0.80; p = 0.008). In contrast, the New York Heart Association functional class improved from baseline to three-month follow-up, regardless of PMA. Approximately 30% of patients undergoing TTVR were found to have low PMA. Although TTVR may be a safe therapeutic option to reduce TR and improve heart failure symptoms in patients with sarcopenia, the prognosis after TTVR remains poor in this population. Pre-procedural CT-based assessment of PMA may enhance risk stratification and support better clinical decision-making for TTVR.

To examine the relationship between body mass index (BMI), abdominal adiposity, handgrip strength and physical function in people with HIV (PWH), and to explore the potential influence of physical activity and diet on this relationship.

Cross-sectional analyses.

The PROSPER-HIV Study was conducted at four clinical sites across the United States. Eligible participants were on antiretroviral therapy and had a viral load less than 200 copies/ml. Measures included: handgrip strength; physical function, assessed with the Short Physical Performance Battery (SPPB); BMI; abdominal adiposity, estimated using waist circumference; physical activity levels, measured using accelerometers; and diet quality, measured using triple-pass 24-h recalls. Data were analyzed using quantile regression between covariates and median of the outcomes.

Among PWH [ n  = 409, 59 years old (51.0-65.0), 76.5% male], 71.4% were overweight or obese, 72.4% had high waist circumference, 12.7% had low handgrip strength, and 11.5% had low SPPB. After controlling for age and sex, there was a negative association between SPPB and waist circumference ( β  = -0.011, P  = 0.02). When physical activity and diet variables were considered in the model, moderate-to-vigorous physical activity (MVPA) and step count were significant ( P  < 0.05) and influenced the relationship between waist circumference and SPPB. Although there was a moderate negative correlation between waist circumference and SPPB for the lowest quartiles of MVPA and steps, this correlation weakens as the activity levels increase.

Increased abdominal adiposity is associated with poorer physical function among PWH. Participants with higher MVPA and steps presented higher physical function even in the presence of high waist circumference.

The muscle-building and strengthening effects of the active form of vitamin D in humans remain unclear.

In this ancillary study of the Diabetes Prevention with active Vitamin D trial, we examined clinical and experimental aspects to investigate the effects and mechanisms of eldecalcitol, an active form of vitamin D, in preventing sarcopenia. We examined changes in molecules involved in muscle synthesis and degradation pathways in muscle samples from 32 participants before and after 1 year of eldecalcitol or placebo treatment. The protein levels of molecules involved in muscle synthesis and degradation pathways were examined using western blotting. Additionally, the skeletal muscle and body fat volumes were measured using bioelectrical impedance analysis with a body composition analyzer.

We found that eldecalcitol treatment for 1 year resulted in higher phosphorylation levels of mTOR and FOXO1 signaling pathways, which are associated with increased muscle mass and strength than those with placebo treatment. Body composition measurements at 1 year showed that the eldecalcitol group had significantly higher skeletal muscle mass (1.9 % vs. -3.4 %, p = 3.26E-9) and muscle strength (4.1 % vs. -0.7 %, p = 2.57E-17), and lower fat mass (-3.2 % vs. 1.8 %, p = 1.73E-12) than those in the placebo group.

This study suggested that the active form of vitamin D regulates the protein synthesis and degradation pathways in human skeletal muscle and may help prevent sarcopenia. This study was registered at UMIN clinical trials registry, UMIN 000005394.

The prevalence of sarcopenia is high in older patients with type 2 diabetes mellitus (T2DM).

We evaluated the accuracy of the Strength, Assistance in Walking, Rise from a Chair, Climb Stairs, and Falls (SARC-F) questionnaire, the SARC-F combined with the Calf Circumference (SARC-CalF) questionnaire, the SARC-F incorporating Elderly and Body Mass Index Information (SARC-F+EBM) questionnaire, the MiniSarcopenia Risk Assessment 5-item (MSRA-5) questionnaire, the MiniSarcopenia Risk Assessment 7-item (MSRA-7) questionnaire, and the Ishii test score (Ishii) as screening tools for sarcopenia in older patients with T2DM.

Patients with T2DM aged 60 years and older were enrolled. The Asian Working Group for Sarcopenia 2019 diagnostic criteria were used to determine the presence of sarcopenia in patients. The accuracy of the 6 screening methods was assessed using sensitivity, specificity, and area under the receiver operating characteristic curve (AUC).

In total, 225 older patients (111 men; 114 women) with T2DM participated in the study. The overall prevalence of sarcopenia was 24%, with 34.23% in men and 14.04% in women. Among all participants, the sensitivity of the 6 screening tools for sarcopenia was 18.52% to 92.59%, the specificity was 31.58% to 92.98%, and the AUC was 0.588 to 0.863. Among the 6 screening tools, the Ishii test has the highest AUC for screening both men and women, and its sensitivity and specificity are relatively balanced, both above 75%.

Of the 6 screening tools, the Ishii test proved to be the most suitable for early sarcopenia screening within this population.

We aimed to analyze the intra-set reliability of 5 sit-to-stand (5-STS) exercises with a functional electromechanical dynamometer (FEMD) and to determine and compare the load-velocity (L-V) profile in the STS exercise in adult pediatric cancer survivors by sex, age, body mass index, and type and treatment of cancer.

A total of 47 participants performed the 5-STS test with 5% and 20% body weight (BW) to assess intrasession reliability and analyze differences in L-V profiles by sex, age, BMI, and type and treatment of cancer.

Very high and extremely high relative reliability was found for both the 5% STS (ICC = 0.80-0.94) and the 20% STS (ICC = 0.87-0.95) relate to average and peak force, power, and velocity. Regarding L-V profiles, significant differences were only found in relation to sex for the velocity-axis intercept and area under the line (p < 0.05).

The 5-STS test with a load of 5% and 20% of BW using a FEMD is a reliable method for assessing strength, power, and velocity exercise in adult pediatric cancer survivors. There was a relation to sex for the variables of L-V profile.

Reliable assessments of muscular strength, like the 5-STS test using FEMD, offer a safer, less demanding alternative to maximal strength tests (e.g., 1RM), enabling precise intensity control and better-tailored rehabilitation programs.

Sarcopenia is increasingly recognized as a risk factor for postoperative complications in gastrointestinal cancer surgery. This study aimed to assess the association between sarcopenia and postoperative complications following laparoscopic radical resection of non-metastatic colorectal cancer (CRC).

In this retrospective study, 387 non-metastatic CRC patients undergoing laparoscopic radical resection were categorized into a sarcopenic group and a non-sarcopenic group based on preoperative skeletal muscle index (SMI, cm2/m2). Logistic regression analysis was performed to identify independent predictors for postoperative complications.

Sarcopenia was present in 156 (40.31%) patients. The incidence of postoperative complications was 32.3%, with a serious complication (Clavien-Dindo III-V) rate of 12.1%. Compared with non-sarcopenic patients, sarcopenic patients had significantly higher incidences of total complications (P < 0.001) and severe complications (P = 0.026). Multivariable analysis identified sarcopenia as an independent risk factor for total postoperative complications (OR = 3.42, 95%CI 1.85-6.31). Further analysis of specific types of postoperative complications revealed that anastomotic leakage (P = 0.001), surgical site infection (P = 0.002), and surgical site adverse events (P = 0.001) rates were higher in sarcopenic patients. In multivariable analysis, sarcopenia was independently associated with anastomotic leakage (OR = 3.36, 95%CI = 1.12-10.12) and surgical site adverse events (OR = 3.02, 95%CI = 1.55-5.90).

Preoperative CT-derived sarcopenia can predict postoperative complications in patients with non-metastatic CRC undergoing laparoscopic radical resection, particularly anastomotic leakage and surgical site adverse events.

Sarcopenia has been associated with adverse postoperative outcomes in older age cohorts, but has not been assessed in older adults with inflammatory bowel disease (IBD). Further, current assessments of sarcopenia among all aged individuals with IBD have used various measures of muscle mass as well as cutoffs to define its presence, leading to heterogeneous findings.

In this single-institution, multihospital retrospective study, we identified all patients aged 60 years and older with IBD who underwent disease-related intestinal resection between 2012 and 2022. Skeletal Muscle Index (SMI) and Total Psoas Index (TPI) were measured at the superior L3 endplate on preoperative computed tomography scans and compared through receiver operating characteristic curve. We then performed multivariable logistic regression to assess risk factors associated with an adverse 30-day postoperative outcome. Our primary outcome included a 30-day composite of postoperative mortality and complications, including infection, bleeding, cardiac event, cerebrovascular accident, acute kidney injury, venous thromboembolism, reoperation, all-cause rehospitalization, and need for intensive care unit-level care.

A total of 120 individuals were included. Overall, 52% were female, 40% had ulcerative colitis, 60% had Crohn's disease, and median age at time of surgery was 70 years (interquartile range: 65-75). Forty percent of older adults had an adverse 30-day postoperative outcome, including infection (23%), readmission (17%), acute kidney injury (13%), bleeding (13%), intensive care unit admission (10%), cardiac event (8%), venous thromboembolism (7%), reoperation (6%), mortality (5%), and cerebrovascular accident (2%). When evaluating the predictive performance of SMI vs TPI for an adverse 30-day postoperative event, SMI had a significantly higher area under the curve of 0.66 (95% CI, 0.56-0.76) as compared to 0.58 (95% CI, 0.48-0.69) for TPI (P = .02). On multivariable logistic regression, prior IBD-related surgery (adjusted odds ratio [adjOR] 6.46, 95% CI, 1.85-22.51) and preoperative sepsis (adjOR 5.74, 95% CI, 1.36-24.17) significantly increased the odds of adverse postoperative outcomes, whereas increasing SMI was associated with a decreased risk of an adverse postoperative outcome (adjOR 0.88, 95% CI, 0.82-0.94).

Sarcopenia, as measured by SMI, is associated with an increased risk of postoperative complications among older adults with IBD. Measurement of SMI from preoperative imaging can help risk stratify older adults with IBD undergoing intestinal resection.

Sarcopenia has been identified as a prognostic factor in various cancers. The aim of the study is to investigate the role of sarcopenia in the development of early complications following Primary Cytoreductive Surgery in advanced stage ovarian cancer patients.

A total of 57 patients who underwent Cytoreductive Surgery due to advanced stage ovarian cancer at the Surgical Oncology Clinic of…………. University Hospital between January 2013 and June 2021 were retrospectively analyzed. Routine preoperative Computed Tomography(CT) images were used to measure the cross-sectional areas of the paraspinal muscles, abdominal wall muscles at the L3 level in cm2. The Skeletal Muscle Index (SMI) and Psoas Muscle Index (PMI) values were calculated. Postoperative early complications were classified as Clavien-Dindo grade 3 and above major complications.

Based on SMI measurements, 23 patients with SMI < 38.5 were classified as sarcopenic, while 34 patients with SMI ≥ 38.5 were classified as nonsarcopenic; based on PMI measurements, 19 patients with PMI < 4.3 were classified as sarcopenic, while 38 patients with PMI ≥ 4.3 were classified as nonsarcopenic. Major complications occurring in the early postoperative period were significantly more common in the sarcopenic group. High Peritoneal Carcinomatosis Index (PCI) score and FIGO 3 C stage were associated with a significantly higher incidence of early complications. High PCI score and SMI < 38.5 value were identified as risk factors for postoperative early complications.

The quantitative measurements of sarcopenia using routine CT imaging for preoperative staging are a useful and cost-effective method. Determining the sarcopenic status of patients before treatment offers an advantage in predicting treatment complications.

Recently, poor sleep was closely related to physical function decline in older adults. To investigate the possible mediation pathway between them, the relationships among sleep status, lower limb composition, and physical performance were analyzed.

The cross-sectional study included 323 adults (46% women) aged 60 years and above (mean age 71.7 years) from the community of China. Sleep duration and sleep satisfaction were collected by questionnaire. The composition of lower limbs was quantified by dual-energy X-ray absorptiometry. Gait speed was measured as a physical performance indicator. The mediation role of low lean mass and high fat mass in the relationship between sleep status and physical performance was analyzed by bootstrap mediation analysis.

The average sleep duration of participants was 6.8 h, about 43% participants were dissatisfied with their sleep. Compared with medium sleep duration, long sleep duration was associated with low lean mass (OR 2.630, 95% CI 1.390-5.013), high fat mass (OR 2.151, 95% CI 1.155-4.010), and slow gait speed (OR 3.143, 95% CI 1.700-5.880). Participants with long sleep duration and unsatisfactory sleep had the worst lower limb composition and physical performance among them. The mediation effect of lower limb composition on the relationship between long sleep and gait speed was significant, with 15.3% of the total effect being mediated by lean mass and 19.9% mediated by fat mass.

Long and unsatisfactory sleep had a great relationship with poor physical performance, and the change of lower limb composition was one of the mediate factors involved in this relationship. The combination of sleep duration and sleep satisfaction together was a good indicator for sleep assessment, which provide a new strategy for the intervention of physical function decline in older adults.

Not applicable.

Given that menopause affects about half of the world's midlife population, it is crucial to understand its impact beyond traditional menopausal symptomology. For instance, many women, while transitioning through menopause, experience profound changes in body composition. These changes may contribute to postmenopausal reductions in metabolic health. This narrative review explores the influence of menopause on skeletal muscle and adipose tissue, highlighting the decline in muscle mass and strength and the gain and redistribution of adipose tissue, particularly the increase in visceral adiposity. Although menopausal changes in body composition are seemingly extensively studied, the longitudinal studies are not that common, and the precise mechanisms driving body composition changes remain unclear, with uncertainties surrounding the roles of hormonal shifts compared with regular aging, energy balance, and lifestyle factors. Notably, it remains debated whether menopause or estrogen meaningfully influences resting energy expenditure. The review also considers the potential mitigating effects of menopausal hormone therapy and regular exercise. Understanding these changes is essential for developing effective strategies to support women's health during and after menopause.

Given the clear association between obstructive sleep apnea (OSA) and metabolic disorders, coupled with a limited understanding of sarcopenia in patients with OSA, this study aimed to investigate the relationship between triglyceride-glucose (TyG) index and sarcopenia and in an elderly population with OSA.

Multiple hematological and sleep-breathing status were meticulously recorded in the cohorts. The SARC-F scale ≥ 4 was considered indicative of probable sarcopenia. The correlations between clinical indicators and the SARC-F score were analyzed. The area under the curve (AUC) was utilized to assess the predictive ability of TyG for sarcopenia and sarcopenic obesity. Logistic regression analysis and sensitivity stratification were employed to explore the influence of TyG.

A total of 1,148 individuals were included, among whom the median age was 66 (62, 71). 46.3% (n = 531) were diagnosed with severe OSA, while 24.0% (n = 276) had probable sarcopenia. The SARC-F score exhibited positive correlations with TyG (r = 0.122, P < 0.01), but it was negatively correlated with mean peripheral oxygen saturation (mean SpO2, r = -0.157, P < 0.01). The AUC for assessing sarcopenia using TyG was 65.7% (95% confidence intervals (95%CI): 61.9-69.5%. Furthermore, the cutoff value for TyG was 8.855 (sensitivity = 67.4%, specificity = 62.8%). Logistic regression and stratified sensitivity analyses, adjusted for various influencing factors, collectively revealed that TyG was a risk-related predictor of probable sarcopenia (all odds ratio > 2.0, P < 0.05).

The TyG index emerges as an independent predictor of sarcopenia in patients with OSA, shedding light on the complex interplay between nighttime hypoxia and muscle health.

Sarcopenia, a degenerative loss of skeletal muscle mass, strength, and function, poses a significant public health issue, particularly among aging populations. Cathepsins have recently emerged as key regulators of muscle metabolism and potential contributors to sarcopenia. This study employed Mendelian randomization (MR) to elucidate the causal relationships between 10 specific cathepsins and sarcopenia-related phenotypes, particularly appendicular lean mass (ALM) and handgrip strength, to identify potential therapeutic targets for sarcopenia intervention. A two-sample MR approach was used, employing genetic variants as instrumental variables to explore the impact of cathepsins on ALM and handgrip strength. ALM-related genetic association data were sourced from the UK Biobank, whereas grip strength data were derived from a meta-analysis focused on muscle weakness. Cathepsin levels were obtained using data from the INTERVAL study. The primary analysis method was the inverse variance weighted method, supplemented by MR-Egger, simple mode, weighted median, and weighted mode analyses to confirm the robustness of the findings. Positive associations of cathepsin S and E with ALM were demonstrated, whereas negative associations were observed for cathepsin F and B. No significant associations were identified between any cathepsin and grip strength in the primary inverse variance weighted analysis; however, secondary analyses indicated that cathepsin S may serve as a potential risk factor for reduced grip strength. Cathepsins S, E, F, and B were identified as playing significant roles in regulating muscle mass and strength, with cathepsin S potentially affecting grip strength. Targeting these enzymes may offer a viable strategy for developing treatments for sarcopenia. Although causal insights were provided, limitations include reliance on genetic data predominantly from European populations and the use of summary-level data, which constrains generalizability and hinders exploration of individual-level variability and molecular mechanisms. Future studies should validate these findings across diverse populations and investigate the effects of cathepsin on muscle health.

Background/Objectives: Obesity pharmacotherapy vastly improved the treatment of the disease of obesity. However, GLP-1 receptor agonists and GIP/GLP-1 dual agonists may lead to nutritional complications, including severe caloric restriction, micronutrient deficiencies, lean body mass loss, dehydration, and ketosis. We examine these risks and outlines dietitian-led strategies to support improved safety and effectiveness. Methods: This narrative review was conducted in three stages: literature search, screening of abstracts and full texts, and synthesis of findings. Searches were carried out in April and May 2025 across PubMed, Embase, Scopus, ScienceDirect, Web of Science, and Google Scholar using keywords related to obesity pharmacotherapy and nutrition. Results: Clinical observations and trial data suggest that some individuals may consume fewer than 800 kcal/day during the initial stages of treatment. Prolonged energy and protein deficits can increase the risk of sarcopenia, metabolic dysfunction, and reduce treatment adherence. Additional risks include inadequate micronutrient intake due to reduced dietary variety, dehydration linked to gastrointestinal symptoms and hypodipsia, and rare but serious cases of ketoacidosis. Patients at heightened risk include older adults, those with low baseline muscle mass, and individuals with restrictive eating patterns. Conclusions: Obesity medications introduce unique nutritional risks that are not yet addressed by standardised clinical protocols. Registered dietitians play a critical role in assessing intake patterns, monitoring for red flags, and delivering targeted nutritional support. Integrating structured dietary assessment tools, checklists, and risk-specific guidance into pharmacotherapy pathways can enhance safety, promote adherence, and improve long-term outcomes.

Background: Prior studies suggest that patients' body composition changes following transjugular intrahepatic portosystemic shunt (TIPS) implantation, potentially influencing complications and survival. Method: A prototype artificial intelligence (AI)-based, automated computed tomography (CT) body composition analysis tool was used to assess body composition imaging parameters in pre- and postinterventional scans of TIPS patients: visceral (VAT) and subcutaneous adipose tissue (SAT) areas, psoas muscle area (PMA), and total abdominal muscle area (TAMA). Sarcopenia was defined as a lumbar skeletal muscle index (LSMI) ≤ 38.5 cm2/m2 in women and ≤52.4 cm2/m2 in men. We analyzed longitudinal changes in body composition and investigated the impact of sarcopenia at TIPS implantation on the risk of TIPS thrombosis, hepatic encephalopathy, complications, and death using Cox regression models. Results: No clear trend emerged regarding changes in body composition parameters during postinterventional follow-up. Sarcopenia at TIPS implantation increased the instantaneous risk of postinterventional complications (hazard ratio (HR) 1.67; 95% confidence interval (CI) 0.95-2.93), development of hepatic encephalopathy (HR 1.65; 0.81-3.33), as well as the risk of dying within one year (HR 1.39; 0.66-2.92). Conclusions: CT body composition analysis may help in identifying high-risk patients undergoing TIPS implantation. Sarcopenia was associated with increased mortality and a higher incidence of postinterventional complications, particularly hepatic encephalopathy.

Background: Sarcopenia is a progressive muscle disorder commonly associated with aging and chronic diseases. It has been linked to worse clinical outcomes and increased vulnerability during acute illness. However, its prevalence in emergency department (ED) populations remains underexplored. This study aimed to evaluate the presence of sarcopenia among ED patients using ultrasound, determine its relationship with underlying comorbidities, and assess its association with in-hospital complications. Methods: We conducted a prospective, observational, cross-sectional study at the Infanta Cristina University Hospital (Madrid, Spain) from January to May 2024. A total of 150 patients aged 18 years and older who presented to the ED were assessed for sarcopenia using rectus femoris ultrasound. Sociodemographic, clinical, and laboratory variables were collected. A multivariate logistic regression model was used to identify independent predictors of in-hospital complications. Patients were followed for 30 days to evaluate outcomes. Comparisons were made between diagnostic groups and sarcopenia indices. Results: The mean age of the cohort was 70.7 years (SD 18.15), and 52% were male. Neurological diseases were associated with the highest degree of sarcopenia (mean Y-axis: 0.93 cm), followed by digestive (1.05 cm), hematological (1.05 cm), and cardiovascular diseases (1.08 cm). Patients who developed in-hospital complications had lower mean muscle thickness values compared to those without complications (1.08 cm vs. 1.24 cm; p < 0.05). Sarcopenia was significantly correlated with the presence of comorbidities and poor clinical outcomes. Conclusions: These findings support the integration of sarcopenia screening protocols into emergency care and highlight the need for studies exploring early nutritional or rehabilitation interventions targeted at high-risk patients.

In recent years medical science and research are increasingly directed towards a holistic approach that considers health as global well-being rather than solely as the absence of disease. In this framework, lifestyle interventions and, in particular, physical exercise, are of crucial importance in prevention and treatment. Therefore, the purpose of this study is to describe this mutual interplay between physical behaviours, sarcopenia, and frailty, as well as to illustrate the role of structured exercise training in aging and disease.

Physical activity and exercise training are determinants of lifelong global wellness and healthy aging. On the contrary, sedentary behaviour and physical inactivity are strictly linked to frailty and pre-frailty, both in adults and the elderly, with or without chronic diseases. On the other hand, the presence of pathological conditions is associated with a more inactive and sedentary behaviour. The co-presence of these factors is characterized by a mutual causal exchange in which they are imbricated in a continuous mechanistic interplay that involves inflammation, sarcopenia, osteopenia, functional impairment and many other pathophysiological aspects that rapidly can lead to a status of frailty.

A sedentary lifestyle and physical inactivity critically affect alterations in body composition and loss in functional capacity, typically linked to aging and accelerated by chronic diseases. However, physical activity and exercise can counteract the onset of pre-frailty and frailty by conferring beneficial effects on the individual's overall well-being.

Obesity and sarcopenia are prevalent among older adults and associated with adverse health outcomes. The aims of the present study were to assess the prevalence of sarcopenic obesity, to evaluate the co-occurence of sarcopenia, obesity and malnutrition (risk) and to assess the association between specific characteristics and sarcopenic obesity/probable sarcopenic obesity in nursing home residents.

Three hundred eighty-seven nursing home residents with low to moderate care requirements from 20 nursing homes in Slovenia participated in the cross-sectional NutriCare study. Data on general patient characteristics, physical activity, usual dietary intake (estimated by a 2 × 24 h dietary recall and a food frequency questionnaire), malnutrition (risk) status (Mini Nutritional Assessment [MNA]), laboratory parameters, hand grip strength and body composition (estimated via BIA) were collected. Obesity was defined as a high body fat percentage. Sarcopenia was defined according to the European Working Group on Sarcopenia in Older People2 (EWGSOP2) criteria. Descriptive statistics were used to characterise the sample. Uni- and multivariable binary logistic regression analyses were performed to explore associations between the predictor variables and sarcopenic obesity.

The prevalence of obesity was 90.7% according to high fat mass and 38.3% according to BMI (≥ 30). Prevalences were 27.6% (sarcopenia) and 24.5% (sarcopenic obesity), respectively. Probable sarcopenic obesity (low hand grip strength combined with obesity) was found in 37.6% of participants. A co-occurence of malnutrition (risk) and sarcopenia was present in 11.9%, whereas a combination of malnutrition (risk) and obesity was found in 28.2%. In 9.6% of the participants, a combination of all three phenomena-sarcopenia, obesity and malnutrition (risk)-was identified. The multivariable logistic regression model shows that higher age (OR 1.07; CI 1.02, 1.11), male sex (OR 2.3; CI 1.22, 4.5) and higher energy intake (OR 1.13; CI 1.04, 1.22) were significantly associated with sarcopenic obesity. Male sex (OR 2.30; CI 1.33, 3.98), higher age (OR 1.07; CI 1.03, 1.11), higher care requirements (OR 2.14; CI 1.20, 3.79), lower MNA score (OR 0.88; CI 0.80, 0.97) and metabolic equivalent of tasks (MET minutes/week) (OR 0.99; CI 0.98, 1.00) were significantly associated with probable sarcopenic obesity.

The study indicates a notable prevalence of obesity and sarcopenic obesity among nursing home residents with lower to moderate care dependency. These findings underscore the importance of optimising nutritional intake and other modifiable lifestyle factors associated with such health conditions and implementing them into targeted, individualised interventions to reduce the risk of obesity and sarcopenic obesity and to improve health outcomes.

Myokine dysregulation and mitochondrial dysfunction are implicated in the pathogenesis of sarcopenia in chronic obstructive pulmonary disease. The objective of this study is to explore the role of myokines and mitochondrial dysfunction in sarcopenia in chronic obstructive pulmonary disease.

We identified mitsugumin 53 and its clinical correlation through an enzyme-linked immunosorbent assay using the plasma samples of patients with chronic obstructive pulmonary disease. The role of mitsugumin 53 was confirmed in mitsugumin 53-knockout mice. The underlying mechanisms were investigated using multi-omics sequencing, live-cell imaging, and histological and molecular experiments. The effectiveness and safety of recombinant mitsugumin 53 in treating cigarette smoke-induced muscle dysfunction were evaluated in vitro and in vivo.

Plasma mitsugumin 53 levels were decreased in patients with chronic obstructive pulmonary disease and were associated with skeletal muscle dysfunction. Mitsugumin 53 deficiency exacerbated cigarette smoking-induced skeletal muscle atrophy. In muscle cells, mitsugumin 53 co-localized with the mitochondria and regulated mitochondrial fission. As a lipid transporter, mitsugumin 53 directly bound to the mitochondria-specific lipid cardiolipin and participated in maintaining mitochondrial homeostasis and membrane integrity. As an E3-ligase, mitsugumin 53 deletion triggered BCL2L13-mediated mitochondrial fission upon cigarette smoking stimulation. Supplementation with recombinant mitsugumin 53 significantly alleviated cigarette smoking-induced muscle atrophy and rescued mitochondrial dysfunction in vitro and in vivo.

Mitsugumin 53 is a vital regulator of sarcopenia in patients with chronic obstructive pulmonary disease. Thus, mitsugumin 53 and mitochondrial fission may be promising therapeutic targets for muscle dysfunction in chronic obstructive pulmonary disease.

The relationship between sarcopenia and post-liver transplant (LT) mortality is still not well understood. This study aims to provide an updated and comprehensive meta-analysis evaluating the impact of sarcopenia on the survival of LT patients.

We conducted searches in PubMed, Web of Science, and EMBASE up until May 2, 2024, without language restrictions. The primary outcome measured was the overall post-LT mortality risk associated with sarcopenia. The DerSimonian-Laird random effects model was used to calculate pooled adjusted hazard ratios (HRs).

Eighteen cohort studies comprising a total 6297 LT patients were included. The overall prevalence of sarcopenia was 27% (95% CI: 26%-28%), and this rate was lower when sarcopenia was defined using the third lumbar-skeletal muscle index in men, and among patients with lower Child-Pugh class. Sarcopenia remained significantly associated with higher mortality, with a pooled adjusted HR of 1.55 (95% CI 1.28-1.89). This association held across subgroups based on sex, study location, sarcopenia definition, study quality, and living donor LT recipients. A sensitivity analysis excluding groups with a high proportion of hepatocellular carcinoma patients showed similar findings (HR 1.63, 95% CI 1.13-2.35). No significant heterogeneity was identified in any of the analyses.

This meta-analysis shows that sarcopenia is significantly associated with increased mortality after LT. Thus, the risk of sarcopenia should be factored into the initial evaluation of LT candidates.

To investigate the association between the Dietary Inflammatory Index (DII) and osteosarcopenia using nationally representative data.

We utilized data from 1,418 men and women aged ≥ 50 years old participating in Iranian Multicenter Osteoporosis Study (IMOS), a nation-wide, cross-sectional study conducted in 2021. Osteosarcopenia was defined based on standard criteria, considering the presence of both osteopenia/osteoporosis and sarcopenia. We assessed dietary patterns using a semi-quantitative 168-item Food Frequency Questionnaire (FFQ) and calculated energy-adjusted DII (E-DII) scores based on 31 specific food items. Multivariable logistic regression models were used to examine the association between osteosarcopenia and E-DII, adjusting for potential confounders. Nutrient intake calculations were performed using Nutritionist IV software.

The mean age of participants was 60.1 (SD = 7.9) years, with 770 (54.3%) being women. The prevalence of osteosarcopenia was 8.8% (95% CI: 7.3-10.6%). Osteosarcopenia was more prevalent among women, older participants, and rural inhabitants. However, the difference was not statistically significant for sex and area of residence. After adjusting for confounders, the odds ratios for osteosarcopenia in the second and third tertiles of E-DII score were 2.23 (95% CI: 1.23-4.05) and 2.47 (95% CI: 1.40-4.37), respectively.

Our findings suggest an association between osteosarcopenia and the DII. A healthy low-inflammatory diet may play a crucial role in maintaining musculoskeletal health among the elderly.

Sarcopenia is a syndrome of severe muscle wasting, associated with adverse outcomes related to liver transplantation (LT). There are several approaches used to identify sarcopenia. We aimed to investigate the prevalence of sarcopenia using 3 different criteria and determine how these performed in relation to clinical outcomes.

The cohort study included 237 adults with cirrhosis referred for LT. Sarcopenia was identified using (1) CT-defined; and the (2) original and (3) updated European Working Group on Sarcopenia in Older People criteria (EWGSOP1 and 2). Logistic regression was used to estimate OR and 95% CI for the relationships between sarcopenia and receiving an LT, unplanned admissions pre-LT, surgical complications, and length of stay for the LT admission. Fine-Gray competing risk analysis explored the impact of sarcopenia on receiving an LT and unplanned admissions. The AUC determined the predictive utility of the criteria.

The prevalence of CT-defined sarcopenia (52%) was more than twice and 4-fold that of EWGSOP1-defined (22%) and EWGSOP2-defined (11%) sarcopenia, respectively. No criteria demonstrated a significant association with time to LT nor the time to unplanned admissions pre-LT. Similarly, none of the 3 criteria had superior predictive utility for the clinical outcomes for unplanned hospital admissions pre-LT of receiving an LT, with all 3 criteria having identical moderate AUCs for unplanned admissions (0.70) and similar weak AUCs (≤0.55) for the likelihood of receiving an LT.

Sarcopenia in patients undergoing LT evaluation is prevalent. EWGSOP criteria appear to offer no advantage over CT-only criteria in identifying patients at increased risk of adverse LT outcomes. Bedside measures of muscle function may be of benefit in tracking the effectiveness of interventions targeting sarcopenia.

Heart failure (HF) impairs skeletal muscle mass and function, which contributes to reduced physical performance. We investigated the prognostic impact of gait speed (GS), handgrip strength (HG) and appendicular skeletal muscle index (ASMI) on cardiovascular outcomes in a prospective HF cohort.

This single-centre prospective cohort study included adults with stable chronic HF with a previous diagnosis of overtly reduced left ventricular ejection fraction (LVEF) <40% and LVEF < 50% at enrolment. GS was measured by the 4 m GS test, maximal HG was measured with a hydraulic dynamometer, and ASMI was measured by dual-energy X-ray absorptiometry. The primary combined outcome was cardiovascular death or worsening HF. Fine and Gray regression models were calculated, treating non-cardiovascular death as the competing event.

Two hundred five patients (78% male) were analysed. The median age was 66 (quartiles: 58-74) years, 31% had diabetes mellitus, and the median LVEF was 37 (30-43) %. Median GS was 1.0 (0.8-1.0) m/s, median HG was 32 (24-40) kg, and median ASMI was 8.0 (7.2-8.9) kg/m2. During a median follow-up of 4.7 (4.0-5.3) years, the primary outcome was observed in 52 patients. In models adjusted for key clinical covariates, lower GS predicted a higher risk of cardiovascular death or worsening HF [subdistribution hazard ratio (SHR) per 0.1 m/s increase = 0.81, 95% confidence interval (CI) 0.68-0.95], whereas HG (SHR per 5 kg increase = 0.97, 95% CI 0.84-1.10) and ASMI (SHR per 1 kg/m2 increase = 1.17, 95% CI 0.94-1.44) did not. In the analysis of effect modification, these associations were consistent across key clinical subgroups.

Higher GS was independently associated with a lower risk of cardiovascular death or worsening HF, whereas HG and ASMI were not. We prospectively confirm GS as a physical performance measure with clear prognostic significance for patients with HF.