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Rojano-Ortega D, Berral-Aguilar AJ, Moya-Amaya H, Molina-López A, Berral-de la Rosa FJ. Association between phase angle and body composition: New equations to predict fat mass and skeletal muscle mass. Nutrition 2025; 135:112772. [PMID: 40222205 DOI: 10.1016/j.nut.2025.112772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Revised: 02/17/2025] [Accepted: 03/04/2025] [Indexed: 04/15/2025]
Abstract
OBJECTIVE 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. METHODS 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. RESULTS 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. CONCLUSIONS 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.
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Affiliation(s)
- Daniel Rojano-Ortega
- CTS-595 Research Group, Department of Informatics and Sports, Universidad Pablo de Olavide, Sevilla, Spain.
| | | | - Heliodoro Moya-Amaya
- CTS-595 Research Group, Department of Informatics and Sports, Universidad Pablo de Olavide, Sevilla, Spain
| | - Antonio Molina-López
- CTS-595 Research Group, Department of Informatics and Sports, Universidad Pablo de Olavide, Sevilla, Spain; Department of Nutrition, Udinese Calcio, Udine, Italy
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Kawata S, Booka E, Honke J, Haneda R, Soneda W, Murakami T, Matsumoto T, Morita Y, Kikuchi H, Hiramatsu Y, Takeuchi H. Relationship of phase angle with postoperative pneumonia and survival prognosis in patients with esophageal cancer: A retrospective cohort study. Nutrition 2025; 135:112743. [PMID: 40203785 DOI: 10.1016/j.nut.2025.112743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2024] [Revised: 02/17/2025] [Accepted: 03/05/2025] [Indexed: 04/11/2025]
Abstract
OBJECTIVES 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. METHODS 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. RESULTS 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). CONCLUSIONS 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.
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Affiliation(s)
- Sanshiro Kawata
- Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Eisuke Booka
- Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan.
| | - Junko Honke
- Department of Perioperative Functioning Care and Support, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Ryoma Haneda
- Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Wataru Soneda
- Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Tomohiro Murakami
- Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Tomohiro Matsumoto
- Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Yoshifumi Morita
- Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Hirotoshi Kikuchi
- Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Yoshihiro Hiramatsu
- Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan; Department of Perioperative Functioning Care and Support, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Hiroya Takeuchi
- Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
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Fukuyama H, Maeo S, Kusagawa Y, Sugiyama T, Kanehisa H, Isaka T. Differences in the Size of Individual Plantar Intrinsic Foot Muscles Between Ballet Dancers and Non-Dancers. J Dance Med Sci 2025; 29:91-97. [PMID: 39164843 DOI: 10.1177/1089313x241273887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/22/2024]
Abstract
INTRODUCTION In classic ballet, choreography often involves tiptoe standing. Tiptoe standing requires a high and stable foot arch structure, which is achieved by contraction of the plantar intrinsic foot muscles (PIFMs). Long-term repetitive loading with a specific movement can induce hypertrophic adaptation of the associated muscles. For dancers, however, limited information on the size of individual PIFMs is available from previous studies. The purpose of this study was to determine the differences in the sizes of 10 individual PIFMs between dancers and non-dancers. METHODS Muscle volumes (MVs) of 10 individual PIFMs were measured using magnetic resonance imaging in 15 female dancers and 15 female non-dancers. Muscles analyzed included abductor hallucis, flexor digitorum brevis, abductor digiti minimi, quadratus plantae, lumbricals, flexor hallucis brevis, adductor hallucis oblique head, adductor hallucis transverse head, flexor digiti minimi, plantar/dorsal interossei. In addition to absolute MVs, relative MVs normalized to body mass (rMVBM) and the percentage of individual MVs relative to the sum of 10 individual PIFM MVs (%MVWHOLE) were calculated. RESULTS The absolute MVs of 6 individual PIFMs, including the flexor digitorum brevis and lumbricals, were +16% to 59% larger in dancers than in non-dancers (P ≤ .048). The rMVBM of all individual PIFMs were +35% to 95% larger in dancers than in non-dancers (P ≤ .019). The %MVWHOLE of the flexor digitorum brevis and lumbricals were +10% to 36% higher (P ≤ .014) and those of the abductor digiti minimi and adductor hallucis oblique head were +8% to 11% lower (P ≤ .037) in dancers than in non-dancers. CONCLUSIONS For all 3 MV measures, only the flexor digitorum brevis and lumbricals, which are functionally specialized for flexion of the second to fifth metatarsophalangeal joints, were consistently larger in dancers than in non-dancers. This may be due to long-term repetitive loading on these PIFMs during ballet training involving tiptoe standing.
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Affiliation(s)
- Hiroshi Fukuyama
- Graduate School of Sport and Health Science, Ritsumeikan University, Kusatsu, Japan
| | - Sumiaki Maeo
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Japan
- Institute of Advanced Research for Sport and Health Science, Ritsumeikan University, Japan
| | - Yuki Kusagawa
- Institute of Advanced Research for Sport and Health Science, Ritsumeikan University, Japan
- Research Organization of Science and Technology, Ritsumeikan University, Kusatsu, Shiga, Japan
| | - Takashi Sugiyama
- Institute of Advanced Research for Sport and Health Science, Ritsumeikan University, Japan
- Research Organization of Science and Technology, Ritsumeikan University, Kusatsu, Shiga, Japan
| | - Hiroaki Kanehisa
- Institute of Advanced Research for Sport and Health Science, Ritsumeikan University, Japan
- Department of Sports and Life Sciences, National Institute of Fitness and Sports in Kanoya, Shiromizu, Kagoshima, Japan
| | - Tadao Isaka
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Japan
- Institute of Advanced Research for Sport and Health Science, Ritsumeikan University, Japan
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Negm A, Roberts B, Vette AH, Jones A, Beaupre L. The effect of sarcopenic obesity on knee biomechanics in individuals with end-stage knee osteoarthritis. Gait Posture 2025; 119:118-126. [PMID: 40054091 DOI: 10.1016/j.gaitpost.2025.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 11/14/2024] [Accepted: 02/10/2025] [Indexed: 05/04/2025]
Abstract
BACKGROUND 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). METHODS 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. RESULTS 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. CONCLUSION 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.
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Affiliation(s)
- Ahmed Negm
- Department of Surgery, University of Calgary, Calgary, Alberta, Canada.
| | - Brad Roberts
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, United States; Department of Mechanical Engineering, University of Alberta, Edmonton, Alberta, Canada.
| | - Albert H Vette
- Department of Mechanical Engineering, University of Alberta, Edmonton, Alberta, Canada; Department of Biomedical Engineering, University of Alberta, Edmonton, Alberta, Canada; Glenrose Rehabilitation Hospital, Alberta Health Services, Edmonton, Alberta, Canada.
| | - Allyson Jones
- Department of Physical Therapy, University of Alberta, Edmonton, Alberta, Canada.
| | - Lauren Beaupre
- Department of Physical Therapy, University of Alberta, Edmonton, Alberta, Canada.
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Martínez-Herrera BE, Trujillo-Hernández B, Sat-Muñoz D, González-Barba F, Cruz-Corona E, Bayardo-López LH, Solórzano-Meléndez A, Oñate-Zubdia DA, Morán-Galavíz RE, Flores-Carlos JD, Dávalos-Cobián C, Salazar-Páramo M, Nava-Zavala AH, Gómez-Sánchez E, Balderas-Peña LMA. Quality of Life and Functionality of Head and Neck Cancer Patients Are Diminished As a Function of Sarcopenia and Obesity. EAR, NOSE & THROAT JOURNAL 2025; 104:NP363-NP372. [PMID: 35226551 DOI: 10.1177/01455613221076791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BackgroundHealth-related quality of life (QoL) is a measure that allows us to know the patient's perception of well-being and how it is affected by their disease and treatments. In cancer patients, sarcopenia has been associated with low scores on various instruments used to assess the QoL; however, little information is available on the effects of sarcopenia and sarcopenic obesity on the QoL of patients with head and neck cancer (H&NC).MethodsIn this cross-sectional study with 71 H&NC patients aged between 40 and 80 years, we describe the scores on the instruments EORTC QLQ C-30 and EORTC QLQ-H&N35 according to the sarcopenia phenotype (NSG, nonsarcopenic group; SG, sarcopenic group; and SOG, sarcopenic obesity group), hand-grip strength, gait speed, total lymphocyte count, albumin, cholesterol and C-reactive protein, and the relationships between these variables.ResultsThe prevalence of sarcopenia and sarcopenic obesity was 48% and 28%, respectively. The QoL analysis showed that NSG had higher scores on the physical functioning scale [NSG 93 (83-100); SG 73 (52-88); SOG 83 (53-93), P = .009] and lower scores on the fatigue scale [NSG 11 (0-22); S 39 (30-67); SOG 44 (14-56); P = .004]. The NSG had a higher hand-grip strength (31.1 kg) than SG (24.1 kg, P = .007) and SOG (26.3 kg, P = .001), and a lower C-reactive protein. The SG and SOG showed no differences between them.ConclusionsPatients with sarcopenia or sarcopenic obesity have lower physical performance and a higher level of fatigue than nonsarcopenic patients. This loss of function can maintain or worsen sarcopenia due to the patient's self-restraint in physical exertion that encourages an increase in muscle tissue.
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Affiliation(s)
- Brenda-Eugenia Martínez-Herrera
- Departamento de Nutrición y Dietética, Hospital General de Zona #02, Instituto Mexicano del Seguro Social, San Luis Potosí, México
- Unidad de Investigación Biomédica 02, Hospital de Especialidades, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, México
- Programa de Doctorado en Ciencias Médicas, Universidad de Colima, Colima, México
| | | | - Daniel Sat-Muñoz
- Clínica de Cirugía de Tumores de Cabeza y Cuello, Departamento de Oncología Quirúrgica, Hospital de Especialidades, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, México
- Departamento de Morfología. Cuerpo Académico UDG CA-874 "Ciencias morfológicas en el diagnóstico y tratamiento de la enfermedad", Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, México
| | - Faviola González-Barba
- Unidad de Investigación Biomédica 02, Hospital de Especialidades, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, México
- Departamento de Patología, Hospital de Especialidades, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, México
- Programa de Maestría en Ciencias Médicas, Universidad de Colima, Colima, México
| | - Eduardo Cruz-Corona
- Unidad de Investigación Biomédica 02, Hospital de Especialidades, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, México
| | - Luis Héctor Bayardo-López
- Departamento de Oncología Radioterapia, Hospital de Especialidades, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, México
| | - Alejandro Solórzano-Meléndez
- Departamento de Oncología Radioterapia, Hospital de Especialidades, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, México
| | - David-Abdiel Oñate-Zubdia
- Departamento de Oncología Radioterapia, Hospital de Especialidades, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, México
| | - Ruben-Eduardo Morán-Galavíz
- Servicio de Soporte Nutricio, Departamento de Cirugía General, Hospital de Especialidades, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, 44340 Guadalajara, México
| | - Juan-Daniel Flores-Carlos
- Servicio de Soporte Nutricio, Departamento de Cirugía General, Hospital de Especialidades, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, 44340 Guadalajara, México
| | - Carlos Dávalos-Cobián
- Departamento Clínico de Gastroenterología, Hospital de Especialidades, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, México
| | - Mario Salazar-Páramo
- Departamento de Fisiología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, México
| | - Arnulfo-Hernán Nava-Zavala
- Unidad de Investigación Biomédica 02, Hospital de Especialidades, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, México
- Unidad de Investigación Social Epidemiológica y en Servicios de Salud, Instituto Mexicano del Seguro Social, Guadalajara, México
- Programa Internacional Facultad de Medicina, Universidad Autónoma de Guadalajara, Zapopan, México
- Servicio de Inmunología y Reumatología, División de Medicina Interna, Hospital General de Occidente, Zapopan, México
| | - Eduardo Gómez-Sánchez
- Departamento de Morfología. Cuerpo Académico UDG CA-874 "Ciencias morfológicas en el diagnóstico y tratamiento de la enfermedad", Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, México
- División Disciplinas Básicas para la Salud, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, México
| | - Luz-Ma-Adriana Balderas-Peña
- Unidad de Investigación Biomédica 02, Hospital de Especialidades, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, México
- Departamento de Morfología. Cuerpo Académico UDG CA-874 "Ciencias morfológicas en el diagnóstico y tratamiento de la enfermedad", Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, México
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Mwala NN, Borkent JW, van der Meij BS, de van der Schueren MA. Challenges in identifying malnutrition in obesity; An overview of the state of the art and directions for future research. Nutr Res Rev 2025; 38:219-228. [PMID: 38576127 PMCID: PMC7616526 DOI: 10.1017/s095442242400012x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Abstract
(Protein-energy) malnutrition in individuals living with obesity presents complex diagnostic challenges due to the distinctive physiological characteristics of obesity. This narrative review critically examines the identification of malnutrition within the population with obesity, distinguishing malnutrition in obesity from related conditions such as sarcopenic obesity. While noting some shared features, the review highlights key differences between these conditions. The review also highlights the limitations of current malnutrition screening tools, which are not designed for individuals living with obesity. These tools primarily rely on anthropometric measurements, neglecting (among others) nutrient intake assessment, which hinders accurate malnutrition detection. Additionally, this review discusses limitations in existing diagnostic criteria, including the Global Leadership Initiative on Malnutrition (GLIM) criteria, when applied to individuals living with obesity. Challenges include the identification of appropriate cut-off values for phenotypic criteria (unintentional weight loss, low body mass index and muscle mass) and aetiological criteria such as reduced food intake and inflammation for the population with obesity. Overall, this review emphasises the need for modified screening tools and diagnostic criteria to recognise and assess malnutrition in obesity, leading to improved clinical outcomes and overall wellbeing.
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Affiliation(s)
- Natasha Nalucha Mwala
- Department of Nutrition, Dietetics and Lifestyle, School of Allied Health, HAN University of Applied Sciences, Nijmegen, the Netherlands
- Department of Human Nutrition and Health, Wageningen University and Research, Wageningen, the Netherlands
| | - Jos W. Borkent
- Department of Nutrition, Dietetics and Lifestyle, School of Allied Health, HAN University of Applied Sciences, Nijmegen, the Netherlands
- Department of Human Nutrition and Health, Wageningen University and Research, Wageningen, the Netherlands
| | - Barbara S. van der Meij
- Department of Nutrition, Dietetics and Lifestyle, School of Allied Health, HAN University of Applied Sciences, Nijmegen, the Netherlands
- Department of Human Nutrition and Health, Wageningen University and Research, Wageningen, the Netherlands
- Bond University Nutrition and Dietetics Research Group, Bond University, Gold Coast, Australia
| | - Marian A.E. de van der Schueren
- Department of Nutrition, Dietetics and Lifestyle, School of Allied Health, HAN University of Applied Sciences, Nijmegen, the Netherlands
- Department of Human Nutrition and Health, Wageningen University and Research, Wageningen, the Netherlands
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Yücel M, Ünlüer NÖ, Sari YA. A comparison of oral health, nutrition, and swallowing function in older adults with and without sarcopenia: A cross-sectional study. Nutr Clin Pract 2025; 40:596-604. [PMID: 40035797 PMCID: PMC12049568 DOI: 10.1002/ncp.11283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 01/30/2025] [Accepted: 01/31/2025] [Indexed: 03/06/2025] Open
Abstract
BACKGROUND Sarcopenia, the age-related loss of muscle mass and strength, may impact the muscles involved in oral functions and swallowing, leading to challenges that may impact quality of life in older adults. The aim of the study was to compare oral health, swallowing function, and malnutrition of older adults with and without sarcopenia. MATERIALS AND METHODS The cross-sectional study included volunteers ≥65 years of age. Sarcopenia status was evaluated by anthropometric (calf circumference and midupper arm circumference) and muscle strength (walking speed and handgrip strength) measurements. Oral health was assessed with the Oral Health Impact Profile (OHIP-14), swallowing function was assessed by the Eating Assessment Tool-10 (EAT-10), and nutrition status was determined using the Mini Nutritional Assessment. RESULTS This study included 65 older adults. The mean age was 80 years, 54% were female, and 43% were diagnosed with sarcopenia. Individuals with sarcopenia had a higher OHIP-14 score (which indicates poor quality of life related to oral and dental health, 16 ± 8 vs 11 ± 7; P = 0.008), were more likely to have a EAT-10 score ≥ 3 (indicating presence of dysphagia, 79% vs 41%; P = 0.002), and were more likely to be at risk for malnutrition (79% vs 54%; P = 0.03) compared with individuals without sarcopenia. CONCLUSIONS Older adults with sarcopenia may be at risk for poor quality of life related to oral health, malnutrition and dysphagia. Further studies with long-term follow-up are needed to determine the long-term effects of sarcopenia on oral health, swallowing function, and malnutrition in older adults.
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Affiliation(s)
- Melike Yücel
- Zirve Special Education and Rehabilitation CenterDiyarbakırTurkey
| | - Nezehat Özgül Ünlüer
- Gülhane Faculty of Physiotherapy and RehabilitationUniversity of Health SciencesAnkaraTurkey
| | - Yasemin Ateş Sari
- Department of Physiotherapy and Rehabilitation, Faculty of Health SciencesAnkara Yıldırım Beyazıt UniversityAnkaraTurkey
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PUŠ K, PIŠOT S, MARUŠIČ U, PESKAR M, TERAŽ K, KALC M, BLAŽUN VOŠNER H, KOKOL P, ZAVRŠNIK J, ŠIMUNIČ B. Prevalence of Sarcopenia Among Slovenian Older Adults and Associated Risk Factors. Zdr Varst 2025; 64:103-111. [PMID: 40026371 PMCID: PMC11870320 DOI: 10.2478/sjph-2025-0013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2024] [Accepted: 01/07/2024] [Indexed: 03/05/2025] Open
Abstract
Introduction 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. Methods 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. Results 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. Conclusion 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.
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Affiliation(s)
- Katarina PUŠ
- Science and Research Centre Koper, Institute for Kinesiology Research, Garibaldijeva ulica 1, Koper, Slovenia
- Alma Mater Europaea University, Department of Health Sciences, Maribor, Slovenska 17, 2000Maribor, Slovenia
- Faculty of Sport, University of Ljubljana, Gortanova ulica 22, 1000Ljubljana, Slovenia
| | - Saša PIŠOT
- Science and Research Centre Koper, Institute for Kinesiology Research, Garibaldijeva ulica 1, Koper, Slovenia
| | - Uroš MARUŠIČ
- Science and Research Centre Koper, Institute for Kinesiology Research, Garibaldijeva ulica 1, Koper, Slovenia
- Alma Mater Europaea University, Department of Health Sciences, Maribor, Slovenska 17, 2000Maribor, Slovenia
| | - Manca PESKAR
- Science and Research Centre Koper, Institute for Kinesiology Research, Garibaldijeva ulica 1, Koper, Slovenia
- Biological Psychology and Neuroergonomics, Department of Psychology and Ergonomics, Faculty V: Mechanical Engineering and Transport Systems, Technische Universität Berlin, Straße des 17. Juni 135, 10623Berlin, Germany
| | - Kaja TERAŽ
- Science and Research Centre Koper, Institute for Kinesiology Research, Garibaldijeva ulica 1, Koper, Slovenia
- Clinical University Department of Medical, Surgical, and Health Sciences, University of Trieste, Strada di Fiume, 447, 34149Trieste, Italy
| | - Miloš KALC
- Science and Research Centre Koper, Institute for Kinesiology Research, Garibaldijeva ulica 1, Koper, Slovenia
| | | | - Peter KOKOL
- Community Healthcare Center Adolf Drolc, Ulica talcev 9, 2000Maribor, Slovenia
| | - Jernej ZAVRŠNIK
- Community Healthcare Center Adolf Drolc, Ulica talcev 9, 2000Maribor, Slovenia
| | - Boštjan ŠIMUNIČ
- Science and Research Centre Koper, Institute for Kinesiology Research, Garibaldijeva ulica 1, Koper, Slovenia
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9
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Gao Y, Huang Y, An R, Yang Y, Chen X, Wan Q. Risk factors for sarcopenia in community setting across the life course: A systematic review and a meta-analysis of longitudinal studies. Arch Gerontol Geriatr 2025; 133:105807. [PMID: 40049056 DOI: 10.1016/j.archger.2025.105807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2024] [Revised: 02/17/2025] [Accepted: 02/26/2025] [Indexed: 04/05/2025]
Abstract
BACKGROUND Sarcopenia is generally an age-related condition in older people that impacts adverse health consequences in terms of quality of life, morbidity and mortality. With the increasing interest of clinical and research interest in sarcopenia internationally, the epidemiological evidence reveals sarcopenia risk begins in early adulthood, influenced by gene, lifestyle and a range of chronic conditions across life course. OBJECTIVES The purpose of this study was to systematically summarize the risk factors for sarcopenia across the life course, and to identity the high-risk population. METHODS Searches were performed in PubMed, Web of Science, Scopus, Embase, MEDLINE, and SPORTDiscus databases from inception to July 2024. Longitudinal studies assessing the risk factors for sarcopenia in community setting were included in the analysis. Fixed- and random-effect models were used to pool effect size. Based on the results of meta-analysis, we developed a risk predictive model for sarcopenia. RESULTS Fifty-three studies were included in our systematic review. Risk factors associating with sarcopenia were grouped into eight domains: sociodemographic, anthropometric, health behaviors, health condition, biomarkers, early life factors, psychosocial and living environment factors. Fifteen risk factors derived from the twenty-three included studies were eligible for meta-analysis, and ten variables were identified as statistically significant. A risk predictive model was developed for secondary sarcopenia in community setting. CONCLUSIONS This study provides a fully understanding of sarcopenia across the life-course. Our risk predictive model could facilitate the early identification and prevention of secondary sarcopenia in community setting. REGISTRATION The systematic review and meta-analysis have been registered in PROSPERO(CRD42024536346).
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Affiliation(s)
- Yajing Gao
- School of Nursing, Peking University, Beijing, China
| | - Yuli Huang
- School of Nursing, Peking University, Beijing, China
| | - Ran An
- School of Nursing, Peking University, Beijing, China
| | - Yi Yang
- School of Nursing, Peking University, Beijing, China
| | - Xinyao Chen
- School of Nursing, Peking University, Beijing, China
| | - Qiaoqin Wan
- School of Nursing, Peking University, Beijing, China.
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10
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Zhang F, Chu A, Bai Y, Huang L, Zhong Y, Li Y. Association of sarcopenia index, a surrogate marker of muscle mass, and incident chronic kidney disease. Clin Nutr ESPEN 2025; 67:184-191. [PMID: 40112920 DOI: 10.1016/j.clnesp.2025.03.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2024] [Revised: 02/12/2025] [Accepted: 03/13/2025] [Indexed: 03/22/2025]
Abstract
BACKGROUND Sarcopenia, characterized by loss of muscle mass and strength, has been linked to various health outcomes, including chronic kidney disease (CKD). This study aims to investigate the association of sarcopenia index, based on serum creatinine and cystatin C levels, with incident CKD in middle-aged and older adults. METHODS This study extracted data from a nation cohort, including age ≥45 years adults without CKD at baseline. Sarcopenia index was calculated based on serum creatinine and cystatin C levels, and incident CKD was assessed through follow-up surveys. Cox proportional hazards regression models were used to analyze the association between sarcopenia index and incident CKD, adjusting for potential confounders, with hazard ratio (HR) with 95 % confidence interval (95 % CI) reported. RESULTS A total of 8618 participants were included in the analysis. The median age was 61.0 years, and 44.7 % were male. During a mean follow-up period of 5.0 years, 514 cases of incident CKD were identified. After adjusting for covariates, compared with participants in the lowest tertile, the corresponding CKD HRs (95 % CIs) for participants in the medium and highest tertile were 0.701 (95 % CI: 0.558-0.880, P = 0.002), 0.784 (95 % CI: 0.618-0.994; P = 0.045). Restricted cubic spline curves revealed that incident rate decreased with increase in sarcopenia index. CONCLUSION This study provides national longitudinal evidence on the association of higher sarcopenia index with lower incident CKD. Our findings suggest that sarcopenia index may be a useful biomarker for predicting the risk of CKD in this population.
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Affiliation(s)
- Fan Zhang
- Department of Nephrology, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Aojiao Chu
- Department of Nephrology, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yan Bai
- Department of Nephrology, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Liuyan Huang
- Department of Nephrology, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yifei Zhong
- Department of Nephrology, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China.
| | - Yi Li
- Department of Nephrology, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China.
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11
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Catapano A, Cimmino F, Petrella L, Pizzella A, D'Angelo M, Ambrosio K, Marino F, Sabbatini A, Petrelli M, Paolini B, Lucchin L, Cavaliere G, Cristino L, Crispino M, Trinchese G, Mollica MP. Iron metabolism and ferroptosis in health and diseases: The crucial role of mitochondria in metabolically active tissues. J Nutr Biochem 2025; 140:109888. [PMID: 40057002 DOI: 10.1016/j.jnutbio.2025.109888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Revised: 11/15/2024] [Accepted: 02/27/2025] [Indexed: 03/30/2025]
Abstract
Iron is essential in various physiological processes, but its accumulation leads to oxidative stress and cell damage, thus iron homeostasis has to be tightly regulated. Ferroptosis is an iron-dependent non-apoptotic regulated cell death characterized by iron overload and reactive oxygen species accumulation. Mitochondria are organelles playing a crucial role in iron metabolism and involved in ferroptosis. MitoNEET, a protein of mitochondrial outer membrane, is a key element in this process. Ferroptosis, altering iron levels in several metabolically active organs, is linked to several non-communicable diseases. For example, iron overload in the liver leads to hepatic fibrosis and cirrhosis, accelerating non-alcholic fatty liver diseases progression, in the muscle cells contributes to oxidative damage leading to sarcopenia, and in the brain is associated to neurodegeneration. The aim of this review is to investigate the intricate balance of iron regulation focusing on the role of mitochondria and oxidative stress, and analyzing the ferroptosis implications in health and disease.
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Affiliation(s)
- Angela Catapano
- Department of Biology, University of Naples Federico II, Naples, Italy
| | - Fabiano Cimmino
- Department of Biology, University of Naples Federico II, Naples, Italy; Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Lidia Petrella
- Department of Biology, University of Naples Federico II, Naples, Italy
| | - Amelia Pizzella
- Department of Biology, University of Naples Federico II, Naples, Italy
| | - Margherita D'Angelo
- Department of Experimental Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Katia Ambrosio
- Department of Biology, University of Naples Federico II, Naples, Italy
| | - Francesca Marino
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Annarita Sabbatini
- Dietetic and Clinical Nutrition Unit, IEO European Institute of Oncology IRCSS, Milan, Italy
| | - Massimiliano Petrelli
- Department of Clinical and Molecular Sciences, Clinic of Endocrinology and Metabolic Diseases, Università Politecnica delle Marche, Ancona, Italy
| | - Barbara Paolini
- Department of Innovation, experimentation and clinical research, Unit of dietetics and clinical nutrition, S. Maria Alle Scotte Hospital, University of Siena, Siena, Italy
| | - Lucio Lucchin
- Dietetics and Clinical Nutrition, Bolzano Health District, Bolzano, Italy
| | - Gina Cavaliere
- Department of Pharmaceutical Sciences, University of Perugia, Perugia, Italy
| | - Luigia Cristino
- Institute of Biomolecular Chemistry, National Research Council of Italy, Pozzuoli, Naples, Italy
| | - Marianna Crispino
- Department of Biology, University of Naples Federico II, Naples, Italy.
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Sun M, Chen WM, Wu SY, Zhang J. Sarcopenia and adverse surgical outcomes following cholecystectomy. J Anesth 2025:10.1007/s00540-025-03512-y. [PMID: 40377658 DOI: 10.1007/s00540-025-03512-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2025] [Accepted: 04/27/2025] [Indexed: 05/18/2025]
Abstract
PURPOSE Postoperative complications and mortality following cholecystectomy persist despite the procedural simplicity. We utilized a nationwide administrative database from Taiwan and conducted propensity score matching (PSM) to investigate the association between sarcopenia and major postoperative complications. PATIENTS AND METHODS This retrospective cohort study analyzed data from the Taiwan National Health Insurance Research Database from 2016 to 2020. Patients who underwent elective cholecystectomy under general anesthesia for gallstone disease were included. They were categorized into two groups: those with sarcopenia and those without. The cohorts were matched at a 1:4 ratio using PSM. RESULTS PSM yielded a final cohort of 13,330 surgical patients (10,664 without sarcopenia and 2666 with sarcopenia). Multivariate logistic regression demonstrated that sarcopenia was significantly associated with higher 30 day mortality (adjusted odds ratio [aOR] = 2.26, 95% confidence interval [CI] 1.61-3.18) and major complications, including acute renal failure (aOR = 1.71, 95% CI 1.02-2.84), pneumonia (aOR = 1.68, 95% CI 1.22-2.31), stroke (aOR = 1.13, 95% CI 1.06-1.57), and overall complications (aOR = 1.23, 95% CI 1.07-1.41). Sarcopenia also increased the risk of 90-day mortality (aOR = 2.09, 95% CI 1.58-2.76) and 90-day major complications, including acute renal failure (aOR = 1.61, 95% CI 1.01-2.56), pneumonia (aOR = 1.70, 95% CI 1.30-2.21), stroke (aOR = 1.28, 95% CI 1.04-1.58), and overall complications (aOR = 1.24, 95% CI 1.09-1.41). CONCLUSIONS We found that sarcopenia is an independent risk factor for increased postoperative complications and mortality following cholecystectomy. These findings highlight the importance of preoperative sarcopenia assessment to improve surgical outcomes.
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Affiliation(s)
- Mingyang Sun
- Department of Anesthesiology and Perioperative Medicine, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Wan-Ming Chen
- Graduate Institute of Business Administration, College of Management, Fu Jen Catholic University, Taipei, Taiwan
- Artificial Intelligence Development Center, Fu Jen Catholic University, Taipei, Taiwan
| | - Szu-Yuan Wu
- Graduate Institute of Business Administration, College of Management, Fu Jen Catholic University, Taipei, Taiwan.
- Artificial Intelligence Development Center, Fu Jen Catholic University, Taipei, Taiwan.
- Department of Food Nutrition and Health Biotechnology, College of Medical and Health Science, Asia University, Taichung, Taiwan.
- Big Data Center, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, No. 83, Nanchang St., Luodong Township, Yilan, 265, Taiwan.
- Division of Radiation Oncology, Department of Medicine, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan, 265, Taiwan.
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan.
- Cancer Center, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan, Taiwan.
- Centers for Regional Anesthesia and Pain Medicine, Taipei Municipal Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
- Department of Management, College of Management, Fo Guang University, Yilan, Taiwan.
| | - Jiaqiang Zhang
- Department of Anesthesiology and Perioperative Medicine, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China
- Institute of Electrophysiology, Henan Academy of Innovations in Medical Science, Zhenzhou, China
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13
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An HE, Park HS, Yin CS. Association of sarcopenia with generalized anxiety disorder in Korean middle-aged and older adults: Results from the Korea National Health and Nutrition Examination Survey in 2022. PLoS One 2025; 20:e0323772. [PMID: 40373026 PMCID: PMC12080804 DOI: 10.1371/journal.pone.0323772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2024] [Accepted: 04/15/2025] [Indexed: 05/17/2025] Open
Abstract
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.
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Affiliation(s)
- Hye-Eun An
- Department of East-West Medicine, Kyung Hee University, Yongin, Republic of Korea
| | - Hye-Su Park
- Department of East-West Medicine, Kyung Hee University, Yongin, Republic of Korea
| | - Chang Shik Yin
- Department of Medical Education, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
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14
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Zhao Q, Xu Y, Chen X. Association of the cardiometabolic index with sarcopenia among U.S. adults: NHANES 2011-2018 findings. PLoS One 2025; 20:e0323905. [PMID: 40373017 PMCID: PMC12080805 DOI: 10.1371/journal.pone.0323905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2024] [Accepted: 04/15/2025] [Indexed: 05/17/2025] Open
Abstract
BACKGROUND 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. METHODS AND RESULTS 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). CONCLUSIONS 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.
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Affiliation(s)
- Qing Zhao
- Department of Clinical Nutrition, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Yue Xu
- Department of Clinical Nutrition, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Xiaotian Chen
- Department of Clinical Nutrition, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China
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15
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Ortiz-Navarro B, Losa-Reyna J, Mihaiescu-Ion V, Garcia-Romero J, Carrillo de Albornoz-Gil M, Galán-Mercant A. Identification of Target Body Composition Parameters by Dual-Energy X-Ray Absorptiometry, Bioelectrical Impedance, and Ultrasonography to Detect Older Adults With Frailty and Prefrailty Status Using a Mobile App in Primary Care Services: Descriptive Cross-Sectional Study. JMIR Aging 2025; 8:e67982. [PMID: 40373218 DOI: 10.2196/67982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2024] [Revised: 01/08/2025] [Accepted: 02/10/2025] [Indexed: 05/17/2025] Open
Abstract
Background Frailty syndrome in older adults represents a significant public health concern, characterized by a reduction in physiological reserves and an increased susceptibility to stressors. This can result in adverse health outcomes, including falls, hospitalization, disability, and mortality. The early identification and management of frailty are essential for improving quality of life and reducing health care costs. Conventional assessment techniques, including dual-energy X-ray absorptiometry (DXA), bioelectrical impedance analysis (BIA), and muscle ultrasound (US), are efficacious but frequently constrained in primary care settings by financial and accessibility limitations. Objective The aim of this study is to analyze the differences in anthropometric characteristics, physical function, nutritional status, cognitive status, and body composition among older adults identified as frail, prefrail, or robust in primary care services using the PowerFrail mobile app. Furthermore, the study assesses the predictive capacity of body composition variables (whole-body phase angle [WBPhA] via BIA, US-measured rectus femoris muscle thickness, and DXA-derived lean mass) in identifying frailty and evaluates their feasibility for implementation in primary care. Methods A descriptive cross-sectional study was conducted with 94 older adult participants aged between 70 and 80 years, recruited through the Andalusian Health Service in Spain. Frailty status was classified using the PowerFrail App, which integrates muscle power assessment and provides personalized physical activity recommendations. Body composition was measured using WBPhA (BIA), muscle US, and DXA. Statistical analyses included 1-way ANOVA for group comparisons, logistic regression to investigate associations, and receiver operating characteristic curve analysis to evaluate the predictive accuracy of the body composition measures. Results Participants were categorized into frail (n=28), prefrail (n=33), and robust (n=33) groups. All body composition measures exhibited high specificity in detecting frailty, with varying sensitivity. Unadjusted US showed the highest specificity but low sensitivity (10.7%). WBPhA and right leg lean mass (LeanM RL) demonstrated significant predictive capabilities, especially when adjusted for age and sex, with area under the curve values ranging from 0.678 to 0.762. The adjusted LeanM RL model showed a good balance between sensitivity (35.7%) and specificity (93.9%; P=.045), indicating its potential as a reliable frailty predictor. These findings are consistent with previous research emphasizing the importance of muscle mass and cellular health in frailty assessment. Conclusions Body composition variables, particularly WBPhA, LeanM RL, and US, are effective predictors of frailty in older adults. The PowerFrail mobile app, combined with advanced body composition analysis, offers a practical and noninvasive method for early frailty detection in primary care settings. Integrating such technological tools can enhance the early identification and management of frailty, thereby improving health outcomes in the aging population.
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Affiliation(s)
| | - José Losa-Reyna
- CIBER of Frailty and Healthy Aging, Madrid, Spain
- Sports Science Research Centre, King Juan Carlos University, Madrid, Spain
| | - Veronica Mihaiescu-Ion
- Institute of Biomedicine of Cádiz, Cádiz, Spain
- MOVE-IT Research Group, Department of Nursing and Physiotherapy, Faculty of Health Sciences, University of Cádiz, Cádiz, Spain
| | - Jerónimo Garcia-Romero
- Área de Educación Física y Deportiva, Facultad de Medicina, Universidad de Málaga, Boulevard Louis Pasteur, Málaga, 29071, Spain, 34 952131574
| | - Margarita Carrillo de Albornoz-Gil
- Área de Educación Física y Deportiva, Facultad de Medicina, Universidad de Málaga, Boulevard Louis Pasteur, Málaga, 29071, Spain, 34 952131574
| | - Alejandro Galán-Mercant
- Institute of Biomedicine of Cádiz, Cádiz, Spain
- MOVE-IT Research Group, Department of Nursing and Physiotherapy, Faculty of Health Sciences, University of Cádiz, Cádiz, Spain
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16
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Kosuge Y, Fujita S, Kamiyama A, Saijo K, Matsumoto R, Ogawa T, Wakabayashi H, Watanabe H. Relationship between Tongue Pressure and Nutritional Status in Patients Undergoing Maintenance Hemodialysis: A Single-center Cross-sectional Study. Prog Rehabil Med 2025; 10:20250012. [PMID: 40370474 PMCID: PMC12068940 DOI: 10.2490/prm.20250012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2025] [Accepted: 04/28/2025] [Indexed: 05/16/2025] Open
Abstract
Objectives This study aimed to investigate tongue pressure in patients undergoing maintenance hemodialysis (MHD) and identify factors associated with tongue pressure, such as nutritional status and sarcopenia components. Methods This cross-sectional study included 80 outpatients undergoing MHD at our hospital between February and August 2024. Tongue pressure was measured using a tongue pressure measuring device. Patients were divided into groups of low tongue pressure (<30 kPa) and high tongue pressure (≥30 kPa). The geriatric nutritional risk index (GNRI) and the nutritional risk index for Japanese hemodialysis patients (NRI-JH) were used as nutritional indicators. To identify factors strongly associated with tongue pressure in MHD, a multiple regression analysis was performed, with tongue pressure as the dependent variable. Results The median age of the participants was 81.0 years. The mean tongue pressure was 29.0 kPa, and 58.8% of the patients had tongue pressure less than 30 kPa. Tongue pressure was significantly lower in the oldest age group (≥85 years) than in the younger groups (≤64 years and 65-74 years). Significant correlations were noted between tongue pressure and age, serum albumin, skeletal muscle mass index, phase angle, and handgrip strength. In the multivariate analysis, age, GNRI, and handgrip strength were independent predictors of tongue pressure. Conclusions This study revealed that age, handgrip strength, and GNRI were independently associated with tongue pressure in patients undergoing MHD. These factors may be used as indicators of tongue pressure in patients undergoing MHD.
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Kim HJ, Chan Shim J, Oh JH, Choi SB, Lee HP, Chang Y. A Novel Nutritional Assessment Tool Combining the mNUTRIC Score and the GLIM Criteria with Prognostic Value for In-Hospital Mortality in Critically Ill Patients : A Single-Center Retrospective Cohort Study. Am J Clin Nutr 2025:S0002-9165(25)00257-6. [PMID: 40354938 DOI: 10.1016/j.ajcnut.2025.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2024] [Revised: 05/01/2025] [Accepted: 05/06/2025] [Indexed: 05/14/2025] Open
Abstract
BACKGROUND There is no gold-standard tool for nutritional assessment in critically ill patients. The modified Nutrition Risk in Critically Ill (mNUTRIC) score assesses the risk of future malnutrition, whereas the Global Leadership Initiative on Malnutrition (GLIM) criteria diagnose only current malnutrition. OBJECTIVE We aimed to evaluate the prognostic performance of a novel nutritional assessment tool that combines the mNUTRIC score and the GLIM criteria for hospital outcomes among ICU patients. METHODS A single-center, retrospective observational cohort study was conducted on patients admitted to the ICU between August 1, 2018, and June 7, 2021. The novel tool was categorized into four groups: Group 1: low risk (0-4 points) by mNUTRIC plus no malnutrition from the GLIM; Group 2: low risk plus moderate malnutrition or high risk (5-9 points) plus no malnutrition; Group 3: high risk plus moderate malnutrition or low risk plus severe malnutrition; and Group 4: high risk plus severe malnutrition. RESULTS Total 724 patients were enrolled. The in-hospital mortality rates for Groups 1-4 were 3%, 16%, 32%, and 52%, respectively. A poor nutritional status by the novel nutritional assessment tool was an independent risk factor for in-hospital mortality when compared to Group 1, particularly as patients progressed to Group 4 (OR: 2.32, 95% CI: 1.84, 2.93). In the receiver operating characteristic (ROC) analysis, the novel tool demonstrated the strongest prognostic performance for in-hospital mortality (AUC = 0.759, 95% CI: 0.723, 0.795) compared with validated severity scoring systems and other significant risk factors such as use of mechanical ventilation. CONCLUSIONS This novel nutritional assessment tool had strong prognostic value in being associated with in-hospital mortality. Prospective validation with an external dataset is warranted. A comprehensive nutritional assessment of the current status and future risk at ICU admission could be the most critical factor in assessing the prognosis of critically ill patients.
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Affiliation(s)
- Hye Jin Kim
- Department of Clinical Nutrition, Inje University Sanggye Paik Hospital, Seoul, Republic of Korea
| | - Jae Chan Shim
- Department of Radiology, Inje University College of Medicine, Sanggye Paik Hospital, Seoul, Republic of Korea
| | - Ju Hyun Oh
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Inje University College of Medicine, Sanggye Paik Hospital, Seoul, Republic of Korea
| | - Sang Bong Choi
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Inje University College of Medicine, Sanggye Paik Hospital, Seoul, Republic of Korea
| | - Hyuk Pyo Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Inje University College of Medicine, Sanggye Paik Hospital, Seoul, Republic of Korea
| | - Youjin Chang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Inje University College of Medicine, Sanggye Paik Hospital, Seoul, Republic of Korea.
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Huang X, Kui X, Ma J, Chen J, Huang Y, He B. Cyr61 promotes D-gal-induced aging C2C12 cell fibrosis by modulating Wnt/β-catenin signaling pathways. Mech Ageing Dev 2025; 225:112067. [PMID: 40339921 DOI: 10.1016/j.mad.2025.112067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2025] [Revised: 04/20/2025] [Accepted: 04/29/2025] [Indexed: 05/10/2025]
Abstract
Sarcopenia is characterized by age-related muscle mass/function loss and fibrosis. Satellite cell (SC) dysfunction during aging promotes fibrotic transdifferentiation and extracellular matrix (ECM) deposition. Cyr61, a pro-fibrotic matricellular protein, and Wnt/β-catenin signaling pathway are implicated in muscle regeneration-fibrosis balance, but their interaction in sarcopenia remains unclear. This study first compared the expression of Cyr61 and fibrosis markers (TGF-β1, collagen type I and III) in skeletal muscle of young and old mice. In vitro, D-gal-induced C2C12 aging models were used to assess Cyr61 and Wnt signaling pathway by proliferation/apoptosis assays, ECM analysis, and detecting the changes of myogenic/fibrotic markers (MyoD, α-SMA). Pathway modulation (FH535 inhibitor/LiCl activator) and combined with Cyr61 overexpression and knockout experiments defined mechanistic roles. Cyr61 was upregulated in skeletal muscle of aged mice, which was positively correlated with increased TGF-β1 and collagen deposition. In D-gal-induced C2C12 cells showed suppressed cell proliferation, increased apoptosis and enhanced ECM deposition, accompanied by elevated Cyr61. Cyr61 knockdown or Wnt signaling pathway inhibition (FH535) reversed fibrosis (α-SMA, collagen) and restored myogenesis (MyoD).This study reveals for the first time that Cyr61 drives sarcopenic fibrosis via Wnt/β-catenin activation, promoting myocyte-to-fibrotic transition. Targeting the Cyr61-Wnt axis may ameliorate age-related muscle degeneration, warranting translational validation in preclinical models.
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Affiliation(s)
- Xinchen Huang
- Department of Medical Imaging, The First Affiliated Hospital of Kunming Medical University, Kunming, China; Department of Radiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaoling Kui
- Department of Medical Imaging, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Jiyao Ma
- Department of Medical Imaging, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Jiaxin Chen
- Department of Medical Imaging, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Yilong Huang
- Department of Medical Imaging, The First Affiliated Hospital of Kunming Medical University, Kunming, China.
| | - Bo He
- Department of Medical Imaging, The First Affiliated Hospital of Kunming Medical University, Kunming, China.
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Kim Y, Park KH, Noh HM. Effects of Integrating Wearable Activity Trackers With a Home-Based Multicomponent Exercise Intervention on Fall-Related Parameters and Physical Function in Older Adults: Randomized Controlled Trial. JMIR Mhealth Uhealth 2025; 13:e64458. [PMID: 40340847 PMCID: PMC12080971 DOI: 10.2196/64458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2024] [Revised: 02/18/2025] [Accepted: 04/01/2025] [Indexed: 05/10/2025] Open
Abstract
Background Older adults with a history of falling often encounter challenges in participating in group exercise programs. Recent technological advances, such as activity trackers, can potentially enhance home-based exercise programs by providing continuous physical activity monitoring and feedback. Objective The aim of the study is to explore whether integrating wearable activity trackers with a home-based exercise intervention is effective in reducing fear of falling and improving physical function in older adults. Methods This was a 12-week, parallel-group, randomized controlled trial involving 30 older adults (≥60 years) with a history of falling. Participants were randomly assigned in a 1:1 ratio to either a group combining an activity tracker with a home-based multicomponent exercise intervention, which included in-person exercise sessions, exercise videos, and objective feedback via phone calls (AT+EX group) or to a group using the activity tracker only for self-monitoring (AT-only group). The primary and secondary outcomes included fall-related parameters (fear of falling assessed by the Activities-Specific Balance Confidence [ABC] and the Falls Efficacy Scale-International [FES-I] scales), depression (Short Geriatric Depression Scale), cognition (Montreal Cognitive Assessment), physical function (grip strength, Short Physical Performance Battery, Timed Up and Go [TUG] test, and 2-Minute Step Test), and body composition. Changes in the average daily step count were monitored and analyzed. Results Overall, 28 (mean age 74.0, SD 6.4 years; n=23, 77% female) participants completed the 12-week follow-up period (28/30, 93%). In the activity tracker and exercise group (AT+EX group), significant improvements were observed in fear of falling (15.5 points of ABC: P=.002; -5.1 points of FES-I: P=.01). The activity tracker alone group (AT-only group) also showed a significant improvement in FES-I score (-5.5 points: P=.01). Physical function significantly improved in the AT+EX group (1.1 points of Short Physical Performance Battery: P=.004; -1.4 seconds of TUG; P=.008; and 26.7 steps of 2-Minute Step Test: P=.001), whereas the AT-only group showed significant improvement only in the TUG test (-1.3 seconds: P=.002). However, no significant between-group differences were observed in the ABC score, FES-I score, or physical function. Despite no significant increase in daily step counts, both groups maintained close to 10,000 steps per day throughout the 12 weeks. Conclusions Both groups showed improvements in the FES-I and TUG test scores without significant between-group differences. Wearable technology, with or without an exercise intervention, seems to be an effective tool in reducing the fear of falling and improving physical function in older adults susceptible to falls.
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Affiliation(s)
- Yejin Kim
- Department of Medical Sciences, College of Medicine, Hallym University, Chuncheon, Republic of Korea
| | - Kyung Hee Park
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Hallym University, 22, Gwanpyeong-ro 170beon-gil, Anyang, 14068, Republic of Korea, 82 313803805
| | - Hye-Mi Noh
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Hallym University, 22, Gwanpyeong-ro 170beon-gil, Anyang, 14068, Republic of Korea, 82 313803805
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20
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Wu J, Tang J, Huang D, Wang Y, Zhou E, Ru Q, Xu G, Chen L, Wu Y. Study on the comorbid mechanisms of sarcopenia and late-life depression. Behav Brain Res 2025; 485:115538. [PMID: 40122287 DOI: 10.1016/j.bbr.2025.115538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2024] [Revised: 03/06/2025] [Accepted: 03/09/2025] [Indexed: 03/25/2025]
Abstract
The increasing global aging population has brought greater focus to age-related diseases, particularly muscle-brain comorbidities such as sarcopenia and late-life depression. Sarcopenia, defined by the gradual loss of muscle mass and function, is notably prevalent among older individuals, while late-life depression profoundly affects their mental health and overall well-being. Epidemiological evidence suggests a high co-occurrence of these two conditions, although the precise biological mechanisms linking them remain inadequately understood. This review synthesizes the existing body of literature on sarcopenia and late-life depression, examining their definitions, prevalence, clinical presentations, and available treatments. The goal is to clarify the potential connections between these comorbidities and offer a theoretical framework for the development of future preventive and therapeutic strategies.
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Affiliation(s)
- Jiale Wu
- Institute of Intelligent Sport and Proactive Health, Department of Health and Physical Education, Jianghan University, Wuhan 430056, China
| | - Jun Tang
- Institute of Intelligent Sport and Proactive Health, Department of Health and Physical Education, Jianghan University, Wuhan 430056, China
| | - Di Huang
- Institute of Intelligent Sport and Proactive Health, Department of Health and Physical Education, Jianghan University, Wuhan 430056, China
| | - Yu Wang
- Institute of Intelligent Sport and Proactive Health, Department of Health and Physical Education, Jianghan University, Wuhan 430056, China
| | - Enyuan Zhou
- Institute of Intelligent Sport and Proactive Health, Department of Health and Physical Education, Jianghan University, Wuhan 430056, China
| | - Qin Ru
- Institute of Intelligent Sport and Proactive Health, Department of Health and Physical Education, Jianghan University, Wuhan 430056, China
| | - Guodong Xu
- Institute of Intelligent Sport and Proactive Health, Department of Health and Physical Education, Jianghan University, Wuhan 430056, China
| | - Lin Chen
- Institute of Intelligent Sport and Proactive Health, Department of Health and Physical Education, Jianghan University, Wuhan 430056, China.
| | - Yuxiang Wu
- Institute of Intelligent Sport and Proactive Health, Department of Health and Physical Education, Jianghan University, Wuhan 430056, China.
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21
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Herranen P, Waller K, Joensuu L, Palviainen T, Laakkonen EK, Kaprio J, Sillanpää E. Genetic Liability to Higher Muscle Strength Associates With a Lower Risk of Cardiovascular Disease Mortality in Men Irrespective of Leisure-Time Physical Activity in Adulthood: A Longitudinal Cohort Study. J Am Heart Assoc 2025; 14:e036941. [PMID: 40240949 DOI: 10.1161/jaha.124.036941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Accepted: 12/20/2024] [Indexed: 04/18/2025]
Abstract
BACKGROUND Low muscle strength predicts premature mortality. We determined whether genetic liability to muscle strength is associated with mortality and whether this association is influenced by long-term leisure-time physical activity (LTPA). METHODS AND RESULTS We estimated the effects of a polygenic score for handgrip strength (PGS HGS) on all-cause and cardiovascular disease (CVD) mortality risk in the older Finnish Twin Cohort (N=8815, 53% women). LTPA was assessed longitudinally using validated questionnaires. During the 16.9-year median follow-up (143 723 person-years), 2896 deaths occurred, of which 1089 were attributable to CVD. We found a significant interaction between sex and PGS HGS (P=0.016) in relation to all-cause mortality. In men, 1-SD increase in the PGS HGS was associated with a decreased risk of all-cause (hazard ratio [HR], 0.93 [95% CI, 0.89-0.98]) and CVD mortality (HR, 0.88 [95% CI, 0.81-0.96]), but was not statistically significantly associated with mortality in women (HR, 1.01 [95% CI, 0.96-1.07]; and HR, 0.96 [95% CI, 0.87-1.05], respectively). In men, associations remained after adjusting for LTPA and persisted for CVD mortality (HR, 0.85 [95% CI, 0.76-0.96]), even after accounting for other lifestyle covariates. This remained statistically significant even when non-CVD death was accounted for as a competing risk event. No PGS HGS×LTPA interactions were found. The predictive area under the curve estimates for PGS HGS alone were limited (0.53-0.64) but comparable to that of several lifestyle factors. CONCLUSIONS Higher PGS HGS was associated with a decreased risk of CVD mortality in men. Long-term LTPA in adulthood did not potentiate this association.
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Affiliation(s)
- Päivi Herranen
- Faculty of Sport and Health Sciences, Gerontology Research Center University of Jyväskylä Finland
| | - Katja Waller
- Faculty of Sport and Health Sciences, Gerontology Research Center University of Jyväskylä Finland
| | - Laura Joensuu
- Faculty of Sport and Health Sciences, Gerontology Research Center University of Jyväskylä Finland
| | - Teemu Palviainen
- Institute for Molecular Medicine Finland, HiLife Helsinki Finland
| | - Eija K Laakkonen
- Faculty of Sport and Health Sciences, Gerontology Research Center University of Jyväskylä Finland
| | - Jaakko Kaprio
- Institute for Molecular Medicine Finland, HiLife Helsinki Finland
| | - Elina Sillanpää
- Faculty of Sport and Health Sciences, Gerontology Research Center University of Jyväskylä Finland
- Wellbeing Services County of Central Finland Hankasalmi Finland
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22
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Yuzefpolskaya M, Colombo PC. Facts and Fallacies of Body Composition Analysis in Heart Failure: Is BMI Ready for Replacement? JACC. HEART FAILURE 2025:S2213-1779(25)00333-6. [PMID: 40372297 DOI: 10.1016/j.jchf.2025.03.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2025] [Accepted: 03/10/2025] [Indexed: 05/16/2025]
Affiliation(s)
- Melana Yuzefpolskaya
- Division of Cardiovascular Medicine, Department of Cardiology, New York Presbyterian Hospital, Columbia University, New York, New York, USA.
| | - Paolo C Colombo
- Division of Cardiovascular Medicine, Department of Cardiology, New York Presbyterian Hospital, Columbia University, New York, New York, USA
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23
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Brunetto B, Saraiva L, Callegari-Jacques SM, Ferri H, Lizott HB, Valões R, Fernandes SA, Hoppe L, Fornari F. Reduced Mastication Is Associated With Dynapenia Markers in Patients With Cirrhosis: A Cross-Sectional Study. Int J Hepatol 2025; 2025:5842659. [PMID: 40365525 PMCID: PMC12069846 DOI: 10.1155/ijh/5842659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2024] [Accepted: 04/09/2025] [Indexed: 05/15/2025] Open
Abstract
Background and Aim: Dental diseases are common in patients with cirrhosis. In these patients, reduced mastication might interfere with protein intake and contribute to malnutrition. We addressed the relationship between reduced mastication and dynapenia in patients with cirrhosis. Methods: This cross-sectional study involved patients with cirrhosis treated in a Brazilian center. Trained dentists performed oral examinations and tested the patients for nutritional parameters such as handgrip strength (HGS) and gait speed test (GST). Reduced mastication was presumed when a patient had molar edentulism (≥ 3 teeth), bad dental occlusion, or ill-fitting denture. Associations between mastication status and malnutrition were evaluated using multivariate linear regression analysis for continuous measures and adjusted prevalence ratio (PR (95% confidence interval)) for binary measures. Results: We included 149 patients with cirrhosis (60 ± 13 years old, 76% men, 64% Child A, 60% due to alcoholism only). Reduced mastication affected 107 patients (72%), low muscle strength (decreased HGS) occurred in 45 (30%), and decreased GST was observed in 58 (41%, among 143 patients able to walk). Thirty-one out of 143 (22%) presented decreased HGS and GST, characterizing dynapenia. Reduced mastication was associated either with decreased HGS [PR = 2.28 (1.08-4.81), p = 0.030; reduced mastication decreases the HGS mean by 12.5 kg for men (p < 0.001) and 8.1 kg for women (p = 0.065)] or with decreased GST [PR 1.97 (1.09-3.55), p = 0.024; reduced mastication increased the time of GST by 1.1 s on average (p = 0.005)], adjusting for age, alcoholic etiology, and Child-Pugh classification. Conclusions: Reduced mastication is associated with dynapenia markers in patients with cirrhosis. Further studies are needed to assess whether oral rehabilitation can change the curse of malnutrition in this population.
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Affiliation(s)
- Bruna Brunetto
- Post Graduate Program in Dentistry, University of Passo Fundo, Passo Fundo, Rio Grande do Sul, Brazil
| | - Leonardo Saraiva
- Post Graduate Program in Dentistry, University of Passo Fundo, Passo Fundo, Rio Grande do Sul, Brazil
| | | | - Hérica Ferri
- Post Graduate Program in Dentistry, University of Passo Fundo, Passo Fundo, Rio Grande do Sul, Brazil
| | | | - Ricardo Valões
- School of Medicine, University of Passo Fundo, Passo Fundo, Rio Grande do Sul, Brazil
- Hepatology Department, São Vicente de Paulo Hospital, Passo Fundo, Rio Grande do Sul, Brazil
| | - Sabrina Alves Fernandes
- Post Graduate Program in Hepatology, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Lisia Hoppe
- School of Medicine, University of Passo Fundo, Passo Fundo, Rio Grande do Sul, Brazil
- Hepatology Department, São Vicente de Paulo Hospital, Passo Fundo, Rio Grande do Sul, Brazil
| | - Fernando Fornari
- Post Graduate Program in Dentistry, University of Passo Fundo, Passo Fundo, Rio Grande do Sul, Brazil
- School of Medicine, University of Passo Fundo, Passo Fundo, Rio Grande do Sul, Brazil
- Hepatology Department, São Vicente de Paulo Hospital, Passo Fundo, Rio Grande do Sul, Brazil
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24
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Kuboi R, Tsubokawa N, Kamigaichi A, Kawamoto N, Mimae T, Miyata Y, Okada M. Impact of pectoralis major muscle mass decrease after lobectomy on the prognosis of lung cancer. Jpn J Clin Oncol 2025:hyaf072. [PMID: 40319477 DOI: 10.1093/jjco/hyaf072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2024] [Accepted: 04/18/2025] [Indexed: 05/07/2025] Open
Abstract
BACKGROUND Low preoperative skeletal muscle mass is a negative prognostic factor for non-small cell lung cancer. However, the clinical significance of postsurgical skeletal muscle loss remains unclear. We investigated the impact of a postoperative decrease in pectoralis major muscle mass on long-term outcomes. METHODS A retrospective evaluation was conducted on 460 patients with pathological stage I-II non-small cell lung cancer who underwent lobectomy. Patients were categorized into two groups based on whether they did or did not show a decrease in pectoralis major muscle mass 12 months postoperatively, using a muscle mass change rate of 0.94 as the cutoff. RESULTS The group showing a decrease in muscle mass (n = 126) exhibited a higher incidence of chronic obstructive pulmonary disease than the group showing no decrease in muscle mass (n = 334). The median rate of change in the muscle mass of the pectoralis major was 1.00. The median follow-up period was 42.8 months. Overall survival was significantly lower in the group showing a decrease in muscle mass than in the group showing no decrease in muscle mass (P < .001). Multivariable Cox regression analysis revealed that a decrease in pectoralis major muscle mass after surgery was an independent prognostic factor for overall survival (hazard ratio, 1.05; 95% confidence interval, 1.03-1.06; P < .001). CONCLUSIONS A decrease in pectoralis major muscle mass following lobectomy is associated with poor prognosis in patients with non-small cell lung cancer.
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Affiliation(s)
- Risa Kuboi
- Department of Surgical Oncology, Hiroshima University, 1-2-3 Kasumi, Minami Ward, Hiroshima City, Hiroshima 734-8551, Japan
| | - Norifumi Tsubokawa
- Department of Surgical Oncology, Hiroshima University, 1-2-3 Kasumi, Minami Ward, Hiroshima City, Hiroshima 734-8551, Japan
| | - Atsushi Kamigaichi
- Department of Surgical Oncology, Hiroshima University, 1-2-3 Kasumi, Minami Ward, Hiroshima City, Hiroshima 734-8551, Japan
| | - Nobutaka Kawamoto
- Department of Surgical Oncology, Hiroshima University, 1-2-3 Kasumi, Minami Ward, Hiroshima City, Hiroshima 734-8551, Japan
| | - Takahiro Mimae
- Department of Surgical Oncology, Hiroshima University, 1-2-3 Kasumi, Minami Ward, Hiroshima City, Hiroshima 734-8551, Japan
| | - Yoshihiro Miyata
- Department of Surgical Oncology, Hiroshima University, 1-2-3 Kasumi, Minami Ward, Hiroshima City, Hiroshima 734-8551, Japan
| | - Morihito Okada
- Department of Surgical Oncology, Hiroshima University, 1-2-3 Kasumi, Minami Ward, Hiroshima City, Hiroshima 734-8551, Japan
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25
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Ye JY, Chang LF, Chen R, Arifin H, Wang CH, Chiang KJ, Banda KJ, Chou KR. Prevalence of sarcopenia in middle-aged and older adults with cognitive impairment: a meta-analysis. Age Ageing 2025; 54:afaf114. [PMID: 40336206 DOI: 10.1093/ageing/afaf114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2024] [Revised: 02/28/2025] [Indexed: 05/09/2025] Open
Abstract
BACKGROUND Cognitive impairment, dementia and sarcopenia significantly reduce the quality of life in middle-aged and older adults by impairing daily functioning, making cognitive decline a major concern for healthcare professionals. OBJECTIVE To estimate the prevalence of sarcopenia and probable sarcopenia in middle-aged and older adults with cognitive impairment. METHODS Six databases-Embase, Ovid MEDLINE, PubMed, CINAHL, Scopus and Web of Science was conducted through February 2025. Cohort and cross-sectional studies included, and a random-effects model was used for pooled prevalence analysis. Cognitive impairment is a decline in cognitive functions, including memory, attention and executive function, covering mild cognitive impairment and dementia. Sarcopenia is decreased skeletal muscle mass and function, assessed by muscle strength or physical performance. RESULTS A total of 67 studies involving 23 532 participants revealed a pooled sarcopenia prevalence of 30.1% and a probable sarcopenia prevalence of 40.5%. Additionally, amongst adults aged 65 and older, the prevalence of sarcopenia was 32.7%. The prevalence of sarcopenia varied by setting: 25.3% in community-dwelling populations, 35.5% in hospitals and 41.5% in institutional settings. Moderating factors included age, female, body mass index, comorbidities and risk factors such as depression, diabetes, hypertension, malnutrition, osteoarthritis, alcohol consumption and smoking. CONCLUSIONS Approximately one-third of middle-aged and older adults with cognitive impairment demonstrate to have sarcopenia. Early detection and tailored interventions by public health professionals are crucial, particularly for individuals with mild cognitive impairment and dementia. Enhanced preventive strategies are essential to improving outcomes and reducing healthcare costs.
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Affiliation(s)
- Jia-You Ye
- School of Nursing, College of Nursing, Taipei Medical University, Taipei City, Taiwan
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Li-Fang Chang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei City, Taiwan
- Department of Medical Education, Taipei Medical University Hospital, Taipei City, Taiwan
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei City, Taiwan
| | - Ruey Chen
- School of Nursing, College of Nursing, Taipei Medical University, Taipei City, Taiwan
- Department of Nursing, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan
- Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei City, Taiwan
| | - Hidayat Arifin
- School of Nursing, College of Nursing, Taipei Medical University, Taipei City, Taiwan
- Department of Basic Nursing, Faculty of Nursing, Universitas Airlangga, Surabaya, East Java, Indonesia
- Research Group in Medical-Surgical Nursing, Faculty of Nursing, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Chia-Hui Wang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei City, Taiwan
| | - Kai-Jo Chiang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei City, Taiwan
- School of Nursing, National Defense Medical Center, Taipei City, Taiwan
- Department of Nursing, Tri-Service General Hospital, Taipei City, Taiwan
| | - Kondwani J Banda
- School of Nursing, College of Nursing, Taipei Medical University, Taipei City, Taiwan
- Endoscopy Unit, Surgery Department, Kamuzu Central Hospital, Lilongwe, Malawi
| | - Kuei-Ru Chou
- School of Nursing, College of Nursing, Taipei Medical University, Taipei City, Taiwan
- Department of Nursing, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan
- Research Center in Nursing Clinical Practice, Wan Fang Hospital Taipei Medical University, Taipei City, Taiwan
- Psychiatric Research Center, Taipei Medical University Hospital, Taipei City, Taiwan
- Research Center for Neuroscience, Taipei Medical University, Taipei City, Taiwan
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26
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Shi R, Chen G, Zhang Y, Zhang J, Yan L, Duan Y. RNA-seq and ChIP-seq unveils thyroid hormone receptor α deficiency affects skeletal muscle myoblast proliferation and differentiation via Col6a1 during aging. J Muscle Res Cell Motil 2025:10.1007/s10974-025-09694-y. [PMID: 40317420 DOI: 10.1007/s10974-025-09694-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2025] [Accepted: 04/22/2025] [Indexed: 05/07/2025]
Abstract
Primary sarcopenia, an age-related syndrome, is a serious threat to the health and longevity of the elderly. Our prior studies indicated that thyroid hormone (TH) activity within muscle tissue undergoes significant age-associated alterations, mainly evidenced by a reduction in thyroid hormone receptor α (TRα) expression over time. TRα regulates the transcription of downstream target genes to exert its biological effects. Although TH is essential for skeletal muscle growth and development, the specific regulatory mechanism and broader role of TH binding its receptors in skeletal muscle aging remain unclear. We used ChIP-seq and RNA-seq to explore the aging changes of TRα target genes in gastrocnemius muscle of natural aging mouse model. ChIP-seq analysis revealed that TRα target genes are involved in nutrient synthesis, energy production, hormone secretion, and ECM-related pathways, suggesting a potential role of TRα in muscle growth, metabolism and component regulation. Further integration of RNA-seq showed that a greater number of down-regulated TRα target genes are associated with skeletal muscle aging. Through GSEA analysis and RT-qPCR screening, Col6a1 was identified as a key target gene. Col6a1 encodes collagen VI which is an important component of the ECM, ECM disorders and abnormal expression of Col6a1 can affect cell proliferation and differentiation. We confirmed that knockdown of Col6a1 inhibited the proliferation and differentiation of C2C12 cells. ChIP-qPCR and TRα silencing in C2C12 cells showed that TRα positively regulates Col6a1 transcription, and TRα deficiency inhibits the proliferation and differentiation of myoblasts, which is probably associated with Col6a1. These findings provide new insights into the molecular mechanisms underlying skeletal muscle aging and the regulatory roles of TH-TRα interactions.
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Affiliation(s)
- Runqing Shi
- Department of Gerontology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Gong Chen
- Department of Gerontology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Yusheng Zhang
- Department of Gerontology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Jiru Zhang
- Department of Gerontology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Lu Yan
- Department of Gerontology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Yu Duan
- Department of Gerontology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China.
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27
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Santos BC, Alves BC, Fonseca ALF, Ferreira SC, Mizubuti YGG, Saueressig C, Boulhosa RSDSB, Santos LAA, Cunha CDM, Lyra AC, Oliveira LPM, de Jesus RP, Romeiro FG, Dall'Alba V, Luft VC, Correia MITD, Ferreira LG, Anastácio LR. Cutoff points for handgrip strength in patients with liver cirrhosis: a multicenter study. Eur J Clin Nutr 2025; 79:484-489. [PMID: 39810007 DOI: 10.1038/s41430-024-01563-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 12/10/2024] [Accepted: 12/27/2024] [Indexed: 01/16/2025]
Abstract
OBJECTIVES This study aimed to define handgrip strength (HGS) cutoff points to predict 1-year mortality in adult patients with liver cirrhosis. METHODS This is an analysis of cohort databases from four reference centers in Brazil. Inpatients or outpatients with cirrhosis and aged ≥18 years were included. The best cutoff values of HGS (highest value from three attempts with the non-dominant hand) for predicting 1-year mortality, stratified by sex and age, were established based on the sensitivity and specificity analyses. Adjusted Cox regression models were used to test the predictive value of low HGS. RESULTS The study included 724 patients with cirrhosis, with a median age of 57.0 years (IQR: 50.0-63.0), 66.4% (n = 481) male. Most patients had alcoholic cirrhosis (n = 281; 38.8%), 400 (55.3%) were classified as Child-Pugh B or C, and 134 (18.5%) patients died after 1-year. The HGS cutoffs were ≤33 kgf and ≤12 kgf for men and women aged <60 years, respectively, and ≤22 kgf and ≤10 kgf for older men and women, respectively (sensitivity: 70.9%; specificity: 61.2%). Low HGS was associated with a 2.5-fold increase in the risk of 1-year mortality. CONCLUSION These cutoff points could be used to identify patients with a higher mortality risk.
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Affiliation(s)
- Bárbara Chaves Santos
- Food Science Graduate Program, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Bruna Cherubini Alves
- Gastroenterology and Hepatology Graduate Program, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | | | | | - Camila Saueressig
- Gastroenterology and Hepatology Graduate Program, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Lívia Alves Amaral Santos
- Gastroenterology Division, Department of Internal Medicine, Universidade Estadual Paulista, Botucatu, Brazil
| | | | - Andre Castro Lyra
- Gastro-Hepatology Service, Hospital Universitario Prof. Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil
| | | | | | - Fernando Gomes Romeiro
- Gastroenterology Division, Department of Internal Medicine, Universidade Estadual Paulista, Botucatu, Brazil
| | - Valesca Dall'Alba
- Gastroenterology and Hepatology Graduate Program, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Food, Nutrition, and Health Graduate Program, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Vivian Cristine Luft
- Food, Nutrition, and Health Graduate Program, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Epidemiology Graduate Program, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Lívia Garcia Ferreira
- Nutrition and Health Graduate Program, Universidade Federal de Lavras, Lavras, Brazil
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Polo-López A, López-Bueno R, Calatayud J, Núñez-Cortés R, Suso-Martí L, Andersen LL. Association of chair stand performance with all-cause and cardiovascular mortality in older adults with hypertension: A 28-country study. Maturitas 2025; 196:108248. [PMID: 40147230 DOI: 10.1016/j.maturitas.2025.108248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2025] [Revised: 02/26/2025] [Accepted: 03/17/2025] [Indexed: 03/29/2025]
Abstract
OBJECTIVE To assess the prospective association of chair stand performance with all-cause and cardiovascular mortality in older adults with hypertension. METHODS From the Survey of Health, Ageing and Retirement in Europe (SHARE) study, we included 18,252 adults aged 50 years or more with hypertension from 28 countries (27 European countries and Israel). Chair stand performance was assessed by the time taken to complete five chair stands. We used time-varying Cox regression with restricted cubic splines to determine the prospective association of chair stand time with all-cause and cardiovascular mortality, controlling for various confounders. KEY RESULTS Over a mean follow-up of 3.5 years, 648 participants died, with 243 deaths attributed to cardiovascular disease. Using the median chair stand time (11 s) as a reference, both faster and slower times were associated with altered mortality risk in a curvilinear fashion. For all-cause mortality, the 10th percentile of chair stand time (7 s) showed a hazard ratio (HR) of 0.71 (95 % CI 0.60-0.85), while the 90th percentile (19 s) showed a HR of 1.20 (95 % CI 1.10-1.32). For cardiovascular mortality, the 10th percentile showed a subdistribution hazard ratio (SHR) of 0.72 (95 % CI 0.53-0.97), while the 90th percentile showed a SHR of 1.28 (95 % CI 1.10-1.48). CONCLUSION Chair stand performance is gradually and inversely associated with risk of all-cause and cardiovascular mortality in older adults with hypertension. These findings highlight the potential of the chair stand test as a prognostic measure.
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Affiliation(s)
- Ana Polo-López
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Spain
| | - Rubén López-Bueno
- National Research Centre for the Working Environment, Copenhagen, Denmark; Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Spain; Department of Physical Medicine and Nursing, University of Zaragoza, Zaragoza, Spain
| | - Joaquín Calatayud
- National Research Centre for the Working Environment, Copenhagen, Denmark; Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Spain.
| | - Rodrigo Núñez-Cortés
- Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Luis Suso-Martí
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Spain
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Cardoso P, Santos TV, Ramon-Krauel M, Pais S, De Sousa-Coelho AL. Impact of Bariatric and Metabolic Surgery on Sarcopenia-Related Parameters According to the EWGSOP2 Consensus Criteria in Persons Living with Obesity. Obes Surg 2025; 35:1900-1910. [PMID: 40164918 PMCID: PMC12065728 DOI: 10.1007/s11695-025-07816-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2024] [Revised: 03/06/2025] [Accepted: 03/17/2025] [Indexed: 04/02/2025]
Abstract
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.
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Affiliation(s)
- Paulo Cardoso
- Unidade Local de Saúde do Algarve (ULSALG), Unidade de Faro, Rua Leão Penedo, Serviço de Cirurgia 1, 8000-286, Faro, Portugal
- Faculdade de Medicina e Ciências Biomédicas (FMCB), Universidade do Algarve (UAlg), Campus de Gambelas, 8005-139, Faro, Portugal
| | - Tânia V Santos
- Faculdade de Ciências e Tecnologia (FCT), Universidade do Algarve (UAlg), Campus de Gambelas, 8005-139, Faro, Portugal
| | - Marta Ramon-Krauel
- Department of Endocrinology, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Sandra Pais
- Universidade de Évora (UE), Comprehensive Health Research Centre (CHRC), Rua Romão Ramalho 59, 7002-554, Évora, Portugal
| | - Ana Luísa De Sousa-Coelho
- Escola Superior de Saúde (ESS), Universidade do Algarve (UAlg), Campus de Gambelas, 8005-139, Faro, Portugal.
- Algarve Biomedical Center Research Institute (ABC-Ri), Universidade do Algarve (UAlg), Campus de Gambelas, 8005-139, Faro, Portugal.
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Prokopidis K, Triantafyllidis KK, Kechagias KS, Mitropoulos A, Sankaranarayanan R, Isanejad M. Are sarcopenia and its individual components linked to all-cause mortality in heart failure? A systematic review and meta-analysis. Clin Res Cardiol 2025; 114:532-540. [PMID: 38085294 PMCID: PMC12058882 DOI: 10.1007/s00392-023-02360-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 12/05/2023] [Indexed: 05/09/2025]
Abstract
OBJECTIVE The objective of this systematic review and meta-analysis was to assess sarcopenia and its components as prognostic factors in patients with heart failure (HF). METHODS From inception to December 2022, a systematic literature search was carried out utilizing PubMed, Web of Science, Scopus, and Cochrane Library databases. A meta-analysis employing a random-effects model was performed to assess the pooled effects. RESULTS The systematic review and meta-analysis included 32 and 18 longitudinal studies, respectively. The prediction of 1- to 2-year all-cause mortality in sarcopenia was not statistically significant (hazard ratio (HR): 1.35, 95% CI 0.76-2.38, I2 = 54%, P = 0.31). The lowest combined quartile and quantile of the population were used to define low handgrip strength that showed identical results (HR: 1.24, 95% CI 0.94-1.62, I2 = 0%, P = 0.13). Low L3-L4 psoas muscle mass (HR: 2.20, 95% CI 1.26-3.83, I2 = 87%, P < 0.01) and slow gait speed (HR: 1.45, 95% CI 1.20-1.74, I2 = 0%, P < 0.01) were significant contributors to all-cause mortality risk. Additionally, a 0.1 m/s increase in gait speed demonstrated a significant reduction of all-cause mortality (HR: 0.77, 95% CI 0.66-0.90, I2 = 60%, P < 0.01). Our narrative synthesis also described appendicular lean mass (ALM) and short physical performance battery (SPPB) scores as significant prognostic factors. CONCLUSIONS Compared to patients with higher overall functional performance, those with HF and low ALM, low psoas muscle mass, low SPPB, and slow gait speed are at an increased risk of all-cause mortality. Early prevention and/or treatment of lower limb physical function deterioration may be an essential strategy to reduce the risk of premature death in HF.
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Affiliation(s)
- Konstantinos Prokopidis
- Department of Musculoskeletal Ageing and Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK.
| | | | | | - Alexandros Mitropoulos
- Lifestyle, Exercise and Nutrition Improvement (LENI) Research Group, Department of Nursing and Midwifery, Sheffield Hallam University, Sheffield, UK
| | - Rajiv Sankaranarayanan
- Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool, UK
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
- National Institute for Health and Care Research, Liverpool, UK
| | - Masoud Isanejad
- Department of Musculoskeletal Ageing and Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
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Kang M, Rho H, Kim M, Lee M, Lim Y, Chon J, Lim H. Effectiveness of Protein-enriched oral nutritional supplements on muscle function in middle-aged and elderly women: A randomized controlled trial. J Nutr Health Aging 2025; 29:100508. [PMID: 39951930 DOI: 10.1016/j.jnha.2025.100508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2024] [Revised: 01/31/2025] [Accepted: 02/06/2025] [Indexed: 02/17/2025]
Abstract
OBJECTIVES This study evaluated the effects of protein-enriched oral nutritional supplementation (ONS) consumption for 12 weeks on muscle mass, muscular strength, and function in middle-aged and elderly women. DESIGN A single-center, double-blind, randomized controlled trial PARTICIPANTS: This study was conducted with 70 healthy female participants aged 50-80. INTERVENTION AND MEASUREMENTS Participants were instructed to incorporate two daily packs of either the test ONS (Nucare Active, Daesang Wellife Corp., Seoul, Republic of Korea; 200 kcal/pack, 23 g carbohydrate, 6 g fat, and 15 g protein including branched chain amino acids or placebo ONS (200 kcal/pack, 33 g carbohydrate, 8 g fat, and 1 g protein) into their routine for 12 weeks while maintaining their regular lifestyle. The primary outcome was lean body mass (LBM), while secondary outcomes included muscular strength, physical performance ability, inflammatory markers, and body fat mass (FM). RESULTS Sixty-four participants (33 in the test group, 31 in the placebo group; mean ± SD age, [test] 63.06 ± 5.51 years, [placebo] 63.29 ± 3.28 years, p = 0.839) completed the 12-week protocol. The test group exhibited a higher percentage change in LBM than the placebo group (0.26 % [95%CI: -0.27, 0.78] vs. -0.47 % [95%CI: -0.81, -0.13]; p = 0.020). The placebo group experienced a significant increase in FM (38.15 % [95%CI: 36.62, 39.69] to 38.67 % [95%CI: 37.14, 40.21]; p < 0.01). The difference in the changes in LBM/BMI and FM/BMI between the two groups was also visually distinct. There were no significant differences between the two groups in terms of muscular strength, physical performance ability, or inflammatory markers. CONCLUSIONS Protein-enriched ONS helped maintain LBM and prevent FM gain in middle-aged and elderly females. This suggests its potential role in preventing frailty and musculoskeletal disorders associated with female aging.
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Affiliation(s)
- Minji Kang
- Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University, Giheong-gu, Yongin 17104, Republic of Korea; Research Institute of Medical Nutrition, Kyung Hee University, Dongdaemoon-gu, Seoul 02447, Republic of Korea
| | - Hyunkyung Rho
- Department of Food and Nutrition, Kyung Hee University, Dongdaemoon-gu, Seoul 02447, Republic of Korea
| | - Minhui Kim
- Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University, Giheong-gu, Yongin 17104, Republic of Korea; Research Institute of Medical Nutrition, Kyung Hee University, Dongdaemoon-gu, Seoul 02447, Republic of Korea
| | - Miji Lee
- Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University, Giheong-gu, Yongin 17104, Republic of Korea; Research Institute of Medical Nutrition, Kyung Hee University, Dongdaemoon-gu, Seoul 02447, Republic of Korea
| | - Yunsook Lim
- Department of Food and Nutrition, Kyung Hee University, Dongdaemoon-gu, Seoul 02447, Republic of Korea
| | - Jinmann Chon
- Department of Rehabilitation Medicine, Kyung Hee University Medical Center, Dongdaemun-gu, Seoul 02447, Republic of Korea.
| | - Hyunjung Lim
- Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University, Giheong-gu, Yongin 17104, Republic of Korea; Research Institute of Medical Nutrition, Kyung Hee University, Dongdaemoon-gu, Seoul 02447, Republic of Korea.
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Fuchs CJ, Hermans WJH, van den Hurk J, Wiggins CJ, Widholm P, Dahlqvist Leinhard O, Veeraiah P, Wildberger JE, Prompers JJ, van Loon LJC. Quantifying Leg Muscle Disuse Atrophy During Bed Rest Using DXA, CT, and MRI. Eur J Sport Sci 2025; 25:e12299. [PMID: 40211056 PMCID: PMC11985322 DOI: 10.1002/ejsc.12299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2024] [Revised: 03/28/2025] [Accepted: 04/01/2025] [Indexed: 04/12/2025]
Abstract
This study evaluated whether dual-energy X-ray absorptiometry (DXA), computed tomography (CT), and magnetic resonance imaging (MRI) provide comparable outcomes in quantifying disuse-induced skeletal muscle atrophy. Although the calculation of muscle volume using MRI analysis may be considered the gold standard, the method remains labor intense and, as such, less practical and more costly. In this context, we also evaluated the efficacy of a commercially available automated MRI analysis method to measure changes in leg muscle volume after two weeks of bed rest. Twelve healthy, male adults (age: 24 ± 3 years, BMI: 23.7 ± 3.1 kg/m2) were subjected to 2 weeks of strict bed rest. Leg muscle assessments were performed before and after bed rest using DXA, single slice (thigh) CT, and MRI. MRI data analyses were performed using both a manual and automated (AMRA) method. Leg lean mass, as assessed with DXA, declined by 5% following bed rest (from 10.2 ± 1.6 to 9.7 ± 1.6 kg; p < 0.001). The thigh muscle cross-sectional area, as assessed with CT, declined by 6% following bed rest (from 155 ± 26 to 146 ± 24 cm2; p < 0.001). Muscle volume, as assessed using MRI, declined by 5% following bed rest, both when assessed manually (from 7.1 ± 1.1 to 6.7 ± 1.0 L; p < 0.001) and automatically (from 7.2 ± 1.1 to 6.8 ± 1.0 L; p < 0.001). A very strong correlation (r = 0.96; p < 0.001) with a low bias (-0.11 ± 0.29 L) was observed between manual and automated muscle volume analysis. DXA, CT, and MRI all show a ∼5% decline in leg muscle quantity following two weeks of bed rest in healthy adults. When using MRI, disuse muscle atrophy can be accurately quantified using an automated approach, rendering time-consuming manual analysis obsolete.
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Affiliation(s)
- Cas J. Fuchs
- Department of Human BiologyNUTRIM Institute of Nutrition and Translational Research in MetabolismMaastricht University Medical CentreMaastrichtthe Netherlands
| | - Wesley J. H. Hermans
- Department of Human BiologyNUTRIM Institute of Nutrition and Translational Research in MetabolismMaastricht University Medical CentreMaastrichtthe Netherlands
| | | | | | | | | | | | - Joachim E. Wildberger
- Department of Radiology and Nuclear MedicineSchool for Cardiovascular Diseases (CARIM)Maastricht University Medical CentreMaastrichtthe Netherlands
| | - Jeanine J. Prompers
- Department of Human BiologyNUTRIM Institute of Nutrition and Translational Research in MetabolismMaastricht University Medical CentreMaastrichtthe Netherlands
- Scannexus Ultra High‐Field MRI CenterMaastrichtthe Netherlands
- Department of Radiology and Nuclear MedicineSchool for Cardiovascular Diseases (CARIM)Maastricht University Medical CentreMaastrichtthe Netherlands
| | - Luc J. C. van Loon
- Department of Human BiologyNUTRIM Institute of Nutrition and Translational Research in MetabolismMaastricht University Medical CentreMaastrichtthe Netherlands
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Alcalde-Estévez E, Moreno-Piedra A, Asenjo-Bueno A, Martos-Elvira M, de la Serna-Soto M, Ruiz-Ortega M, Olmos G, López-Ongil S, Ruiz-Torres MP. Aging-related hyperphosphatemia triggers the release of TNF-α from macrophages, promoting indicators of sarcopenia through the reduction of IL-15 expression in skeletal muscle. Life Sci 2025; 368:123507. [PMID: 40010633 DOI: 10.1016/j.lfs.2025.123507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2024] [Revised: 02/11/2025] [Accepted: 02/21/2025] [Indexed: 02/28/2025]
Abstract
AIMS The association between aging-related hyperphosphatemia and sarcopenia has been documented, and evidence suggests that inflammaging is involved in the manifestation of sarcopenia. The present study investigates whether hyperphosphatemia triggers inflammation, thereby inducing the appearance of sarcopenia along with the cytokines involved in these processes. MATERIALS AND METHODS RAW 264.7 macrophages were incubated with β-glycerophosphate (BGP), as a phosphate donor, at different time intervals, to assess the production of proinflammatory markers. Conditioned medium from macrophages was collected and added to cultured C2C12 myoblasts to analyse whether proinflammatory molecules, released by macrophages, modified myogenic differentiation, cell senescence or myokine IL-15 expression. A neutralising antibody anti-TNF-α and recombinant IL-15 were added to evaluate the role of these cytokines in the observed effects. Additionally, TNF-α, IL-15, serum phosphate, and sarcopenia signs were evaluated in 5-month-old mice, 24-month-old mice and 24-month-old mice fed with a hypophosphatemic diet. KEY FINDINGS BGP increased TNF-α expression in macrophages through NFkB activation. Conditioned medium from BGP-treated macrophages impaired myogenic differentiation in differentiating myoblasts and promoted cellular senescence and reduced IL-15 expression in undifferentiated myoblasts. These effects were mediated by TNF-α. Old mice displayed reduced expression of muscle IL-15 and elevated circulating TNF-α, along with increased serum phosphate levels, which correlated with the appearance of sarcopenia indicators. The hypophosphatemic diet prevented these changes in old mice. SIGNIFICANCE Hyperphosphatemia induces TNF-α production in macrophages, which contributes to the reduced expression of muscular IL-15. This mechanism may play a role in inducing sarcopenia in elderly mice.
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Affiliation(s)
- Elena Alcalde-Estévez
- University of Alcalá, Faculty of Medicine and Health Sciences, Department of Systems Biology, Alcalá de Henares, Madrid 28871, Spain
| | - Ariadna Moreno-Piedra
- University of Alcalá, Faculty of Medicine and Health Sciences, Department of Systems Biology, Alcalá de Henares, Madrid 28871, Spain; Ramón y Cajal Health Research Institute (IRYCIS), Madrid 28034, Spain
| | - Ana Asenjo-Bueno
- University of Alcalá, Faculty of Medicine and Health Sciences, Department of Systems Biology, Alcalá de Henares, Madrid 28871, Spain
| | - María Martos-Elvira
- University of Alcalá, Faculty of Medicine and Health Sciences, Department of Systems Biology, Alcalá de Henares, Madrid 28871, Spain
| | - Mariano de la Serna-Soto
- University of Alcalá, Faculty of Medicine and Health Sciences, Department of Systems Biology, Alcalá de Henares, Madrid 28871, Spain
| | - Marta Ruiz-Ortega
- Cellular and Molecular Biology in Renal and Vascular Pathology, Institute of Medical Research of the Jiménez Díaz Foundation, Autonomous University of Madrid, Madrid, Spain
| | - Gemma Olmos
- University of Alcalá, Faculty of Medicine and Health Sciences, Department of Systems Biology, Alcalá de Henares, Madrid 28871, Spain; Renal and Vascular Physiology and Physiopathology Research Group of Area 5 of IRYCIS, Madrid 28034, Spain; Reina Sofía Institute of Nephrology Research (IRSIN), Íñigo Álvarez de Toledo Renal Foundation (FRIAT), Madrid 28003, Spain
| | - Susana López-Ongil
- Renal and Vascular Physiology and Physiopathology Research Group of Area 5 of IRYCIS, Madrid 28034, Spain; Reina Sofía Institute of Nephrology Research (IRSIN), Íñigo Álvarez de Toledo Renal Foundation (FRIAT), Madrid 28003, Spain; Foundation for Biomedical Research of the Príncipe de Asturias University Hospital, Alcalá de Henares, Madrid 28805, Spain
| | - María P Ruiz-Torres
- University of Alcalá, Faculty of Medicine and Health Sciences, Department of Systems Biology, Alcalá de Henares, Madrid 28871, Spain; Renal and Vascular Physiology and Physiopathology Research Group of Area 5 of IRYCIS, Madrid 28034, Spain; Reina Sofía Institute of Nephrology Research (IRSIN), Íñigo Álvarez de Toledo Renal Foundation (FRIAT), Madrid 28003, Spain
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Tian M, Xu H, Wang H, Wang H, Dai Z, Ding C, Guo H, Jin X. Pretreatment Computed Tomography-Defined Sarcopenia, Treatment-Associated Muscle Loss, and Survival in Patients With Cervical Cancer: A Systematic Review and Meta-Analysis. Nutr Rev 2025; 83:797-808. [PMID: 39340837 DOI: 10.1093/nutrit/nuae130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2024] Open
Abstract
CONTEXT Sarcopenia has been identified as a potential predictor of poor prognosis in various types of cancer. However, the impact of pretreatment sarcopenia and the reduction of skeletal muscle mass during treatment on survival outcomes of patients with cervical cancer is still not well understood. OBJECTIVE This meta-analysis was conducted to investigate the impact of pretreatment sarcopenia and treatment-associated muscle loss on survival outcomes in patients with cervical cancer. DATA SOURCES The PubMed, EMBASE, Web of Science, and Cochrane Library databases were searched for studies exploring the relationship between muscle loss and the prognosis of cervical cancer until January 1, 2023. DATA EXTRACTION The hazard ratios (HRs) and 95% CIs for overall survival (OS) and progression-free survival (PFS) were extracted. DATA ANALYSIS The data were analyzed using R software. The studies' quality was assessed using the Quality in Prognostic Studies tool. Twelve observational studies involving 1498 patients with cervical cancer were included in the analysis, with a prevalence of sarcopenia ranging from 24.8% to 57.5%. Sarcopenia was an independent predictor of poor OS (HR, 1.68; 95% CI, 1.28-2.21; P < .01) and PFS (HR, 1.53; 95% CI, 1.19-1.98; P < .01) in patients with cervical cancer. Additionally, the decrease in skeletal muscle during treatment was also significantly related to the OS (HR, 4.46; 95% CI, 2.87-6.94; P < .01) and PFS (HR, 2.89; 95% CI. 1.83-4.55; P < .01). CONCLUSIONS The prevalence of pretreatment sarcopenia was high among patients with cervical cancer. Pretreatment sarcopenia and skeletal muscle loss during treatment both negatively affected prognosis in cervical cancer.
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Affiliation(s)
- Mengxing Tian
- Department of Clinical Nutrition, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430079, China
| | - Huiting Xu
- Department of Abdominal Oncology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430079, China
| | - Hongbin Wang
- Department of Gynecology and Oncology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430079, China
| | - Huifen Wang
- Nursing Department, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430079, China
| | - Zhu Dai
- Department of Clinical Nutrition, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430079, China
| | - Chenchen Ding
- Department of Clinical Nutrition, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430079, China
| | - Huan Guo
- Department of Clinical Nutrition, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430079, China
| | - Xin Jin
- Department of Clinical Nutrition, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430079, China
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Nam S, Yun HY, Kim O. Risk factors for pressure injuries in individuals with spinal cord injuries who have sarcopenic obesity: A comparison of time-dependent changes in sacral region pressure between individuals with and without sarcopenic obesity. J Spinal Cord Med 2025; 48:438-446. [PMID: 39047200 PMCID: PMC12035926 DOI: 10.1080/10790268.2024.2379068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/27/2024] Open
Abstract
OBJECTIVE To identify the risk factors for pressure injuries in individuals with spinal cord injuries (SCIs) who have sarcopenic obesity, comparing time-dependent changes in sacral region pressure in individuals with and without sarcopenic obesity. DESIGN An experimental time series study. SETTING Single-center hospital. PARTICIPANTS Twenty-five adult participants with subacute and chronic paraplegia who visited our rehabilitation center, Republic of Korea, between May 2021 and June 2022. INTERVENTIONS Whole-body dual-energy X-ray absorptiometry was performed to diagnose sarcopenic obesity. After the participants were placed in the supine position for 1 hour, the average pressure (mmHg), peak pressure (mmHg), and total contact area (cm2) of the sacral region were measured using the pressure-mapping system. RESULTS Compared with the non-sarcopenic obesity group, the sarcopenic obesity group showed significant before-and-after differences in peak pressure. Furthermore, the risk factors that were significantly associated with peak pressure in the sarcopenic obesity group were the American Spinal Injury Association Impairment Scale score and the fat mass index. CONCLUSION Among participants with SCIs, the risk of pressure injuries is higher in the sarcopenic obesity group than in the non-sarcopenic obesity group. Notably, the risk of pressure injuries increases in participants who have complete injury and an increased fat mass index, indicating the importance of close monitoring and more active management to prevent pressure injuries in this subpopulation.
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Affiliation(s)
- Sumin Nam
- Department of Physical Medicine and Rehabilitation, National Rehabilitation Center, Seoul, Republic of Korea
| | - Hye Yeong Yun
- Department of Physical Medicine and Rehabilitation, National Rehabilitation Center, Seoul, Republic of Korea
| | - Onyoo Kim
- Department of Physical Medicine and Rehabilitation, National Rehabilitation Center, Seoul, Republic of Korea
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36
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Zuo W, Peng J, Guo W, Wu J. Unraveling the protein-metabolite network of sarcopenia in plasma: A large-scale Mendelian randomization study. Arch Gerontol Geriatr 2025; 132:105788. [PMID: 40009978 DOI: 10.1016/j.archger.2025.105788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2024] [Revised: 02/08/2025] [Accepted: 02/17/2025] [Indexed: 02/28/2025]
Abstract
BACKGROUND Some plasma molecules may have an effect on sarcopenia, but it is not fully understood. We aimed to comprehensively explore the causal effects of plasma proteins and metabolites on sarcopenia traits, and to unravel their network. METHODS A two-sample Mendelian randomization design was adopted. The levels of 4,907 plasma proteins from 35,559 Icelanders, and 1,400 plasma metabolites from 8,299 Europeans, were set as exposures. Low handgrip strength, appendicular lean mass, and usual walking pace from Europeans were set as outcomes. Inverse-variance weighted (IVW) and four other methods, along with sensitivity analyzes, were performed to estimate the causal effects. Enrichment and pathway analyzes were conducted to present their characteristics. IVW was used to estimate the bidirectional relationships between sarcopenia-related proteins and metabolites, and to visualize them within a network. RESULTS We identified 76 relationships between proteins and sarcopenia traits. The absolute values of causal effects (βIVW) ranging from 0.01 to 0.35. IL2, AIF1, GDNF, CXCL13, LRRTM3, and SLPI were the top six proteins ranked by causal effects. Additionally, 22 relationships between metabolites and sarcopenia traits were identified, with absolute values of βIVW ranging from 0.02 to 0.22. Sulfate and serine/pyruvate ratio had the highest values. The network diagram showed some key nodes, such as ISOC1, GSTA1, tryptophan and 5α-androstan-3α,17β-diol monosulfate. CONCLUSIONS This work unraveled a molecular network of sarcopenia in plasma for the first time and identified some key proteins and metabolites. It may help to understand the mechanisms of sarcopenia, providing new insights for predicting, diagnosing and treating sarcopenia.
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Affiliation(s)
- Wenhang Zuo
- Center of Gerontology and Geriatrics, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, PR China
| | - Jin Peng
- Center of Gerontology and Geriatrics, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, PR China
| | - Wen Guo
- Center of Gerontology and Geriatrics, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, PR China
| | - Jinhui Wu
- Center of Gerontology and Geriatrics, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, PR China.
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Ito K, Maeshima E, Saito K, Koshiba H, Nakamata T, Yamaguchi K, Ihara H, Hattori K, Hatanaka Y. Effects of short-term strength training based on hip flexion angle-torque characteristics using a prototype machine. J Phys Ther Sci 2025; 37:226-230. [PMID: 40322582 PMCID: PMC12045609 DOI: 10.1589/jpts.37.226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2025] [Accepted: 02/27/2025] [Indexed: 05/08/2025] Open
Abstract
[Purpose] An unexpected finding was previously observed that hip flexion torque was maximal in the deep flexion position. This study aimed to compares the short-term effects of strength training using a machine with load torque based on the hip flexion angle-torque characteristics identified in our prior study to those of an existing weight stack machine. [Participants and Methods] Seventeen participants were divided into two groups. The conventional training group (CT group) trained with a weight stack resistance machine. The non-conventional training group (non-CT group) trained with a prototype machine based on the hip flexion angle-torque characteristics identified in our previous study. Both groups trained twice weekly for four weeks. Maximum isometric hip flexion torque at 0°, 30°, 60°, 90°, and 105° was measured before and after training, and compared between the groups. [Results] Maximum isometric hip flexion torque showed an interaction between training type and training duration only at 105° of hip flexion, with significantly higher torque observed in the non-CT group. [Conclusion] Short-term training based on the hip flexion angle-torque characteristics identified in our prior study was effective in significantly strengthened muscles in the deep hip flexion range.
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Affiliation(s)
- Kazuhiro Ito
- Department of Rehabilitation Physical Therapy Course,
Faculty of Health Science, Suzuka University of Medical Science: 1001-1 Kishioka,
Suzuka-shi, Mie 510-0293, Japan
- Graduate School of Sport and Exercise Sciences, Osaka
University of Health and Sport Sciences, Japan
| | - Etsuko Maeshima
- Graduate School of Sport and Exercise Sciences, Osaka
University of Health and Sport Sciences, Japan
| | - Koichi Saito
- Department of Rehabilitation Physical Therapy Course,
Faculty of Health Science, Suzuka University of Medical Science: 1001-1 Kishioka,
Suzuka-shi, Mie 510-0293, Japan
| | - Hiroya Koshiba
- Graduate School of Sport and Exercise Sciences, Osaka
University of Health and Sport Sciences, Japan
| | - Takaaki Nakamata
- Department of Rehabilitation Physical Therapy Course,
Faculty of Health Science, Suzuka University of Medical Science: 1001-1 Kishioka,
Suzuka-shi, Mie 510-0293, Japan
| | - Kazuki Yamaguchi
- Department of Rehabilitation Physical Therapy Course,
Faculty of Health Science, Suzuka University of Medical Science: 1001-1 Kishioka,
Suzuka-shi, Mie 510-0293, Japan
| | - Hideo Ihara
- Development Division, Ihara Kogyo Co., Ltd., Japan
| | - Koji Hattori
- Development Division, Ihara Kogyo Co., Ltd., Japan
| | - Yasuhiko Hatanaka
- Department of Rehabilitation Physical Therapy Course,
Faculty of Health Science, Suzuka University of Medical Science: 1001-1 Kishioka,
Suzuka-shi, Mie 510-0293, Japan
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Zhao X, Liu Y, Wang D, Li T, Xu Z, Li Z, Bai X, Wang Y. Role of GLP‑1 receptor agonists in sepsis and their therapeutic potential in sepsis‑induced muscle atrophy (Review). Int J Mol Med 2025; 55:74. [PMID: 40052580 PMCID: PMC11936484 DOI: 10.3892/ijmm.2025.5515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2024] [Accepted: 01/17/2025] [Indexed: 03/27/2025] Open
Abstract
Sepsis‑induced myopathy (SIM) is a common complication in intensive care units, which is often associated with adverse outcomes, primarily manifested as skeletal muscle weakness and atrophy. Currently, the management of SIM focuses on prevention strategies, as effective therapeutic options remain elusive. Glucagon‑like peptide‑1 (GLP‑1) receptor agonists (GLP‑1RAs) have garnered attention as hypoglycemic and weight‑loss agents, with an increasing body of research focusing on the extrapancreatic effects of GLP‑1. In preclinical settings, GLP‑1RAs exert protective effects against sepsis‑related multiple organ dysfunction through anti‑inflammatory and antioxidant mechanisms. Based on the existing research, we hypothesized that GLP‑1RAs may serve potential protective roles in the repair and regeneration of skeletal muscle affected by sepsis. The present review aimed to explore the relationship between GLP‑1RAs and sepsis, as well as their impact on muscle atrophy‑related myopathy. Furthermore, the potential mechanisms and therapeutic benefits of GLP‑1RAs are discussed in the context of muscle atrophy induced by sepsis.
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Affiliation(s)
- Xuan Zhao
- Trauma Center, Department of Emergency and Traumatic Surgery, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, P.R. China
| | - Yukun Liu
- Department of Plastic and Cosmetic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, P.R. China
| | - Dongfang Wang
- Trauma Center, Department of Emergency and Traumatic Surgery, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, P.R. China
| | - Tonghan Li
- Trauma Center, Department of Emergency and Traumatic Surgery, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, P.R. China
| | - Zhikai Xu
- Trauma Center, Department of Emergency and Traumatic Surgery, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, P.R. China
| | - Zhanfei Li
- Trauma Center, Department of Emergency and Traumatic Surgery, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, P.R. China
| | - Xiangjun Bai
- Trauma Center, Department of Emergency and Traumatic Surgery, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, P.R. China
| | - Yuchang Wang
- Trauma Center, Department of Emergency and Traumatic Surgery, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, P.R. China
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Hu X, Wu B, Yang Y, Zhang L, Xue C. Sarcopenia in Peritoneal Dialysis: Prevalence, Pathophysiology, and Management Strategies. Kidney Med 2025; 7:100989. [PMID: 40247955 PMCID: PMC12005912 DOI: 10.1016/j.xkme.2025.100989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2025] Open
Abstract
Sarcopenia, defined as the loss of skeletal muscle mass, strength, and function, is a significant complication in patients with chronic kidney disease, particularly those undergoing peritoneal dialysis (PD). This review explores the prevalence, pathophysiology, diagnostic challenges, and management strategies of sarcopenia in the PD population. The multifactorial etiology of sarcopenia in PD, including protein-energy wasting, chronic inflammation, insulin resistance, and hormonal imbalances, underscores the complexity of its management. The prevalence of sarcopenia in patients treated with PD is influenced by age, duration of dialysis, and comorbid conditions, presenting a considerable variation across studies due to differing diagnostic criteria. Diagnostic challenges arise from fluid overload and the PD process, affecting the accuracy of muscle mass measurements. Intervention strategies focusing on nutritional supplementation and physical exercise have shown promise; however, the need for PD-specific diagnostic criteria and treatment protocols remains. This review highlights the critical effect of sarcopenia on functional status and survival in patients treated with PD, emphasizing the importance of addressing this condition to improve patient outcomes. Future directions call for comprehensive, longitudinal studies to better understand sarcopenia's progression in patients treated with PD and the development of tailored interventions.
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Affiliation(s)
- Xiaohua Hu
- Department of Nephrology, Zhabei Central Hospital of Jing’an District, Shanghai, China
| | - Bibo Wu
- Department of Nephrology, Zhabei Central Hospital of Jing’an District, Shanghai, China
| | - Yang Yang
- Department of Nephrology, 981th Hospital of PLA, Chengde, Hebei province, China
| | - Liming Zhang
- Department of Nephrology, Zhabei Central Hospital of Jing’an District, Shanghai, China
| | - Cheng Xue
- Department of Nephrology, Zhabei Central Hospital of Jing’an District, Shanghai, China
- Department of Nephrology, Shanghai Changzheng Hospital, Second Affiliated Hospital of Naval Medical University (Second Military Medical University), Shanghai, China
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Fang T, Xue Z, Zhou Q, Gao J, Mi J, Yang H, Zhou F, Liu H, Zhang J. Impact of Paraspinal Sarcopenia on Clinical Outcomes in Intervertebral Disc Degeneration Patients Following Percutaneous Transforaminal Endoscopic Lumbar Discectomy. Orthop Surg 2025; 17:1332-1339. [PMID: 40012002 PMCID: PMC12050173 DOI: 10.1111/os.70006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2024] [Revised: 02/03/2025] [Accepted: 02/09/2025] [Indexed: 02/28/2025] Open
Abstract
OBJECTIVE The paraspinal muscles are a crucial component of the spine's extrinsic stabilization system. While the impact of paraspinal muscle sarcopenia on patient-reported outcome measures (PROMs) after lumbar surgery is well known, its effects following percutaneous transforaminal endoscopic discectomy (PTED) have not been investigated. To investigate the prognostic value of preoperative paraspinal sarcopenia on long-term PROMs after PTED, and to identify independent predictors of chronic postoperative low back pain. METHODS In this retrospective cohort study, 145 patients who underwent PTED for lumbar disc herniation (2017-2022) were stratified into sarcopenia (n = 52) and non-sarcopenia (n = 93) groups using sex-specific psoas muscle index (PMI) thresholds (male: < 6.36 cm2/m2; female: < 3.92 cm2/m2). Preoperative MRI/CT was used to quantify paraspinal muscle parameters, including PMI, multifidus muscle index (MMI), erector spinae muscle index (EMI), Goutallier-classified fat infiltration (FI) severity (Grades 0-4), and multifidus muscle density (MMD). Primary outcomes were assessed via the visual analog scale (VAS; 0-10) and Oswestry disability index (ODI; 0%-100%) at preoperative, 1-month, 6-month, and final follow-up (mean 65.6 weeks). Multivariate logistic regression was performed to identify independent predictors of chronic pain (defined as VAS ≥ 4 at final follow-up). RESULTS The study cohort comprised 145 patients (69 female, 76 male; mean age: 50.1 ± 7.6 years). The sarcopenia group exhibited significantly lower muscle indices (PMI: 4.55 vs. 7.48 cm2/m2, p < 0.001, MMI: 2.61 ± 0.80 vs. 3.66 ± 0.94 cm2/m2, p < 0.001, EMI: 9.72 ± 2.46 vs. 12.54 ± 2.27 cm2/m2, p < 0.001) and higher FI severity (p < 0.05). At final follow-up, the sarcopenia group reported significantly worse pain (VAS: 3.04 ± 1.25 vs. 2.31 ± 1.50, p = 0.004) and disability (ODI: 28.33 ± 6.61 vs. 21.57 ± 7.28, p < 0.001). Multivariate analysis identified BMI (OR = 1.319), PMI (OR = 0.745), MMI (OR = 0.454), and moderate/severe multifidus FI (OR = 7.036) as independent predictors of chronic pain (all p < 0.05). CONCLUSION Paraspinal sarcopenia, particularly multifidus degeneration, is a modifiable determinant of chronic pain after PTED. Preoperative muscle quality assessment combined with targeted rehabilitation may optimize outcomes.
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Affiliation(s)
- Tianci Fang
- Department of OrthopaedicsThe First Affiliated Hospital of Soochow University, Soochow UniversitySuzhouChina
- Orthopaedic Institute, Medical College, Soochow UniversitySuzhouChina
| | | | - Quan Zhou
- Department of OrthopaedicsThe First Affiliated Hospital of Soochow University, Soochow UniversitySuzhouChina
| | | | - Jian Mi
- Department of OrthopaedicsThe First Affiliated Hospital of Soochow University, Soochow UniversitySuzhouChina
| | - Huilin Yang
- Department of OrthopaedicsThe First Affiliated Hospital of Soochow University, Soochow UniversitySuzhouChina
| | - Feng Zhou
- Department of OrthopaedicsThe First Affiliated Hospital of Soochow University, Soochow UniversitySuzhouChina
| | - Hao Liu
- Department of OrthopaedicsThe First Affiliated Hospital of Soochow University, Soochow UniversitySuzhouChina
| | - Junxin Zhang
- Department of OrthopaedicsThe First Affiliated Hospital of Soochow University, Soochow UniversitySuzhouChina
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Wang X, Wang Z, Cheng Y, Chen X. Effects of sarcopenia on postoperative recovery in elderly patients after cardiac surgery with cardiopulmonary bypass. BMC Geriatr 2025; 25:295. [PMID: 40307687 PMCID: PMC12042521 DOI: 10.1186/s12877-025-05966-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2024] [Accepted: 04/18/2025] [Indexed: 05/02/2025] Open
Abstract
BACKGROUND Few studies have assessed sarcopenia identified by erector spinae muscle (ESM) using thoracic computed tomography (CT) before cardiac surgery. We aimed to explore the relationship between sarcopenia evaluated via ESM and poor outcomes following cardiac surgery with cardiopulmonary bypass (CPB) in elderly patients. METHODS 268 patients older than 65 years who underwent cardiac surgery with CPB at our institution in 2020 were included in the retrospective, single center, cohort study. Preoperative chest CT scans were used to measure the cross-sectional areas of the ESM (ESMCSA), which were then adjusted for body surface area (BSA) to determine the muscle mass index. Patients were categorized into sarcopenia and non-sarcopenia groups based on ESMCSA/BSA scores, and their short- and long-term clinical outcomes were compared. RESULTS The ESMCSA/BSA detected sarcopenia in 51.1% of patients. Patients with sarcopenia had significantly extended durations of stay in both the intensive care unit and the hospital compared to those without sarcopenia. Furthermore, the incidence of major adverse events was significantly higher in the sarcopenia group compared to the non-sarcopenia group (15.3% vs. 32.1%, P < 0.001). Furthermore, multivariate logistic regression analysis demonstrated that sarcopenia (OR 2.457, 95% CI 1.178-5.126, P = 0.017) independently predicted the risk of postoperative complications after adjusting for gender, preoperative nutritional status, serum albumin, estimated glomerular filtration rate, creatinine, white blood cell count, lymphocytes, type of surgery, surgical time, and aortic cross-clamp time. Kaplan-Meier survival analysis revealed a statistically significant difference in overall mortality between groups (log-rank P = 0.011). The Cox proportional hazards model identified preoperative sarcopenia as an independent risk factor for long-term mortality (HR, 2.132; 95% CI 1.144-3.972, P = 0.017). CONCLUSION Our study identified preoperative sarcopenia, assessed via ESM muscle mass on chest CT, as an independent predictor of postoperative complications and long-term overall mortality in elderly cardiac surgery patients with CPB.
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Affiliation(s)
- Xiaoqian Wang
- Department of Clinical Nutrition, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
| | - Zhen Wang
- Department of Clinical Nutrition, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China.
| | - Yongqing Cheng
- Department of Cardiac Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China.
| | - Xiaotian Chen
- Department of Clinical Nutrition, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China.
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Kim S, Gu B, So CY, Mantik KEK, Jung SH, Moon S, Park DH, Kwak HB, Cho J, Cho EJ, Lee JS, Kang JH. Cdkn1a silencing restores myoblast differentiation by inducing selective apoptosis in senescent cells. Cell Mol Biol Lett 2025; 30:53. [PMID: 40307745 PMCID: PMC12042464 DOI: 10.1186/s11658-025-00731-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2024] [Accepted: 04/08/2025] [Indexed: 05/02/2025] Open
Abstract
BACKGROUND Sarcopenia, characterized by a progressive loss of skeletal muscle mass and function, is associated with the accumulation of senescent muscle stem cells, which impair muscle regeneration and contributes to the decline in muscle health. Cdkn1a, which encodes p21, is a well-known marker of cellular senescence. However, it remains unclear whether p21 inhibition eliminates senescent myoblasts and restores the differentiation capacity. METHODS We performed transcriptomic analysis to identify genes related to aging-induced sarcopenia using 21 month-old Sprague-Dawley rats. To investigate the specific role of Cdkn1a gene in muscle aging, we used an in vitro model of ceramide-induced senescence in myoblasts, which was verified by the upregulation of p21 and increased senescence-associated beta-galactosidase (SA-β-gal) staining. To inhibit p21, we treated myoblasts with small interfering RNA (siRNA) targeting Cdkn1a. Using fluorescence-activated cell sorting, we separated subpopulations of cells with high or low caspase 3/7 activity. Protein expression related to myogenesis, muscle atrophy, protein synthesis, and apoptosis were quantified by western blotting. RESULTS In our transcriptomic analysis, we identified Cdkn1a as an upregulated gene in both the soleus and white gastrocnemius muscles of aged rats, among 36 commonly upregulated genes. The upregulation of Cdkn1a appears to be linked to mitochondrial dysfunction and cellular senescence, underscoring its significance in sarcopenia pathogenesis. C2-ceramide treatment effectively induced senescence, as evidenced by increased p21 expression, enhanced SA-β-gal staining, decreased myogenesis, and increased apoptosis. Knockdown of p21 in ceramide-treated myoblasts significantly reduced SA-β-gal-positive cells, restored cell proliferation, reduced the expression of senescence-associated cytokines (i.e., interleukin (IL)-6 and tumor necrosis factor (TNF)-α), and selectively induced apoptosis in the senescent cell population, demonstrating a senolytic effect. Notably, p21 inhibition also improved differentiation of myoblasts into myotubes, as indicated by increased myosin heavy chain expression and improvements in myotube diameter and fusion index. CONCLUSIONS Our data suggest that p21 inhibition selectively eliminates senescent cells while simultaneously enhancing the regenerative capacity of healthy myoblasts, which may combine to improve muscle regeneration and promote myogenesis, ultimately improving muscle health and function in aged individuals.
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Affiliation(s)
- Sujin Kim
- Department of Pharmacology, Inha University College of Medicine, 100, Inha-Ro, Michuhol-Gu, Incheon, 22212, Republic of Korea
- Research Center for Controlling Intercellular Communication, Inha University College of Medicine, Incheon, 22212, Republic of Korea
| | - Bonsang Gu
- Department of Pharmacology, Inha University College of Medicine, 100, Inha-Ro, Michuhol-Gu, Incheon, 22212, Republic of Korea
- Research Center for Controlling Intercellular Communication, Inha University College of Medicine, Incheon, 22212, Republic of Korea
- Program in Biomedical Science and Engineering, Inha University, Incheon, South Korea
| | - Chan-Young So
- Department of Pharmacology, Inha University College of Medicine, 100, Inha-Ro, Michuhol-Gu, Incheon, 22212, Republic of Korea
- Research Center for Controlling Intercellular Communication, Inha University College of Medicine, Incheon, 22212, Republic of Korea
- Program in Biomedical Science and Engineering, Inha University, Incheon, South Korea
| | - Keren Esther Kristina Mantik
- Department of Pharmacology, Inha University College of Medicine, 100, Inha-Ro, Michuhol-Gu, Incheon, 22212, Republic of Korea
- Research Center for Controlling Intercellular Communication, Inha University College of Medicine, Incheon, 22212, Republic of Korea
- Program in Biomedical Science and Engineering, Inha University, Incheon, South Korea
| | - Seung-Hyun Jung
- Department of Biochemistry, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Integrated Research Center for Genomic Polymorphism, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Department of Medical Sciences, Graduate School of The Catholic University of Korea, Seoul, Republic of Korea
| | - Sohee Moon
- Department of Pharmacology, Inha University College of Medicine, 100, Inha-Ro, Michuhol-Gu, Incheon, 22212, Republic of Korea
- Research Center for Controlling Intercellular Communication, Inha University College of Medicine, Incheon, 22212, Republic of Korea
| | - Dong-Ho Park
- Program in Biomedical Science and Engineering, Inha University, Incheon, South Korea
- Department of Kinesiology, Inha University, Incheon, Republic of Korea
| | - Hyo-Bum Kwak
- Program in Biomedical Science and Engineering, Inha University, Incheon, South Korea
- Department of Kinesiology, Inha University, Incheon, Republic of Korea
| | - Jinkyung Cho
- College of Sport Science, Sungkyunkwan University, Suwon, Republic of Korea
| | - Eun-Jeong Cho
- Program in Biomedical Science and Engineering, Inha University, Incheon, South Korea
- Department of Kinesiology, Inha University, Incheon, Republic of Korea
| | - Jae-Seon Lee
- Research Center for Controlling Intercellular Communication, Inha University College of Medicine, Incheon, 22212, Republic of Korea.
- Program in Biomedical Science and Engineering, Inha University, Incheon, South Korea.
- Department of Molecular Medicine, Inha University College of Medicine, 100, Inha-Ro, Michuhol-Gu, Incheon, 22212, Republic of Korea.
| | - Ju-Hee Kang
- Department of Pharmacology, Inha University College of Medicine, 100, Inha-Ro, Michuhol-Gu, Incheon, 22212, Republic of Korea.
- Research Center for Controlling Intercellular Communication, Inha University College of Medicine, Incheon, 22212, Republic of Korea.
- Program in Biomedical Science and Engineering, Inha University, Incheon, South Korea.
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Gholizade M, Marzban M, Jamshidi A, Afshar A, Afshar M, Kalantarhormozi M, Nabipour I, Larijani B, Farhadi A. Relationship between anemia, hemoglobin level and risk of osteosarcopenia in community-dwelling older adults: the Bushehr Elderly Health (BEH) program. Arch Osteoporos 2025; 20:55. [PMID: 40301141 DOI: 10.1007/s11657-025-01535-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2024] [Accepted: 03/21/2025] [Indexed: 05/01/2025]
Abstract
This study investigates the relationship between anemia, hemoglobin levels, and osteosarcopenia risk in older adults. Analyzing data from 2,398 participants in the Bushehr Elderly Health program, the research reveals that anemia significantly increases osteosarcopenia risk. The findings suggest that routine hemoglobin screening and anemia treatment could help prevent osteosarcopenia in the elderly population. PURPOSE In the older adult population, osteosarcopenia, defined as having both sarcopenia and osteopenia, is a recent concern. In this study, we aimed to evaluate anemia as a common condition in the older adult population and osteosarcopenia. Given that anemia can contribute to musculoskeletal decline through impaired oxygen delivery and metabolic dysfunction, we hypothesized that lower hemoglobin levels and anemia may be significant risk factors for osteosarcopenia. This study aims to investigate this potential relationship in an elderly population. METHODS This cross-sectional study was conducted on men and women ≥ 60 years, based on the second phase of the Bushehr elderly health (BEH) program. Osteopenia/osteoporosis was defined as a t-score ≤-1.0 standard deviation below the mean values of a young healthy adult and sarcopenia was defined based on the revised edition of the European Working Group on Sarcopenia in Older People (EWGSOP2) based on the Iranian cut-off point. Anemia is defined as 12 for women and 13 g/dl for men. We calculated odds ratios (OR), 95% confidence intervals (95% CI), and adjusted OR (AOR) using univariate and adjusted multivariate logistic regression. RESULTS Among 2398 who enrolled, 534 (22.27%) of participants had osteosarcopenia. The mean level of hemoglobin (Hgb) was 14.49 ± 1.73, and 219 participants (9.13%) were diagnosed with anemia. Participants with osteosarcopenia were more likely to be older, have lower body mass index, suffer from frailty syndrome and cognitive disorder, and have anemia. Moreover, analysis showed lower levels of Hgb were associated with osteosarcopenia (AOR = 0.89, 95% CI: 0.82-0.96) and anemia almost increase 1.5 times risk of osteosarcopenia (AOR = 1.55, 95% CI: 1.05-2.30). CONCLUSION The results of this study indicate that anemia dramatically increased the risk of osteosarcopenia. Routine Hgb screening and treatment of anemia might prevent the older adult population from osteosarcopenia.
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Affiliation(s)
- Mohamad Gholizade
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Student Research Committee, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Maryam Marzban
- Department of Biostatistics and Epidemiology, Faculty of Health and Nutrition, Bushehr University of Medical Sciences, Bushehr, Iran
- Department of Human Genetics, Mcgill University, Montreal, QC, Canada
| | - Ali Jamshidi
- Department of Nutritional Sciences, School of Health, Bushehr University of Medical Science, Bushehr, Iran
- The Persian Gulf Tropical Medicine Research Center, the Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Alireza Afshar
- The Persian Gulf Tropical Medicine Research Center, the Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
- Student Research Committee, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Mohammadreza Afshar
- The Persian Gulf Tropical Medicine Research Center, the Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
- Student Research Committee, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Mohammadreza Kalantarhormozi
- The Persian Gulf Tropical Medicine Research Center, the Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Iraj Nabipour
- The Persian Gulf Tropical Medicine Research Center, the Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Akram Farhadi
- The Persian Gulf Tropical Medicine Research Center, the Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran.
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Ren Y, He X, Wang L, Chen N. Comparison of the gut microbiota in older people with and without sarcopenia: a systematic review and meta-analysis. Front Cell Infect Microbiol 2025; 15:1480293. [PMID: 40357398 PMCID: PMC12066693 DOI: 10.3389/fcimb.2025.1480293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2024] [Accepted: 03/31/2025] [Indexed: 05/15/2025] Open
Abstract
Introduction Sarcopenia, an age-related disorder marked by decreased skeletal muscle mass, strength, and function, is associated with negative health impacts in individuals and financial burdens on families and society. Studies have suggested that age-related alterations in gut microbiota may contribute to the development of sarcopenia in older people through the gut-muscle axis, thus modulation of gut microbiota may be a promising approach for sarcopenia treatment. However, the characteristic gut microbiota for sarcopenia has not been consistent across studies. Therefore, the aim of this study was to compare the diversity and compositional differences in the gut microbiota of older people with and without sarcopenia, and to identify gut microbiota biomarkers with therapeutic potential for sarcopenia. Methods The PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, and Wanfang Database were searched studies about the gut microbiota characteristics in older people with sarcopenia. The quality of included articles was assessed by the Newcastle-Ottawa Scale (NOS). Weighted standardized mean differences (SMDs) and 95% confidence intervals (CIs) for α-diversity index were estimated using a random effects model. Qualitative synthesis was conducted for β-diversity and the correlation between gut microbiota and muscle parameters. The relative abundance of the gut microbiota was analyzed quantitatively and qualitatively, respectively. Results Pooled estimates showed that α-diversity was significantly lower in older people with sarcopenia (SMD: -0.41, 95% CI: -0.57 to -0.26, I²: 71%, P < 0.00001). The findings of β-diversity varied across included studies. In addition, our study identified gut microbiota showing a potential and negative correlation with sarcopenia, such as Prevotella, Slackia, Agathobacter, Alloprevotella, Prevotella copri, Prevotellaceae sp., Bacteroides coprophilus, Mitsuokella multacida, Bacteroides massiliensis, Bacteroides coprocola Conversely, a potential and positive correlation was observed with opportunistic pathogens like Escherichia-Shigella, Eggerthella, Eggerthella lenta and Collinsella aerofaciens. Discussion This study showed that α-diversity is decreased in sarcopenia, probably predominantly due to diminished richness rather than evenness. In addition, although findings of β-diversity varied across included studies, the overall trend toward a decrease in SCFAs-producing bacteria and an increase in conditionally pathogenic bacteria. This study provides new ideas for targeting the gut microbiota for the prevention and treatment of sarcopenia. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/view/CRD42024573090, identifier CRD42024573090.
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Affiliation(s)
- Yanqing Ren
- Department of Rehabilitation, Chongming Hospital Affiliated to Shanghai University of Medicine and Health Sciences, Shanghai, China
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai, China
| | - Xiangfeng He
- Department of Rehabilitation, Chongming Hospital Affiliated to Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Ling Wang
- Department of Rehabilitation, Chongming Hospital Affiliated to Shanghai University of Medicine and Health Sciences, Shanghai, China
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai, China
| | - Nan Chen
- Department of Rehabilitation, Chongming Hospital Affiliated to Shanghai University of Medicine and Health Sciences, Shanghai, China
- Department of Rehabilitation, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
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Le KDR, Nguyen S, Gomez S, Hassanali A, Hassanali H, Barnett A, Masterson R, Hughes P, Dwyer KM. The Prognostic Significance of Preoperative Computed Tomography Diagnosed Sarcopenia on Allograft and Postoperative Outcomes Following Kidney Transplantation: A Systematic Review and Meta-Analysis. Transplant Proc 2025:S0041-1345(25)00208-8. [PMID: 40300907 DOI: 10.1016/j.transproceed.2025.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2024] [Revised: 03/14/2025] [Accepted: 03/15/2025] [Indexed: 05/01/2025]
Abstract
BACKGROUND The identification of individuals who will benefit most from kidney transplantation is challenging, with no clear consensus as to which clinical features provide the most prognostic information. Recently, computed tomography (CT)-diagnosed sarcopenia has proven to be accurate in predicting poorer outcomes solid organ transplant recipients. This systematic review and meta-analysis evaluates the role of sarcopenia, as defined by preoperative CT, in the prediction of postoperative recipient and allograft outcomes in patients undergoing kidney transplantation. METHODS A comprehensive literature search was performed on Medline, Embase, Google Scholar and CINAHL databases. Seven articles involving 1153 patients were included in this review. RESULTS There was strong evidence to suggest that CT-defined sarcopenia was associated with increased mortality (OR: 2.72, 95% CI, 1.66-4.47, P < .0001) and greater likelihood of readmission (OR: 1.98, 95% CI, 1.34-2.92, P = .00006). There was a lack of evidence to support the use of preoperative CT to define sarcopenia as a prognostic factor for allograft and other postoperative outcomes following kidney transplantation. CONCLUSIONS This systematic review and meta-analysis demonstrates evidence to suggest pretransplant sarcopenia identified on CT imaging is predictive of increased mortality and readmission. Given the limitations of evidence related to risk of bias and heterogeneity, there is a need for more robust prospective research to elucidate the true effect of CT diagnosed sarcopenia as a prognostic factor in the kidney transplant setting.
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Affiliation(s)
- Khang Duy Ricky Le
- Department of General Surgical Specialties, The Royal Melbourne Hospital, Melbourne, Victoria, Australia; Department of General Surgery, Northeast Health Wangaratta, Wangaratta, Victoria, Australia; Geelong Clinical School, Deakin University, Geelong, Victoria, Australia.
| | - Steven Nguyen
- Department of Medicine, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Samyuktha Gomez
- Monash Medical Centre, Monash Health, Clayton, Victoria, Australia
| | - Adnan Hassanali
- Geelong Clinical School, Deakin University, Geelong, Victoria, Australia
| | - Hussein Hassanali
- Geelong Clinical School, Deakin University, Geelong, Victoria, Australia
| | - Amy Barnett
- Department of Nephrology and Kidney Care Services, The Royal Melbourne Hospital, Melbourne, Victoria, Australia; Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Rosemary Masterson
- Department of Nephrology and Kidney Care Services, The Royal Melbourne Hospital, Melbourne, Victoria, Australia; Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Peter Hughes
- Department of Nephrology and Kidney Care Services, The Royal Melbourne Hospital, Melbourne, Victoria, Australia; Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Karen M Dwyer
- Department of Nephrology and Kidney Care Services, The Royal Melbourne Hospital, Melbourne, Victoria, Australia; Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
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Ruiz-Ariza B, Hita-Contreras F, Aibar-Almazán A, Carcelén-Fraile MDC, Castellote-Caballero Y. A Pilates Exercise Program as a Therapeutic Strategy in Older Adults with Type 2 Diabetes: Effects on Functional Capacity and Blood Glucose. Healthcare (Basel) 2025; 13:1012. [PMID: 40361790 PMCID: PMC12071747 DOI: 10.3390/healthcare13091012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2025] [Revised: 04/25/2025] [Accepted: 04/26/2025] [Indexed: 05/15/2025] Open
Abstract
Background/Objectives: Older adults with type 2 diabetes mellitus (T2DM) often experience impaired physical function and metabolic control. This study aimed to evaluate the effectiveness of a 12-week Pilates-based intervention on blood glucose concentration and physical function in this population. Methods: A randomized controlled trial was conducted with 104 older adults (mean age: 70.6 ± 3.15 years; 70.2% women), all diagnosed with T2DM. The participants were assigned to a control group (CG, n = 52) or a Pilates training group (PG, n = 52). The intervention included 24 Pilates sessions over 12 weeks (2 sessions/week, 60 min each). Outcomes were assessed pre- and post-intervention and included capillary blood glucose, handgrip strength, functional mobility (Timed Up and Go), balance (Berg Balance Scale), and flexibility (Chair Sit-and-Reach Test and Back Scratch Test). Results: Compared to the control group, the Pilates group showed statistically significant improvements in blood glucose levels (-4.06 mg/dL (p < 0.001; d = 0.68)), handgrip strength (+1.76 kg (p < 0.001; d = 0.48)), gait speed (p < 0.001; d = 0.53), balance (Berg score) (+2.37 points (p < 0.001; d = 0.66)), and flexibility (improvements in upper limbs (BST, d = 0.78-0.98) and lower limbs (CSRT, d = 1.07 right; d = 0.63 left)). Conclusions: A 12-week Pilates program led to significant improvements in glycemic control, muscular strength, gait speed, balance, and flexibility in older adults with T2DM. These findings support Pilates as a safe, effective, and adaptable non-pharmacological intervention to promote functional and metabolic health in this population.
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Affiliation(s)
- Beatriz Ruiz-Ariza
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, 23071 Jaén, Spain
| | - Fidel Hita-Contreras
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, 23071 Jaén, Spain
| | - Agustín Aibar-Almazán
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, 23071 Jaén, Spain
| | - María Del Carmen Carcelén-Fraile
- Department of Educational Sciences, Faculty of Social Sciences, University of Atlántico Medio, 35017 Las Palmas de Gran Canaria, Spain
| | - Yolanda Castellote-Caballero
- Department of Health Sciences, Faculty of Health Sciences, University of Atlántico Medio, 35017 Las Palmas de Gran Canaria, Spain
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Topkan E, Somay E, Selek U. Comment on "The prognostic value of pre-treatment sarcopenia in overall survival in head and neck cancer patients: a systematic review". Int J Oral Maxillofac Surg 2025:S0901-5027(25)00123-7. [PMID: 40300944 DOI: 10.1016/j.ijom.2025.04.1140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2024] [Revised: 10/17/2024] [Accepted: 04/16/2025] [Indexed: 05/01/2025]
Affiliation(s)
- E Topkan
- Department of Radiation Oncology, Faculty of Medicine, Baskent University, Adana, Turkey
| | - E Somay
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Baskent University, Ankara, Turkey.
| | - U Selek
- Department of Radiation Oncology, School of Medicine, Koc University, Istanbul, Turkey
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Chinoraso J, Phoocharoenpaiboon V, Yeekian C, Ongkanchana C. Effect of the Finger-ring Test, compared with the standard test, as a predictor of sarcopenia in older adult patients: A systematic review and meta-analysis. Geriatr Gerontol Int 2025. [PMID: 40288423 DOI: 10.1111/ggi.70045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2024] [Revised: 02/19/2025] [Accepted: 03/25/2025] [Indexed: 04/29/2025]
Abstract
AIM The Finger-ring Test is valued for its simplicity and cost-effectiveness. This has prompted a systematic literature review to evaluate the effectiveness of the Finger-ring Test in the assessment of sarcopenia. METHODS Research studies in various online databases were accessed and perused, including PubMed, Web of Science, Scopus, Ovid, Embase, Medline and the Cochrane Database to identify relevant observational studies without any language restriction from database access to July 2024. To avoid missing any relevant matches, searches targeted specific words typically associated with the Finger-ring Test, such as Yubu-wakka Test and the Finger-circle Test. The research quality was evaluated using the ROBINS-E tool. A meta-analysis was performed using the SPSS software version 29. The review protocol was registered on PROSPERO, with the assigned ID CRD42024593561. RESULTS From a total of 286 studies, only four studies met the inclusion criteria. From a total of 2754 participants, the mean age of the participants was 68.35 ± 2.57 years. The pooled association of each group of the Finger-ring Test with sarcopenia showed the bigger group (OR 2.47; 95% CI 1.42-4.28; I2 = 64%), just fit group (OR 0.30; 95% CI 0.13-0.67; I2 = 75%) and the smaller group (OR 0.16; 95% CI 0.08-0.32; I2 = 62%). CONCLUSIONS This systematic review shows that the Finger-ring Test offers a practical method to identify older adults at risk of sarcopenia. These outcomes might serve as valuable indicators for creating public health initiatives in both the prevention and the management of sarcopenia. Geriatr Gerontol Int 2025; ••: ••-••.
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Affiliation(s)
- Jarumon Chinoraso
- Department of Family Medicine, Queen Savangvadhana Memorial Hospital, Chonburi, Thailand
| | | | - Chuenrutai Yeekian
- Department of Academic and Research, Queen Savangvadhana Memorial Hospital, Chonburi, Thailand
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Sato S, Nakayama S, Shinohara H. Preoperative myosteatosis as a novel prognostic biomarker after anatomical lung resection for non-small cell lung cancer. Surg Today 2025:10.1007/s00595-025-03049-3. [PMID: 40285846 DOI: 10.1007/s00595-025-03049-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2024] [Accepted: 03/31/2025] [Indexed: 04/29/2025]
Abstract
PURPOSE Myosteatosis, or excessive deposition of adipose tissue within skeletal muscle, has been widely used to explain an impaired muscle quality. This study aimed to investigate the association between preoperative myosteatosis and surgical outcomes in patients with non-small-cell lung cancer (NSCLC). METHODS We retrospectively examined 492 patients who underwent anatomical lung resection for stages I-III NSCLC between January 2014 and December 2022. The patients were divided into low- and high-paraspinal muscle density (MD) groups based on the lowest quartile cutoff value of MD on contrast-enhanced computed tomography, with the low-MD group defined as having myosteatosis. RESULTS The five-year overall survival (OS) and recurrence-free survival (RFS) rates were significantly lower in the myosteatosis group than in the control group (59.1% vs. 86.8%, P < 0.001; 52.0% vs. 72.6%, P < 0.001, respectively). A multivariate analysis identified myosteatosis as an independent predictor of OS (hazard ratio [HR], 2.809; 95% confidence interval [CI], 1.781-4.430; P < 0.001) and RFS (HR, 1.894; 95%CI, 1.340-2.678; P < 0.001). There was a significant correlation between myosteatosis and prolonged air leak postoperatively (P = 0.039). CONCLUSION Perioperative nutritional and exercise interventions facilitate changes in body composition, which may improve the outcomes in patients with lung cancer undergoing anatomical resection.
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Affiliation(s)
- Seijiro Sato
- Division of General Thoracic Surgery, Nagaoka Red Cross Hospital, 2-297-1 Senshu, Nagaoka City, Niigata, 940-2085, Japan.
| | - Saeko Nakayama
- Division of General Thoracic Surgery, Nagaoka Red Cross Hospital, 2-297-1 Senshu, Nagaoka City, Niigata, 940-2085, Japan
| | - Hirohiko Shinohara
- Division of General Thoracic Surgery, Nagaoka Red Cross Hospital, 2-297-1 Senshu, Nagaoka City, Niigata, 940-2085, Japan
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Kai W, Takano Y, Kobayashi Y, Kanno H, Hanyu N, Eto K. Impact of osteosarcopenia on short- and long-term outcomes in patients with gastric cancer. Jpn J Clin Oncol 2025; 55:477-483. [PMID: 39827455 DOI: 10.1093/jjco/hyaf003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2024] [Accepted: 01/07/2025] [Indexed: 01/22/2025] Open
Abstract
BACKGROUNDS Osteopenia and sarcopenia are associated with adverse clinical outcomes. This study investigated the impact of osteosarcopenia on short- and long-term outcomes after gastrectomy for gastric cancer. METHODS The present study included patients who underwent gastrectomy for gastric cancer. Osteopenia was evaluated by bone mineral density measurement in the midvertebral core of the 11th thoracic vertebra on preoperative computed tomography images. Sarcopenia was evaluated by measuring the skeletal muscle cross-sectional area at the third lumbar vertebra level. Osteosarcopenia was defined as the coexistence of osteopenia and sarcopenia. We investigated the relationship of preoperative osteosarcopenia with short- and long-term outcomes after gastrectomy for gastric cancer. RESULTS Of all 122 patients, 38 (31%) patients were diagnosed with osteosarcopenia. Multivariate logistic regression analysis revealed that osteosarcopenia (P = .008) was an independent risk factor for postoperative complications. Furthermore, multivariate Cox regression analysis revealed that male sex (P = .007), and osteosarcopenia (P = .038) were independent predictors of disease-free survival, while osteosarcopenia (P = .045) and pathological T stage ≥3 (P = .033) were independent predictors of overall survival. CONCLUSIONS Osteosarcopenia was a strong predictor of short- and long-term outcomes after gastrectomy for gastric cancer. Preoperative screening of osteosarcopenia may be helpful for better management of patients with gastric cancer.
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Affiliation(s)
- Wataru Kai
- Department of Surgery, Tokyo Generel Hospital, Tokyo, Japan
| | - Yasuhiro Takano
- Department of Surgery, Tokyo Generel Hospital, Tokyo, Japan
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | | | - Hironori Kanno
- Department of Surgery, Tokyo Generel Hospital, Tokyo, Japan
| | | | - Ken Eto
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
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