Risultati per: Sarcopenia

Objectives
To determine the association of non-alcoholic fatty liver disease (NAFLD) with the incidence of sarcopenia.

Design
Systematic review and meta-analysis of observational clinical studies.

Setting and participants
Adults with NAFLD.

Methods
Databases such as PubMed, Embase, Cochrane and Web of Science were searched for eligible studies published from the inception of each database up to 4 April 2023. All cross-sectional studies on the association between NAFLD and sarcopenia were included in this study. The quality of the included studies and risk of bias was assessed using the Agency for Healthcare Research and Quality checklist. STATA V.15.1 software was used for statistical analysis.

Results
Of the 1524 retrieved articles, 24 were included in this review, involving 88 609 participants. Our findings showed that the prevalence of sarcopenia was higher in the NAFLD group than in the control group (pooled OR 1.74, 95% CI 1.39 to 2.17). In a subgroup analysis by region, patients with NAFLD showed an increased risk of sarcopenia (pooled OR 1.97, 95% CI 1.54 to 2.51) in the Asian group, whereas patients with NAFLD had no statistically significant association with the risk of sarcopenia in the American and European groups, with a pooled OR of 1.31 (95% CI 0.71 to 2.40) for the American group and a pooled OR of 0.99 (95% CI 0.21 to 4.69) for the European group. Similar results were observed in the sensitivity analysis, and no evidence of publication bias was observed.

Conclusions and implications
The current study indicated a significant positive correlation between NAFLD and sarcopenia, which may be affected by regional factors. This study provides the correlation basis for the relationship between NAFLD and sarcopenia and helps to find the quality strategy of sarcopenia targeting NAFLD.

Objectives
There are limited data on the relationship between sleep duration and possible sarcopenia. Hence, this study aimed to investigate the associations of sleep duration with possible sarcopenia and its defining components based on the China Health and Retirement Longitudinal Study (CHARLS).

Design
A retrospective cohort study.

Setting
This study was conducted on participants aged over 45 years applying the 2011 baseline and 2015 follow-up survey from CHARLS covering 450 villages, 150 counties and 28 provinces.

Participants
Data from 5036 individuals (2568 men and 2468 women) free of possible sarcopenia at baseline were analysed.

Primary and secondary outcome measures
The dose-response relationship between sleep duration and possible sarcopenia.

Results
During 4 years of follow-up, 964 (19.14%) participants developed possible sarcopenia. Compared with participants who slept 6–8 hours per night, those with shorter sleep duration (8 hours per night) was not significantly associated with incident possible sarcopenia. The plots of restricted cubic splines exhibited an atypical inverse J-shaped association between sleep duration and possible sarcopenia. Subgroup analysis showed a stronger association between sleep duration and possible sarcopenia in participants aged 45–59 years and composed of male populations.

Conclusions
Short sleep duration was a potential risk factor for possible sarcopenia and low handgrip strength. The improvement of sleep duration should be considered a target in early preventive and administrative strategies against the development of handgrip strength decline and further reduced the occurrence of sarcopenia.

Objective
This review aims to provide an estimate of sarcopenia prevalence and its impact on clinical characteristics in patients with systemic sclerosis (SSc).

Design
Systematic review and meta-analysis.

Data sources
Embase, Medline, Web of Science and the Cochrane Central Register of Controlled Trials were systemically searched from inception to 24 May 2023.

Eligibility criteria for selecting studies
We included observational studies that reported the prevalence of sarcopenia in patients with SSc.

Data extraction and synthesis
Two reviewers independently performed study selection and data extraction using standardised methods. Risk of bias was assessed using the Agency for Healthcare Research and Quality Scale and the Newcastle–Ottawa Scale. Meta-analysis was conducted using random effects models.

Results
A total of 4583 articles were screened and 9 studies with data from 815 patients were included in the analysis (8 cross-sectional studies and 1 retrospective cohort study). The overall prevalence of sarcopenia in patients with SSc was 22% (95% CI 17% to 28%). Patients with SSc with sarcopenia had a poorer quality of life (mean difference –12.02; 95% CI –19.11 to –4.93) and higher C reactive protein (CRP) levels (standardised mean difference 0.67; 95% CI 0.35 to 1.00).

Conclusions
Sarcopenia is common in patients with SSc. Patients with SSc with sarcopenia had a worse quality of life and higher CRP levels, based on our findings. Given the detrimental impact of sarcopenia on quality of life, future efforts aimed at early identification of sarcopenia in the clinical assessment of patients with SSc may have significance.

PROSPERO registration number
CRD42022368326.

Introduction
Sarcopenia is the age-associated loss of muscle mass and strength. Nicotinamide adenine dinucleotide (NAD) plays a central role in both mitochondrial function and cellular ageing processes implicated in sarcopenia. NAD concentrations are low in older people with sarcopenia, and increasing skeletal muscle NAD concentrations may offer a novel therapy for this condition. Acipimox is a licensed lipid-lowering agent known to act as an NAD precursor. This open-label, uncontrolled, before-and-after proof-of-concept experimental medicine study will test whether daily supplementation with acipimox improves skeletal muscle NAD concentrations.

Methods and analysis
Sixteen participants aged 65 and over with probable sarcopenia will receive acipimox 250 mg and aspirin 75 mg orally daily for 4 weeks, with the frequency of acipimox administration being dependent on renal function. Muscle biopsy of the vastus lateralis and MRI scanning of the lower leg will be performed at baseline before starting acipimox and after 3 weeks of treatment. Adverse events will be recorded for the duration of the trial. The primary outcome, analysed in a per-protocol population, is the change in skeletal muscle NAD concentration between baseline and follow-up. Secondary outcomes include changes in phosphocreatine recovery rate by 31P magnetic resonance spectroscopy, changes in physical performance and daily activity (handgrip strength, 4 m walk and 7-day accelerometry), changes in skeletal muscle mitochondrial respiratory function, changes in skeletal muscle mitochondrial DNA copy number and changes in NAD concentrations in whole blood as a putative biomarker for future participant selection.

Ethics and dissemination
The trial is approved by the UK Medicines and Healthcare Products Regulatory Agency (EuDRACT 2021-000993-28) and UK Health Research Authority and Northeast – Tyne and Wear South Research Ethics Committee (IRAS 293565). Results will be made available to participants, their families, patients with sarcopenia, the public, regional and national clinical teams, and the international scientific community.

Protocol
Acipimox feasibility study Clinical Trial Protocol V.2 2/11/21.

Trial registration number
The ISRCTN trial database (ISRCTN87404878).

Objectives
The association between sarcopenia severity and fall history remains under-researched at present. Accordingly, this study was developed to evaluate the relationship between sarcopenic status and prior fall events in a multiethnic group of older community-dwelling adults in Western China.

Design
A retrospective survey study, the data comes from the West China Health and Aging Trend study.

Setting
The study was based in Western China.

Participants
In total, this retrospective analysis incorporated data from 2719 older adults (59.2% women).

Primary and secondary outcome measures
Grip strength, gait speed and skeletal muscle mass index values were analysed for all participants, and the Asian Working Group for Sarcopenia (AWGS) 2014 and 2019 consensus criteria were leveraged to assess sarcopenia status in these individuals. Prior fall history was defined by any incidents in which an individual unintentionally came to rest on the floor within the past year. The association between sarcopenia status and fall history was examined through a binary logistic regression approach, with p

Inflammatory bowel disease (IBD) can impact patients’ nutritional status. Poor oral intake, poor nutrient absorption, stool protein loss, and increased energy requirement all contribute. Poor nutritional status can manifest as inadequate growth, reduced weight gain, and sarcopenia, defined as decreased muscle mass and strength. Studies demonstrate decreased muscle mass in pediatric IBD patients leads to higher rates of therapy escalation, surgery, and post-operative complications. We sought to obtain the muscle mass at IBD diagnosis via cross-sectional imaging, compare to pediatric age- and sex-specific psoas muscle reference values for pediatric norms, and analyze muscle mass comparison between IBD subtypes and correlations with anthropometrics at diagnosis.

Introduction
Sarcopenia is characterised by age-related loss of skeletal muscle and function and is associated with risks of adverse outcomes. The prevalence of sarcopenia increases due to ageing population and effective interventions is in need. Previous studies showed that β-hydroxy β-methylbutyrate (HMB) supplement and vibration treatment (VT) enhanced muscle quality, while the coapplication of the two interventions had further improved muscle mass and function in sarcopenic mice model. This study aims to investigate the efficacy of this combination treatment in combating sarcopenia in older people. The findings of this study will demonstrate the effect of combination treatment as an alternative for managing sarcopenia.

Methods and analysis
In this single-blinded randomised controlled trial, subjects will be screened based on the Asian Working Group for Sarcopenia (AWGS) 2019 definition. 200 subjects who are aged 65 or above and identified sarcopenic according to the AWGS algorithm will be recruited. They will be randomised to one of the following four groups: (1) Control+ONS; (2) HMB+ONS; (3) VT+ONS and (4) HMB+VT + ONS, where ONS stands for oral nutritional supplement. ONS will be taken in the form of protein formular once/day; HMB supplements will be 3 g/day; VT (35 Hz, 0.3 g, where g=gravitational acceleration) will be received for 20 mins/day and at least 3 days/week. The primary outcome assessments are muscle strength and function. Subjects will be assessed at baseline, 3-month and 6-month post treatment.

Ethics and dissemination
This study was approved by Joint CUHK-NTEC (The Chinese University of Hong Kong and New Territories East Cluster) Clinical Research Management Office (Ref: CRE-2022.223-T) and conformed to the Declaration of Helsinki. Trial results will be published in peer-reviewed journals and disseminated at academic conferences.

Trial registration number
NCT05525039.

Circulation, Volume 148, Issue Suppl_1, Page A16118-A16118, November 6, 2023. Introduction:Aging is the leading risk factor for multiple chronic diseases especially cardio and cerebrovascular and for a decline in physical and mental function. Progressive stiffening arterial wall, cognitive impairment and sarcopenia are hallmarks of aging. Due to the pleiotropic actions that have been discovered in vitamin D (VD), which include vascular ,muscular and cognitive effects, we hypothesized that VD3 supplementation might decrease vascular stiffness and could have beneficial effect on mental status and sarcopenia in a frailty elderly population.Methods:We randomized 42 residents (78±6.5 yo; 24 females) from a public geriatric institution, to receive either 100,000 IU of VD3 or placebo (P) every 15 days for 6 months. Arterial stiffness (AS) was evaluated through central systolic pressure (cSYS), central pulse pressure (cPP), and the augmentation index (AIx) a measure of systemic AS derived from the ascending aortic pressure waveform; using Uscom® device. Cognitive function was evaluated using the Clock-Drawing Test (CDT), which is simple and effective for this population. Skeletal muscle strength/sarcopenia, were assess with the up and go test (UGT), muscle strength with hydraulic dynamometer, body mass index (BMI) and mini-nutritional assessment (MNA) test.Results:VD group showed a statistically significant decrease in AS vs P. VD Δ cSYS -12.3 mmHg, Δ cPP -6.7 mmHg mmHg and Δ AIx -17.8 %, for all three parameters: p

Circulation, Volume 148, Issue Suppl_1, Page A13076-A13076, November 6, 2023. Background:The Geriatric Nutrition Risk Index (GNRI) is a simple nutritional assessment tool used in elderly patients. Sarcopenia, defined as reduced muscle mass strength, is widely prevalent in patients with advanced heart failure, and has been associated with worse clinical outcomes including post-transplant infections and mortality but is not routinely assessed. The relationship between GNRI and sarcopenia in advanced heart failure patients undergoing cardiac transplantation has not been well-established.Aims/Hypotheses:The primary outcome was to determine if GNRI was associated with sarcopenia as diagnosed using pectoralis muscle area index. We hypothesize that patients with a higher nutritional risk (GNRI < 92) will have higher rates of sarcopenia.Methods:Patients who underwent cardiac transplantation from January 2018 to June 2022 and who underwent preoperative chest CT scans were included. GNRI was calculated using albumin, height and weight on the day of transplant. Previous literature has defined malnutrition status as a GNRI < 92. The primary outcome was sarcopenia which was diagnosed as pectoralis muscle area index in the lowest sex-specific tertile.Results:172 patients were included in the primary analysis and were stratified into high (GNRI92) nutritional risk. Patients with high nutritional risk had a lower BMI than those with low nutritional risk. Patients with high nutritional risk were more likely to meet criteria for sarcopenia than those with low risk (56.5% vs 28.9%, p=0.02). Additionally, patients with high nutritional risk had a longer hospital length of stay at their index hospitalization than patients with low nutritional risk (29 vs 22 days, p=0.03). There were no significant differences by nutritional risk in outcomes of rehospitalizations, days alive and out of the hospital, or death.Conclusions:Lower GNRI (higher nutritional risk) was associated with a greater prevalence of sarcopenia in patients undergoing cardiac transplantation. This index may represent a simple screening tool utilizing readily available data to ascertain sarcopenia in patients with advanced heart failure.

Circulation, Volume 148, Issue Suppl_1, Page A17932-A17932, November 6, 2023. Background:Sarcopenia and smoking are independently associated with worse heart failure (HF) outcomes; therefore, their combined effect is likely even more detrimental.Research Questions:We studied the impact of sarcopenia and smoking on outcomes in patients admitted for acute decompensated HF (ADHF).Methods:We conducted a retrospective cohort study of 406 consecutive patients hospitalized at our tertiary care center for ADHF from 2017 to 2020 with computed tomography of the chest one month before the discharge date. Semi-automatic measurements were made at T12 (Figure 1A) and adjusted for height squared to obtain skeletal muscle index (SMI). To compare survival, patients were divided into four groups: nonsarcopenic nonsmokers (controls, 22.4%), sarcopenic nonsmokers (10.6%), nonsarcopenic smokers (44.3%), and sarcopenic smokers (22.7%). Sarcopenia was the lowest sex-stratified SMI tertile (cutoffs of 29.6 cm2/m2in males and 25.7 cm2/m2in females), and smokers were those who had ever smoked.Results:The mean admission age of our cohort was 70±14 years, 44.3% were female, and 67.0% had a smoking history (191 former and 81 active). Compared to nonsmokers, patients with a smoking history had more COPD (53.3% vs. 18.7%, p

Circulation, Volume 148, Issue Suppl_1, Page A11787-A11787, November 6, 2023. Introduction:Sarcopenia, or reduced muscle mass and function, is underdiagnosed in advanced heart failure and is not routinely assessed. In patients receiving a left ventricular assist device (LVAD), preoperative sarcopenia, defined using CT-derived pectoralis muscle area index (muscle area indexed to height), was an independent predictor of post-operative mortality. The association between preoperative sarcopenia and outcomes after cardiac transplantation is unknown.Aims/Hypotheses:The primary aim was to determine if preoperative sarcopenia, diagnosed using pectoralis muscle area index, is an independent predictor of days alive & out of the hospital at 1-year post-cardiac transplant. We hypothesize that patients with preoperative sarcopenia will have fewer days alive & out of the hospital compared to those without.Methods:Patients who underwent cardiac transplantation from January 2018 to June 2022 with available preoperative chest CT scans (68% of total cohort) were included. Sarcopenia was diagnosed as pectoralis muscle area index in the lowest sex-specific tertile (male < 5.7 cm2/m2; female < 4.4 cm2/m2). The primary endpoint was days alive & out of the hospital at 1-year post-transplant.Results:172 patients were included of whom 32.7% met criteria for sarcopenia. Patients with sarcopenia were more likely white with lower body mass index (BMI) (23.5 vs 27.7 kg/m2). Patients with sarcopenia had fewer days alive & out of the hospital compared to those without, with a median difference of 16.5 days (320.5 vs. 337 days, p=0.004). Patients with sarcopenia had a longer index hospitalization (28.5 vs. 22 days) and were more likely to be discharged to a facility other than home (40.4% vs. 12.3%). In a linear regression model, sarcopenia was a significant univariable and the strongest multivariable predictor of days alive & out of the hospital at 1-year when controlling for diabetes status (β = -14.4, 95% CI -28, -1.2, p = 0.032).Conclusions:Preoperative sarcopenia, diagnosed using pectoralis muscle area index, is an independent predictor of poor outcomes after cardiac transplant. This parameter is easily measurable from commonly obtained preoperative CT scans and may be considered in the transplant evaluation as a marker of risk.

Introduction
Evidence suggests that the pathology underlying cognitive decline leading to dementia begins 15–20 years before cognitive symptoms emerge. Thus, identifying biomarkers in this preclinical phase is critically important. Age-related decrease in muscle mass and strength, a known risk factor for sarcopenia, frailty and cognitive decline, also affects the tongue. This paper describes an a priori protocol by a multidisciplinary team to address the following questions relating to adults ≥50 years of age: (1) What is the current evidence on the association of tongue strength with cognitive decline? (2) How does tongue strength associate with frailty and sarcopenia? (3) What is the association of tongue strength with nutritional health?

Methods and analysis
Search terms will be identified then multiple electronic databases (PubMed, PsycINFO (Ovid), Scopus, Embase (Ovid), CINAHL and Web of Science) searched systematically for peer-reviewed articles published in English that address the following inclusion criteria: (1) human studies, (2) participants ≥50 years of age and (3) studies with tongue pressure values measured in relation to at least one of the following: frailty, sarcopenia, nutritional health, cognitive function and dementia (Alzheimer’s, vascular, frontotemporal and Lewy body). Grey literature also will be searched to identify additional studies, clinical trials and policy papers appropriate for inclusion. The search will be from database inception. After removing duplicates, two research team members will independently screen abstracts and identify articles for full-text review. The team will use a data charting tool for data extraction. Data will be analysed quantitatively and qualitatively.

Ethics and dissemination
The scoping review does not require ethics approval as data will be from publicly available sources. Results will be disseminated in workshops and conferences and a peer-reviewed journal paper.