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Background: Sarcopenia, characterized by loss of muscle mass and function, has gained importance in the evaluation of cirrhotic patients. Evidence suggests its role in adverse clinical outcomes, including minimal hepatic encephalopathy (MHE). This study aimed to investigate the association between sarcopenia and MHE in patients with cirrhosis. Methods: We prospectively enrolled outpatients with cirrhosis to assess sarcopenia using the 2019 criteria from the Asian Working Group for Sarcopenia. MHE was diagnosed through the Psychometric Hepatic Encephalopathy Score. Results: Of the 210 cirrhotic patients (57.1% male, mean age 62.7 ± 9.6 years), 54 (25.7%) had sarcopenia, with 26 (12.3%) classified as severe. Thirty-seven patients (17.6%) were diagnosed with MHE. Sarcopenia prevalence was significantly higher in patients with MHE compared to those without MHE (45.9% vs. 21.4%). MHE was significantly associated with age, education level, Mini-Mental State Examination score, and a history of hepatic decompensation. No significant associations were found regarding gender, body mass index, comorbidities, sleep quality, and the etiology of cirrhosis. Multivariable logistic regression showed that MHE was significantly associated with age (adjusted odds ratio [aOR] 1.08, 95% CI 1.02–1.13), sarcopenia (aOR 3.29, 95% CI 1.44–7.50), history of overt hepatic encephalopathy (aOR 7.40, 95% CI 1.20-45.56), and variceal bleeding (aOR 3.13, 95% CI 1.38–7.10). Severe sarcopenia was also independently associated with MHE (aOR 3.64, 95% CI 1.32–10.05). Conclusions: Sarcopenia is prevalent in cirrhotic patients and is associated with an increased risk of MHE. Our findings emphasize the importance of assessing sarcopenia to potentially mitigate MHE risk in managing patients with cirrhosis. [ABSTRACT FROM AUTHOR]

Background: Gastric cancer remains a major health concern worldwide, with locally advanced gastric cancer (LAGC) posing significant challenges due to frequent lymph node metastasis and poor prognosis. While curative gastrectomy with D2 lymph node dissection is the standard treatment, sarcopenia and perioperative skeletal muscle loss (SML) have emerged as critical prognostic factors. Methods: We retrospectively analyzed 198 LAGC patients who underwent curative gastrectomy. Preoperative and postoperative sarcopenia were assessed via computed tomography (CT)-derived skeletal muscle index (SMI) at the L3 level. SML was defined based on sex-specific thresholds of SMI changes (%/30 days). Prognostic significance for overall survival (OS) and disease-free survival (DFS) was evaluated using Kaplan-Meier and Cox regression analyses. Results: The prevalence of sarcopenia increased from 23.7% preoperatively to 33.3% postoperatively. Patients with significant muscle loss (SML) showed worse OS and DFS compared to non-SML patients (P < 0.05). SML was also associated with a higher incidence of Clavien-Dindo grade ≥ 3a complications (P < 0.05). Multivariate analysis identified preoperative sarcopenia (HR = 2.332, P = 0.001), postoperative sarcopenia (HR = 3.189, P = 0.011), and SML (HR = 11.231, P = 0.002) as independent risk factors for OS. Adjuvant chemotherapy significantly improved both OS (HR = 0.532, P = 0.015) and DFS (HR = 0.587, P = 0.041). Conclusions: Both preoperative sarcopenia and perioperative SML may negatively impact postoperative prognosis in LAGC patients, suggesting that perioperative evaluation of skeletal muscle mass may help identify high-risk surgical candidates for targeted interventions. [ABSTRACT FROM AUTHOR]

Objectives: Sarcopenia is a common geriatric syndrome that significantly increases the risk of falls, fractures, disability, and death in older adults. Sensory impairments are also prevalent among the elderly and may exacerbate the decline in physical function, even affecting muscle health. Understanding whether sensory impairments are risk factors affecting sarcopenia in older adults is crucial for developing effective public health policies and intervention strategies. Therefore, this study aims to explore the association between sensory impairments and sarcopenia and its components. Methods: This study, based on the Chinese Health and Retirement Longitudinal Study (CHARLS), included 4,195 participants aged 60 and above. The assessment of sensory impairment was based on self-reported visual and hearing capabilities. The diagnosis of sarcopenia followed the consensus of the Asian Working Group on Sarcopenia (AWGS) from 2019. Data analysis was conducted using an ordered logistic regression model, and the results report the odds ratios (ORs) and their 95% confidence intervals (CI). Results: Single sensory impairments at baseline showed no significant correlation with sarcopenia four years later, while dual sensory impairments (DSI) at baseline were significantly associated with sarcopenia (ORs: 1.308, 95% CI: 1.126–1.519). In the analysis of trends over time, transitions from no sensory impairments (NSI) to DSI (ORs: 1.372, 95% CI: 1.028–1.830), from hearing impairments (HI) to DSI (ORs: 1.334, 95% CI: 1.002–1.778), and persistent DSI (ORs: 1.470, 95% CI: 1.159–1.864) were all significantly associated with sarcopenia. Additionally, we found DSI is associated with poor physical performance and muscle mass but not muscle strength. Conclusions: Our study indicates that DSI have a more severe impact on sarcopenia compared to single sensory impairments. Our findings offer a new perspective for prevention and intervention strategies, suggesting the inclusion of sensory impairment assessments in the clinical evaluation of sarcopenia risk. For elderly individuals with DSI, comprehensive intervention measures should be provided, such as sensory rehabilitation, nutritional support, and guidance on physical activities. For those with only a single sensory impairment, proactive preventive measures should be taken to prevent the progression to DSI. [ABSTRACT FROM AUTHOR]

Background & aims: Sarcopenia, characterized by the loss of muscle mass and strength, is a significant concern in cirrhotic patients. Nutritional interventions have been explored for its management, but the comparative efficacy of these interventions remains unclear. This study synthesizes current evidence to evaluate the effectiveness of nutritional interventions for sarcopenia in cirrhosis. Methods: Data sources included Scopus, PubMed, Web of Science Core Collection, and Cochrane Library up to Dec 2024. Eligible trials compared different nutritional interventions against control diets, placebos, or each other. A Bayesian network meta-analysis was performed to combine direct and indirect evidence. Effect sizes were calculated as mean differences (MD) with 95% confidence intervals (CIs). Intervention rankings were assessed using P-score, and evidence quality was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. Results: A total of 14 randomized controlled trials (RCTs) involving 1,437 patients met the inclusion criteria. For improving muscle mass (MAMC), post-paracentesis intravenous nutritional support combined with an oral nutritional protocol (Treat A) showed the greatest effect compared to high-calorie, high-protein diets (HCHP) (MD: 2.78 cm, 95% CI: 1.15 to 4.40, low certainty), and oral nutritional protocol (Treat B) (MD of 3.41 cm, 95% CI: 2.12, 4.69). For muscle strength, the HINT diet (MD: 8.01 kg, 95% CI: 7.64 to 8.37, low certainty) and the HCHP (MD: 5 kg, 95% CI: 3.90 to 6.10, low certainty) were more effective than control diets. HCHP also demonstrated greater handgrip improvement than the HINT diet (MD: 3.00 kg, 95% CI: 1.84, 4.16; low certainty evidence). BCAA combined with vitamin D (2000 IU once a day) significantly improved skeletal muscle index (SMI) compared to both BCAA (MD: 0.72 kg/m2, 95% CI: 0.11 to 1.34; low certainty evidence) and placebo (MD: 0.25 kg/m2, 95% CI: -0.05 to 0.05; very low certainty evidence). BCAA supplementation effectively improved handgrip strength compared to placebo (MD: 2.36 kg, 95% CI: 1.85, 2.88; low certainty evidence). Conclusions: Post-paracentesis intravenous nutritional support combined with an oral nutritional protocol effectively improves muscle mass, while high-calorie, high-protein diets enhance handgrip strength. BCAA supplementation alone or with vitamin D has been shown to effectively enhance muscle strength and muscle mass. However, these findings should be interpreted cautiously due to low evidence certainty. [ABSTRACT FROM AUTHOR]

Objectives: In previous studies, several inflammatory biomarkers derived from complete blood cell counts (CBC), such as systemic immune inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), and non‑high‑density lipoprotein cholesterol to high‑density lipoprotein cholesterol ratio (NHHR) have been identified as predictors of sarcopenia. However, whether Monocyte to High-Density Lipoprotein Cholesterol Ratio (MHR) can predict the development of sarcopenia has not yet been established. The research first attempts to investigate the association between MHR and low muscle mass and to compare the predictive abilities of MHR, SII, NLR, and NHHR for low muscle mass risk. Methods: The study comprised 10,321 participants aged 20 years and above from the United States. Multiple logistic regression was performed to explore the association between ln-transformed MHR, SII, NLR, NHHR and low muscle mass. Additionally, AUC values and ROC curves were used to assess the predictive effectiveness of ln MHR and other markers (ln SII, ln NLR, ln NHHR, ln MHR + ln SII, ln MHR + ln NHHR, and ln MHR + ln NLR). The bootstrap estimated 95% Cl was shown with the AUC. Results: In the fully adjusted model, ln SII, ln NLR, ln NHHR, ln MHR, ln MHR + ln SII, ln MHR + ln NHHR, and ln MHR + ln NLR were positively associated with low muscle mass (ln SII: OR = 1.59 [1.37–1.84]; ln NLR: OR = 1.35 [1.13–1.60]; ln NHHR: OR = 1.49[1.27–1.75]; ln MHR: OR = 1.98 [1.68–2.33]; ln MHR + ln SII: OR = 1.61 [1.46–1.79]; ln MHR + ln NHHR: OR = 1.42 [1.29–1.56]; ln MHR + ln NLR: OR = 1.58 [1.41–1.78]). Compared to the lowest quartile of ln MHR, higher quartiles were significantly associated with increased odds of low muscle mass (P for trend < 0.0001). In ROC analysis, ln MHR + ln SII had a higher AUC value than other indicators (AUC = 0.608). Conclusion: Ln-transformed MHR, SII, NLR, and NHHR were positively associated with low muscle mass. MHR outperforms SII, NLR, and NHHR in predicting sarcopenia. [ABSTRACT FROM AUTHOR]

This study aimed to compare the anthropometric and physical characteristics of elite 15-, 16-, and 17-year-old male soccer players by playing position. We recruited 238 players under 17 years of age from Chinese professional soccer clubs. The measurements included body height and mass, body girth and length, and body composition. The countermovement jump (CMJ), T-test, and Yo-Yo intermittent recovery test level 1 (YYIR1) were used to assess physical ability. The results revealed that the U16 and U17 players had significantly greater body mass (p < 0.05), body height (p < 0.05), muscle mass (p < 0.05), lower limb length (p < 0.05), and chest girth (p < 0.05) than did the U15 players. Significant differences in calf girth (p < 0.001), thigh girth (p < 0.05), and Achilles tendon length (p < 0.05) were observed between the U17 group and U15 group. Additionally, the U16 group and U17 group both scored significantly better than the U15 group on the 5-m sprinting test, 20-m sprinting test, 30-m sprinting test (p < 0.001), single left jump test with arm swing (p < 0.001), single right jump test with arm swing (p < 0.001), T-test (p < 0.001), CMJ test (p < 0.001), and YYIR test (p < 0.001). Furthermore, U17 players performed significantly better on the CMJ test (p < 0.001) and YYIR test (p < 0.001) than U16 players did. This study revealed significant differences in body height, body mass, muscle mass, chest girth, lower limb length, ankle circumference, calf length, Achilles tendon length, 20-m speed, 30-m speed, and YYIR test results among the six playing position groups. Goalkeepers and central defenders had significantly greater body heights than players at other playing positions. Goalkeepers scored significantly lower on the YYIR test than players in other positions did. These findings revealed the anthropometric and physical characteristics of elite 15-17-year-old male soccer players in China, helping soccer coaches better understand the anthropometric and physical characteristics across ages and playing positions when selecting youth soccer players and optimizing soccer training programs. Moreover, youth soccer players can gain insights into their own strengths and weaknesses, enabling them to develop training for personal improvement. [ABSTRACT FROM AUTHOR]

Background: Among cancer patients, pancreatic cancer patients have the highest rate of sarcopenia, which is a critical prognostic factor. Serum creatine kinase (CK) is closely related to skeletal muscle mass and has been reported to decline with the progression of cancer. This study investigated whether preoperative serum CK is associated with the survival of patients with pancreatic cancer. Methods: Data were obtained from patients with pathologically confirmed pancreatic cancer between June 2016 and March 2022. The prognostic significance of CK was analyzed based on sex-stratified groups. The Kaplan-Meier method was used to compare overall survival (OS) and disease-free survival (DFS). Multivariate Cox proportional hazards models were used to determine prognostic factors. Body composition was analyzed based on preoperative abdominal CT images to explore the sex-specific associations between skeletal muscle area (SMA) and serum CK levels. Results: A total of 166 patients were included in this study. Sarcopenia was presented in 70 patients (42.2%). A low serum CK level showed a significant correlation with the diagnosis of sarcopenia in male patients (P = 0.026). The levels of CK did not predict the outcome in female patients, while a low preoperative CK was notably linked to shorter OS in male patients (median OS: 15 months vs. 33 months, P = 0.011; median DFS: 5 months vs. 14 months, P = 0.007). Multivariate analyses further confirmed the effect of CK in predicting OS (CK>44 IU/L, HR:0.226, 95% CI:0.107–0.478, P < 0.001) and DFS (CK>44 IU/L, HR:0.272, 95% CI:0.139–0.529, P < 0.001) of male patients. Correlation analysis revealed a significant association between SMA and CK levels in male patients (r = 0.225, P = 0.025), and such a correlation was not observed in female patients (r = 0.088, P = 0.478). Conclusion: The pretherapeutic CK may represent a simple marker for predicting poor survival in male patients with resectable pancreatic cancer, thereby aiding in the selection of therapeutic strategies. [ABSTRACT FROM AUTHOR]

Background: The metabolic score for visceral fat (METS-VF) is a recently identified index for evaluating visceral fat, also referred to as abdominal obesity. The skeletal muscle mass index (SMI) serves as a critical measure for assessing muscle mass and sarcopenia. Both obesity and the reduction of muscle mass can significantly affect human health. However, research exploring the relationship between METS-VF and SMI remains limited. This study aims to investigate whether a association exists between these two indices, and if so, to elucidate the nature of their interactions. Methods: We conducted a cross-sectional study using data from the NHANES database, focusing on U.S. adults aged 20 years and older from 2013 to 2018. Controlling for relevant covariables, we primarily investigated the association between METS-VF and SMI values utilizing weighted multivariable linear regression models. Additionally, we assessed the diagnostic efficacy of METS-VF for sarcopenia. Results: A total of 3,594 participants were included in this study for analysis. The final adjusted model from the weighted multivariable linear regression indicated that METS-VF was negatively associated with SMI, with a coefficient of β = -0.13 (95% CI: -0.14, -0.12; P < 0.001). Subgroup analyses further demonstrated that this negative association was consistent across different populations. Notably, the negative association varied significantly between diabetic and nondiabetic population, as well as among populations classified by different BMI categories. Additionally, threshold effect analysis identified a significant inflection knot at 6.33. The characteristic curves of the subjects' work illustrated that, compared to other indicators, METS-VF exhibited excellent diagnostic efficacy for sarcopenia, with an area under the curve (AUC) of 0.825. Conclusion: Our results indicate that METS-VF is negatively correlated with SMI among adults in the United States, suggesting that visceral obesity exerts a detrimental effect on muscle mass. Furthermore, METS-VF shows potential as a valuable indicator for assessing SMI and sarcopenia. These findings underscore the importance of considering lipid metabolism disorders in the context of muscle health and highlight the potential for developing prevention strategies for sarcopenia. [ABSTRACT FROM AUTHOR]

Background: The synchronized absorption of amino acids (AAs) and glucose in the gut is crucial for effective AA utilization and protein synthesis in the body. The study investigated how the starch digestion rate and AA levels impact intestinal AA digestion, transport and metabolism, breast muscle protein metabolism, and growth in grower broilers. A total of 720 21-day-old healthy male Arbor Acres Plus broilers were randomly assigned to 12 treatments, each with 6 replicates of 10 birds. The treatments comprised 3 different starch [corn: control, cassava: rapidly digestible starch (RDS), and pea: slowly digestible starch (SDS)] with 4 different AA levels [based on standardized ileal digestible lysine (SID Lys), 0.92%, 1.02% (as the standard), 1.12% and 1.22%]. Results: An interaction between dietary starch sources and SID Lys levels significantly affected breast muscle yield (P = 0.033). RDS and SDS diets, or SID Lys levels of 0.92%, 1.02%, or 1.22%, significantly decreased the breast muscle yield of broilers in contrast to the corn starch diet with 1.12% SID Lys (P = 0.033). The SID Lys levels of 1.12% and 1.22% markedly improved body weight (BW), body weight gain (BWG) from 22 to 42 days of age, and mRNA expression of y+LAT1 and mTOR while reducing feed intake (FI) and feed/gain ratio (F/G) compared to the 0.92% SID Lys level (P < 0.05). The SDS diet significantly decreased BW and BWG of broilers from 22 to 42 days of age, distal ileal starch digestibility, jejunal amylase and chymotrypsin activities, and mRNA expression of GLUT2 and y+LAT1 compared to the corn starch diet (P < 0.05). The RDS diet suppressed the breast muscle mass by down-regulating expression of mTOR, S6K1, and eIF4E and up-regulating expression of MuRF, CathepsinB, Atrogin-1, and M-calpain compared to the corn starch diet (P < 0.05). Targeted metabolomics analysis revealed that the SDS diet significantly increased acetyl-CoA and α-ketoglutaric acid levels in the tricarboxylic acid (TCA) cycle (P < 0.05) but decreased the ileal digestibility of Lys, Tyr, Leu, Asp, Ser, Gly, Pro, Arg, Ile, and Val compared to the corn starch group (P < 0.05). Conclusion: The SDS diet impaired broiler growth by reducing intestinal starch digestibility, which inhibited intestinal AA and glucose absorption and utilization, increased AA oxidation for energy supply, and lowered the efficiency of protein synthesis. Although the RDS diet resulted in growth performance similar to the corn starch diet, it reduced breast muscle mass by inhibiting protein synthesis and promoting degradation. [ABSTRACT FROM AUTHOR]

Cardiolipin, a unique phospholipid predominantly present in the inner mitochondrial membrane, is critical for maintaining mitochondrial integrity and function. Its dimeric structure and role in supporting mitochondrial dynamics, energy production, and mitophagy make it indispensable for skeletal muscle health. This review provides a comprehensive overview of cardiolipin biosynthesis, remodeling processes, and essential functions within mitochondria. We explore the influences of cardiolipin on the stability of the mitochondrial complexes, cristae formation, and calcium handling, all of which are vital for efficient oxidative phosphorylation and muscle contraction. Skeletal muscle, with its high energy demands, is particularly dependent on cardiolipin for optimal performance. We discuss the impact of aging on cardiolipin levels, which correlates with a decline in mitochondrial function and muscle mass, contributing to conditions such as sarcopenia. Furthermore, we examined the relationship between cardiolipin and endurance exercise, highlighting the effects of exercise-induced increase in cardiolipin levels on the improvement of mitochondrial function and muscle health. The role of Crls1 in cardiolipin synthesis has been emphasized as a potential therapeutic target for the treatment of sarcopenia. Increasing cardiolipin levels through gene therapy, pharmacological interventions, or specific exercise and nutritional strategies holds promise for mitigating muscle atrophy and promoting muscle regeneration. By focusing on the multifaceted role of cardiolipin in mitochondria and muscle health, we aimed to provide new insights into therapeutic approaches for enhancing muscle function and combating age-related muscle decline. Cardiolipin and Crls1 were reduced in aged skeletal muscle, contributing to mitochondrial dysfunction and muscle atrophy. In aged skeletal muscle, reduced CL levels are directly associated with impaired mitochondrial respiration capacity and structural degradation. Upregulating CL synthesis enhances mitochondrial function by stabilizing ETC proteins, increasing oxygen flux, and improving cristae architecture. Therapeutic strategies, including CL-targeting compounds like elamipretide and gene therapy, show promise for mitigating sarcopenia by improving mitochondrial bioenergetics and muscle regeneration. [ABSTRACT FROM AUTHOR]

Background: Depression presents sexual dimorphism, and one important factor that increases the frequency of depression and contributes to sex-specific variations in its presentation is obesity. The conventional use of Body Mass Index (BMI) as an indicator of obesity is inherently limited due to its inability to distinguish between fat and lean mass, which limits its predictive utility for depression risk. Implementation of dual-energy X-ray absorptiometry (DXA) investigated sex-specific associations between body composition (fat mass, appendicular lean mass) and depression. Methods: Data from the NHANES cycles between 2011 and 2018 were analyzed, including 3,637 participants (1,788 males and 1,849 females). Four body composition profiles were identified in the subjects: low adiposity-low muscle (LA-LM), low adiposity-high muscle (LA-HM), high adiposity-low muscle (HA-LM) and high adiposity-high muscle (HA-HM). After accounting for confounding variables, the associations between fat mass index (FMI), appendicular skeletal muscle mass index (ASMI), body fat percentage (BFP), body composition phenotypes, and depression risk were assessed using restricted cubic spline (RCS) curves and multivariable logistic regression models. We further conducted interaction analyses for ASMI and FMI in females. Results: RCS curves indicated a U-shaped relationship between ASMI and the risk of depression in males. Logistic regression analysis revealed that in males, the second (OR = 0.43, 95%CI:0.22–0.85) and third (OR = 0.35, 95%CI:0.14–0.86) quartile levels of ASMI were significantly negatively associated with depression risk. In females, increases in BFP (OR = 1.06, 95%CI:1.03–1.09) and FMI (OR = 1.08, 95% CI:1.04–1.12) were significantly associated with an increased risk of depression. Additionally, compared to females with a low-fat high-muscle phenotype, those with LA-LM (OR = 3.97, 95%CI:2.16–7.30), HA-LM (OR = 5.40, 95%CI:2.34–12.46), and HA-HM (OR = 6.36, 95%CI:3.26–12.37) phenotypes were more likely to develop depression. Interestingly, further interaction analysis of ASMI and FMI in females revealed an interplay between height-adjusted fat mass and muscle mass (OR = 4.67, 95%CI: 2.04–10.71). Conclusion: The findings demonstrate how important it is to consider body composition when estimating the risk of depression, particularly in females. There is a substantial correlation between the LA-LM, HA-LM, and HA-HM phenotypes in females with a higher prevalence of depression. It is advised to use a preventative approach that involves gaining muscle mass and losing fat. [ABSTRACT FROM AUTHOR]

Background: The oxidative handicap hypothesis posits that testosterone-dependent traits, such as muscle mass and strength, may be costly to develop due to testosterone's pro-oxidative properties, leading to increased oxidative stress. This hypothesis suggests that only individuals with superior biological conditions can afford these costs. This study examines the oxidative handicap hypothesis, exploring the relationship between muscle mass or handgrip strength and oxidative stress markers in men. Methods: Handgrip strength and muscle mass were measured in 179 men, with muscle mass assessed using bioelectrical impedance analysis (BIA) and handgrip strength measured using a hydraulic dynamometer. Serum testosterone levels and antioxidant capacity were measured. 8-OH-dG, 8-epi-PGF2α, and protein carbonyls were measured to evaluate oxidative stress level. Pearson's correlation and multivariate regression analyses were performed to examine the relationships between handgrip strength, muscle mass, and oxidative stress markers, controlling for age, serum testosterone levels, and antioxidant capacity. Results: No significant correlations were found between handgrip strength and oxidative stress markers, even when controlling for muscle mass, antioxidant capacity, testosterone levels, and age. Conclusions: The study's findings do not support the oxidative handicap hypothesis in the context of muscle parameters in men. The results suggest that testosterone-driven traits like handgrip strength or muscle mass may not necessarily incur oxidative stress costs in healthy young men, possibly due to effective compensatory antioxidant mechanisms. Factors like lifestyle, diet, and genetic predisposition, which were not controlled in this study, could also influence the observed outcomes and should be included in future research. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to investigate the association between sarcopenia and liver fibrosis in patients aged 18–59 years with metabolic dysfunction-associated steatotic liver disease (MASLD) and to assess the potential of sarcopenia as a risk factor for the progression of liver fibrosis. Methods: The study included 821 patients with MASLD in the US cohort and 3,405 patients with MASLD in the Chinese cohort. Liver controlled attenuation parameters (CAP) and liver stiffness measurements (LSM) were assessed by vibration-controlled transient elastography (VCTE) to evaluate the extent of hepatic steatosis and fibrosis. Sarcopenia was assessed by measuring appendicular skeletal muscle mass (ASM) and calculating ASMI. To analyze the relationship between sarcopenia, ASMI, and liver fibrosis, logistic regression models, multivariate-adjusted models, and restricted cubic spline (RCS) models were employed, with stratification and interaction analyses. Results: The results demonstrated that patients with sarcopenia exhibited a markedly elevated risk of significant liver fibrosis, advanced liver fibrosis, and cirrhosis compared to those without sarcopenia in both cohorts. After adjusting for confounding variables, sarcopenia was identified as an independent risk factor for the progression of liver fibrosis in patients with MASLD. A significant negative correlation was observed between ASMI and the severity of liver fibrosis, with a progressive reduction in the risk of liver fibrosis associated with increasing ASMI. Additionally, a non-linear feature was evident in some liver fibrosis indicators. Subgroup analysis further corroborated the finding that the harmful effect of sarcopenia on liver fibrosis was consistent across all identified subgroups. Conclusion: Sarcopenia may be associated with the progression of liver fibrosis in patients with MASLD. Monitoring ASMI may assist in identifying individuals at an elevated risk of liver fibrosis in MASLD patients. [ABSTRACT FROM AUTHOR]

Background: Increased levels of inflammation in cancer patients and survivors can make them more prone to muscle wasting and sarcopenia. Diet can be an appropriate treatment for alleviating patient complications. Therefore, this study was performed to determine the association between sarcopenia and its components with the dietary inflammatory index (DII) among breast cancer survivors. Methods: A total of 223 female breast cancer survivors were included in this research at the Cancer Prevention Research Center of Seyyed Al-Shohada Hospital and the Iranian Cancer Control Charity Institute (MACSA). Forty-three items of dietary inflammatory index (DII) were extracted from the Food Frequency Questionnaire. Sarcopenia detection was performed according to the Asian criteria. The linear and binary logistic regression was used to assess the association between sarcopenia and its components with DII. Results: Participants in the highest DII quartile had significantly elevated risk of impaired hand grip strength and calf circumference in both crude and adjusted models. Moreover, individuals consuming a more pro-inflammatory diet displayed a greater risk of abnormal appendicular skeletal muscle index in the crude model. After controlling for potential confounders, participants in the top quartile of DII had a 2.992-fold greater risk of possible sarcopenia than those in the bottom quartile (P value = 0.035). In addition, a decreasing linear trend was observed between higher DII score and 0.059 and 0.349- units lower in appendicular skeletal muscle mass index and hand grip strength variables in the crude Model (P-value < 0.05). Conclusion: Diets with more pro-inflammatory features might be associated with increased risk of possible sarcopenia, as well as its components especially muscle mass and strength in women recovering from breast cancer. [ABSTRACT FROM AUTHOR]

Background: Sarcopenia is an age-related syndrome marked by a gradual decline in skeletal muscle mass and function. While various factors influencing sarcopenia have been studied, the link between daily sedentary time and sarcopenia remains underexplored. Method: This study analyzed the association between daily sitting time and sarcopenia using data from the National Health and Nutrition Examination Survey (NHANES 2011–2018). Daily sitting time was assessed through questionnaires, while sarcopenia was measured using body mass index (BMI) adjusted appendicular skeletal muscle mass (ASM). The relationship was analyzed using weighted logistic regression models and smoothing curves. Stratified analyses and interaction testing were employed to investigate population-specific characteristics of this association. Furthermore, chi-square test and grouped logistic regression were used to further analyze the impact of vigorous activity on the relationship between the two variables. Result: This study included 9998 participants with complete information. The fully adjusted model showed a significant positive correlation between daily sitting time and the prevalence of sarcopenia (OR = 1.07, 95% CI: 1.03–1.10, P = 0.0026). The group with daily sitting time ≥ 9 h had a 90% higher risk of sarcopenia compared to the < 4 h group (OR = 1.90, 95% CI: 1.22–2.84, P = 0.0040). Smooth curve fitting analysis showed a linear correlation between this relationship. Stratified analysis shows that non-Hispanic white men with a lower BMI (BMI < 25) have a higher risk of sarcopenia. Compared to those who actively participate in vigorous activities, individuals who lack recreational activities have a higher prevalence and risk of sarcopenia. Conclusion: Our research has found that increased sedentary time significantly increases the risk of sarcopenia, especially among non-Hispanic white men with lower BMI. Additionally, individuals who lack vigorous physical activity also have a higher prevalence and risk of sarcopenia. Therefore, reducing sedentary behavior and increasing moderate exercise may be effective prevention strategies. [ABSTRACT FROM AUTHOR]

In vertebrates, skeletal muscle comprises fast and slow fibers. Slow and fast muscle cells in fish are spatially segregated; slow muscle cells are located only in a superficial region, and comprise a small fraction of the total muscle cell mass. Slow muscles support low-speed, low-force movements, while fast muscles are responsible for high-speed, high-force movements. However, speed and strength of movement are not binary states, but rather fall on a continuum. This raises the question of whether any recruitment patterns exist within fast muscles, which constitute the majority of muscle cell mass. In the present study, we investigated activation patterns of trunk fast muscles during movements of varying speeds and strengths using larval zebrafish. We employed two complementary methods: calcium imaging and electrophysiology. The results obtained from both methods supported the conclusion that there are spatially-ordered recruitment patterns in fast muscle cells. During weaker/slower movements, only the lateral portion of fast muscle cells is recruited. As the speed or strength of the movements increases, more fast muscle cells are recruited in a spatially-ordered manner, progressively from lateral to medial. We also conducted anatomical studies to examine muscle fiber size. The results of those experiments indicated that muscle fiber size increases systematically from lateral to medial. Therefore, the spatially ordered recruitment of fast muscle fibers, progressing from lateral to medial, correlates with an increase in fiber size. These findings provide significant insights into the organization and function of fast muscles in larval zebrafish, illustrating how spatial recruitment and fiber size interact to optimize movement performance. [ABSTRACT FROM AUTHOR]

Background: The long-term relationship between body composition and lung function has not yet been fully demonstrated. We investigated the longitudinal association between muscle-to-fat (MF) ratio and lung function among middle-aged general population. Methods: Participants were enrolled from a community-based prospective cohort between 2005 and 2014. Lung function parameters (forced vital capacity [FVC], forced expiratory volume in 1 s [FEV1], and FEV1/FVC) and the MF ratio (total body muscle mass [kg]/fat mass [kg]) were assessed biannually via spirometry and bioelectrical impedance analysis, respectively. Results: We followed up 4,712 participants (age 53.9 ± 7.9 years, men 45.8%) for 8 years. With an increase in MF ratio of 1, in men, the FVC increased by 43.9 mL, FEV1 by 37.6 mL, and FEV1/FVC by 0.320%, while in non-smoking women, the FVC increased by 55.8 mL, FEV1 by 44.3 mL, and FEV1/FVC by 0.265% (all P < 0.001). The MF ratio-decreased group showed further annual deterioration in lung function than the MF ratio-increased group (men: FVC − 44.1 mL vs. -28.4 mL, FEV1 -55.8 mL vs. -39.7 mL, FEV1/FVC − 0.53% vs. -0.42%; non-smoking women: FVC − 34.2 mL vs. -30.3 mL, FEV1 -38.0 mL vs. -35.2 mL; all P < 0.001, except FEV1 in non-smoking women; P = 0.005). The odds ratio for the incidence of airflow obstruction according to the MF ratio was 0.77 (95% CI, 0.68–0.87) in men and 0.85 (95% CI, 0.74–0.97) in non-smoking women. Conclusions: Long-term changes in the MF ratio are related to lung function deterioration and incidence of airflow obstruction in middle-aged general population. [ABSTRACT FROM AUTHOR]

Background: With the increasing number of older adults, musculoskeletal disorders such as sarcopenia have become increasingly important to research because of their strong association with falls and fractures. Sarcopenia, which is characterized by reduced muscle mass, is common among older adults and significantly increases the risk of falls. This study aimed to assess the effectiveness of the SARC-F and SARC-CalF questionnaires, along with calf circumference measurements, for sarcopenia screening among Thai community-dwelling older adults, following the 2019 criteria of the Asian Working Group for Sarcopenia. Methods: This analysis drew on data from the Thai Musculoskeletal Diseases Nationwide Study, which included 2543 participants aged 60 years or older. The SARC-F, SARC-CalF, and calf circumference data were evaluated against the 2019 Asian Working Group for Sarcopenia criteria. We calculated the sensitivity, specificity, and area under the curve to determine the diagnostic performance of each tool. Results: Of the 2455 participants analyzed, 18.1% were diagnosed with sarcopenia. The SARC-F and SARC-CalF questionnaires showed limited effectiveness in diagnosing sarcopenia, with area under the curve values of 0.508 and 0.729, respectively. In contrast, calf circumference demonstrated greater diagnostic accuracy, with area under the curve values of 0.897 in males and 0.878 in females. Adjusting the cutoff points to < 33 cm for males and < 31 cm for females improved the overall diagnostic accuracy from 66.4 to 82%. Conclusions: Sarcopenia is relatively prevalent in Thailand. The SARC-F and SARC-CalF questionnaires are inadequate for diagnosing sarcopenia, while calf circumference alone is the most effective screening tool. Adding more parameters to the SARC-F questionnaire could enhance its diagnostic accuracy. Trial registration: This study was registered at ClinicalTrials.gov (NCT06558617). Registration Date 16 August 2024. [ABSTRACT FROM AUTHOR]

Background: Hypertension and muscle strength are known to be associated; however, identifying simple clinical indicators of this relationship is challenging. Relative muscle strength (RMS), defined as strength per unit muscle mass, has been proposed as a potential indicator, but its association with hypertension is unclear. This study aimed to estimate the prevalence of hypertension and determine its association with RMS in an adult Indian population attending a tertiary care center in Gujarat. Methods: This hospital-based cross-sectional study included 430 adults aged 18 years and older who were admitted to outpatient medicine clinics between January and October 2023. Grip strength and appendicular lean muscle mass (ALM), estimated using a validated formula, were measured. The RMS was calculated as grip strength/ALM. Hypertension was defined using standard criteria. Logistic regression was used to analyze the association between RMS (analyzed continuously and categorically in tertiles) and hypertension, adjusting for confounders. A p value of < 0.05 was considered significant. Results: The prevalence of prehypertension and hypertension was 187 (43%) and 96 (23%), respectively. Compared to participants in the low RMS tertile (0.00–2.45 kg/kg ALM), those in the high tertile (3.79–6.12 kg/kg ALM) had 26% lower odds of hypertension (OR 0.74, 95% CI 0.59–0.89) and 33% lower odds of prehypertension (OR 0.67, 95% CI 0.49–0.91) after adjusting for confounders. The RMS also showed strong negative correlations with systolic and diastolic blood pressure (r = − 0.559 and − 0.418, respectively; p < 0.001). Conclusion: Increased RMS was significantly protective against prehypertension and hypertension. These findings highlight the potential importance of muscle quality, beyond muscle mass, in blood pressure regulation. [ABSTRACT FROM AUTHOR]

Background: Metabolically unhealthy non-obese (MUNO) individuals are at higher risk of cardiovascular diseases, while not receiving sufficient attention. This study was conducted to explore the association between BMI-adjusted CC and MUNO in non-obese US adults using the NHANES database. Methods: A total of 9,628 non-obese US adults (48.01% female and 51.99% male) were included in this cross-sectional study. The metabolically unhealthy phenotype was defined as ≥ 2 components of metabolic abnormalities. BMI-adjusted CC and BMI-adjusted skeletal muscle mass (SMM) were divided into quartiles. Weighted multiple logistic regression model was used to evaluate the study aims. The relation between BMI-adjusted CC and BMI-adjusted SMM was tested by Spearman correlation. Results: In the multivariate analysis, compared with the lowest quartile of BMI-adjusted CC and BMI-adjusted SMM, OR (95%CI) of the highest quartile was 0.30 (0.25, 0.35) (P < 0.001, P for trend < 0.001) and 0.39 (0.29, 0.53) (P < 0.001, P for trend < 0.001), respectively. BMI-adjusted CC was positively correlated with BMI-adjusted SMM for all participants (r = 0.48). A weak non-linear association was observed in BMI-adjusted CC and MUNO (P = 0.047). Similar results were observed in sex- and BMI-specific subgroup and sensitivity analysis. Conclusion: BMI-adjusted CC was inversely associated with MUNO, suggesting more attention should be paid to monitoring BMI-adjusted CC for the public to ease the disease burden, especially for people without obesity. [ABSTRACT FROM AUTHOR]

Background: Sarcopenia was recognized to be one of the common comorbidities in heart failure (HF). The sarcopenia index (SI), based on serum creatinine to cystatin C ratio, was developed as a simple tool to evaluate skeletal muscle mass but has not been well-studied in the correlation of left ventricular ejection fraction (LVEF). The aim of this study is to analyze the SI in patients with HF, especially patients with HF with preserved ejection fraction (HFpEF), and to develop a prediction model for HFpEF. Methods: The training cohort included 229 hospitalized patients with HF and 73 healthy controls (HCs) from the Third Affiliated Hospital of Soochow University between December 2019 and February 2022. An additional 78 patients with HF hospitalized at the same hospital between March 2022 to June 2023 were considered as an external validation cohort. Binary logistic regression model was used to analyze the influence factors of HFpEF. A prediction model was constructed and optimized based on the least absolute shrinkage and selection operator (LASSO), displayed by Nomogram and verified internally by Bootstrap with 500 resamples. Results: SI was significantly different between the HF and HC groups (67.95 ± 13.07 vs. 98.57 ± 31.51) and had a significant negative correlation with LVEF. Multivariate logistic regression demonstrated that SI (OR 0.948, 95% CI 0.914—0.983, P = 0.004) was independently associated with HFpEF. The area under the curve (AUC) for the nomogram constructed based on SI was 0.902. The calibration curve was approximately distributed along the reference line in Bootstrap and the decision curve analysis demonstrated significantly better net benefit in the model. The external validation proved the good predictive performance of the model. Conclusions: Lower SI is an independent factor associated with hospitalized patients with HF, especially patients with HFpEF. A prediction nomogram based on SI has good predictive power for HFpEF. Trial registration: The study was registered with the China Clinical Trials Centre Registry (registration number: ChiCTR2200063401). [ABSTRACT FROM AUTHOR]

Background: Osteosarcopenia, characterized by the simultaneous loss of bone and muscle mass, is a serious health problem in the aging population. This study investigated the interplay between host genetics, gut microbiota, and musculoskeletal health in a mouse model of osteosarcopenia, exploring the therapeutic potential of gut microbiota modulation. Methods: We examined the effects of Rg3, a phytochemical, on osteosarcopenia and its interactions with host genetics and gut microbiota in six founder strains of the Collaborative Cross (CC) population. Subsequently, we evaluated the therapeutic potential of Eubacterium nodatum (EN) and Eubacterium ventriosum (EV), two gut microbes identified as significant correlates of Rg3-mediated osteosarcopenia improvement, in selected C57BL/6 J (B6) and 129S1/SvImJ (129S1) mouse strains. Results: Rg3 treatment altered gut microbiota composition aligned with osteosarcopenia phenotypes, which response varied depending on host genetics. This finding enabled the identification of two microbes in the Eubacterium genus, potential mediator of Rg3 effect on osteosarcopenia. Oral administration of EN and EV differentially impacted bone density, muscle mass, exercise performance, and related gene expression in a mouse strain-specific manner. In 129S1 mice, EN and EV significantly improved these parameters, effectively reversing osteosarcopenic phenotypes. Mechanistic investigations revealed that these effects were mediated through the modulation of osteoblast differentiation and protein degradation pathways. In contrast, EN and EV did not significantly improve osteosarcopenic phenotypes in B6 mice, although they did modulate mitochondrial biogenesis and microbial diversity. Conclusions: Our findings underscore the complex interplay between host genetics and the gut microbiota in osteosarcopenia and emphasize the need for personalized treatment strategies. EN and EV exhibit strain-specific therapeutic effects, suggesting that tailoring microbial interventions to individual genetic backgrounds may be crucial for optimizing treatment outcomes. 9Nfyi13u2tifXMNNi2cAAq Video Abstract [ABSTRACT FROM AUTHOR]

Background: Muscle strength is one of the most reliable measures used for the identification of sarcopenia. The European Working Group on Sarcopenia in Older People update (EWGSOP2) proposed the use of grip strength and chair stand tests, while clarifying that isometric torque methods can be used when performing the grip strength test is impossible. This study aims to evaluate the diagnostic accuracy of isometric knee extension strength in screening for sarcopenia. Methods: This cross-sectional study included community-dwelling women aged 70 years and over. IKE and sarcopenia criteria (EWGSOP2) were assessed. Skeletal muscle mass was assessed by bioelectrical impedance analysis; muscle mass strength by handgrip; and physical performance by the 5 times sit-to-stand test, the Short Physical Performance Battery, and gait speed. The diagnostic accuracy for each sarcopenia criterion was calculated using sensitivity, specificity, positive and negative predictive value, and the area under the curve (AUC). Cutoff points for sarcopenia from IKE were defined with the ROC curve. Results: The sample comprised 94 women with a mean age of 75.9 years (standard deviation 5.6, range 70–92), of whom 25.5% (n = 24) met criteria for sarcopenia—mainly severe sarcopenia (73.8%, n = 17). Correlations were observed between IKE and each individually analyzed sarcopenia criterion except skeletal muscle mass, with AUC values exceeding 0.70 in all cases. The IKE cutoff showing the highest accuracy for the diagnosis of sarcopenia was 12.5 kg or less (AUC 0.76, 95% confidence interval [CI] 0.64–0.88; sensitivity: 65.2%, 95% CI 45.7–84.7; specificity 77.4%, 95% CI 60.3–94.5; positive predictive value 62.5%, 95 CI% 42.7–82.3; negative predictive value 88.8%, 95% CI 75.9–100). Conclusions: IKE could be a suitable tool for measuring muscular strength in sarcopenia when other strength parameters cannot be assessed or in people with walking difficulties. [ABSTRACT FROM AUTHOR]

The fibrogenic conversion of satellite cells contributes to the atrophy and fibrosis of skeletal muscle, playing a significant role in the pathogenesis of age-related sarcopenia. Melatonin, a hormone secreted by the pineal gland, exhibits anti-aging and anti-fibrotic effects in various conditions. However, the effect of melatonin on satellite cell fate and age-related sarcopenia remains under-explored. Here, we report that melatonin treatment mitigated the loss of muscle mass and strength in aged mice, replenished the satellite cell pool and curtailed muscle fibrosis. When primary SCs were cultured in vitro and subjected to aging induction via d-galactose, they exhibited a diminished myogenic potential and a conversion from myogenic to fibrogenic lineage. Notably, melatonin treatment effectively restored the myogenic potential and inhibited this lineage conversion. Furthermore, melatonin attenuated the expression of the fibrogenic cytokine, transforming growth factor-β1, and reduced the phosphorylation of its downstream targets Smad2/3 both in vivo and in vitro. In summary, our findings show melatonin's capacity to counteract muscle decline and inhibit fibrogenic conversion in aging SCs and highlight its potential therapeutic value for age-related sarcopenia. [ABSTRACT FROM AUTHOR]

The use of bioelectrical impedance analysis (BIA) is now well established in healthcare as an essential support tool for patient management in various clinical settings. Its use in sports is rapidly expanding due to the valuable insights it offers, helping to better structure athletes' diets and training programs, thereby optimizing their performance. In the context of sport, however, there is a consensus regarding the importance of proper interpretation of BIA-derived data, which cannot be limited to mere estimation of body composition. In this sense, therefore, the evaluation and interpretation of raw bioelectrical parameters, including resistance, reactance, and phase angle (PhA) is of relevant importance. The assessment of PhA is particularly significant in the context of sports, as it is closely linked to key factors such as muscle mass, strength, and overall muscle quality. However, the existing relationship between PhA and systemic, and loco-regional inflammation, which, in a broader sense, is the rationale behind its use for assessing and monitoring localised muscle damage. Thus, the importance of PhA monitoring during training becomes evident, as it plays a crucial role in assessing and potentially identifying functional impairments, such as overtraining syndrome, as well as muscle injury and related changes in fluid distribution, at an early stage. The aim of this review is to provide the scientific basis necessary to consider the use of whole-body PhA as an indicator of overtraining. [ABSTRACT FROM AUTHOR]

Background: Sarcopenia and knee osteoarthritis (KOA) are two common musculoskeletal disorders, often coexisting in aged population and potentially influencing each other. However, the underlying relationship between two conditions remains unclear and controversial. To fill this knowledge gap, we aimed to investigate the longitudinal association among the older Chinese population. Methods: Data were attracted from 2 waves of the China Health and Retirement Longitudinal Study (CHARLS), and 6212 individuals aged ≥ 60 years were included. Sarcopenia status was defined by the Asian Working Group for Sarcopenia 2019 criteria. Multivariate logistic regression and generalized estimation equation models were applied to estimate the impact of sarcopenia on KOA. A prognostic nomogram was developed through train-test cross-validation. Results: At baseline in CHARLS 2015, the prevalence of symptomatic KOA was 12.7% (792/6212) in total population, 9% (270/2996) in no-sarcopenia group, 17.5% (286/1638) in possible sarcopenia group, and 15.0% (236/1578) in sarcopenia group. Over a 3-year follow-up, 4980 respondents were included, with incident KOA cases identified as 56 (2.2%), 38 (3.0%), and 43 (3.6%) in no-sarcopenia, possible sarcopenia, and sarcopenia groups, respectively. Sarcopenia was significantly associated with increased new-onset KOA compared to no-sarcopenia peers in the fully adjusted model (OR: 1.91, 95% CI: 1.15–3.18), whereas this association was non-significant for possible sarcopenia. In females, low muscle mass alone significantly increased the incident risk of KOA (OR: 2.58, 95% CI: 1.05–6.49). The final prognostic model and nomogram, including sarcopenia status, age, gender, body mass index, self-reported health status, comorbidities, history of falls and physical activity, had a considerable discrimination (AUC = 0.744, C-index = 0.660). The calibration curve indicated significant agreement between predicted and actual observations. Decision curve analysis revealed net benefits for clinical intervention at a probability threshold of 1–17%. Conclusions: Sarcopenia was associated with a higher incident risk of symptomatic KOA, wherein low muscle mass may play an important role. The inferior prognosis of sarcopenia in KOA needs more attention in clinical practice. [ABSTRACT FROM AUTHOR]

Objectives: In the context of musculoskeletal health, the emergence of pre-sarcopenia as a precursor to sarcopenia has garnered attention for its potential insights into early muscle loss. We explored the association between different metabolic phenotypes of obesity, and the incidence of pre-sarcopenia over a 3-year follow-up in a cohort from the Tehran Lipid and Glucose Study (TLGS). Methods: In this 3-year longitudinal study, 2257 participants were categorized into four groups based on their BMI and metabolic status: metabolically healthy normal weight (MHNW), metabolically healthy overweight/obese (MHO), metabolically unhealthy normal weight (MUNW), and metabolically unhealthy overweight/obese (MUO). The participants were assessed for various anthropometric and body composition indices including muscle mass determined by bioelectrical impedance analysis (BIA). Blood samples were collected for metabolic indices, and participants underwent measurements for blood pressure. Pre-sarcopenia was defined based on low muscle mass. Statistical analyses included logistic regression and chi-squared tests. Results: The MUNW group exhibited the highest prevalence of pre-sarcopenia (33.5%), while the MHO group had the lowest (2.8%). Adjusted models revealed that the odds ratio for pre-sarcopenia was higher in the MUNW group (OR = 2.23, P < 0.001), whereas the MHO and MUO groups showed lower odds (OR = 0.11 and 0.13, both P < 0.001). Notably, the association was gender-dependent, with MUNW females having a higher risk even after adjustments (OR = 2.37, P = 0.042). Conclusion: Our findings suggest that metabolic health may play a pivotal role in pre-sarcopenia, emphasizing the need for targeted interventions based on both metabolic and obesity phenotypes. [ABSTRACT FROM AUTHOR]

Objective: To investigate the association of serum creatinine-cystatin C ratio (Cr/CysC) with long-term all-cause mortality and cause-specific (cardiovascular and cancer) mortality among US general adults. Methods: This nationally representative cohort study included adults in the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2004. Participants were linked to National Death Index data from the survey date through December 31, 2019. Weighted Cox proportional hazards regression models were used to calculate hazard ratios and 95% confidence intervals (CIs), and restricted cubic splines and stratified analyses were also performed. Results: A total of 12,914 participants were included in this study (mean [SD] age, 45.3 [17.3] years; males, 48.9%). During a median follow-up of 17.9 years (maximum follow-up, 20.8 years), 3439 total deaths occurred, including 1098 cardiovascular deaths and 736 cancer deaths. Cumulative incidence curves revealed that increased Cr/CysC ratio had lower risk of all-cause (P < 0.001), cardiovascular (P < 0.001) and cancer (P < 0.001) mortality. Cox regression an Fine-Gray hazards models demonstrated that the multivariable-adjusted hazard ratios comparing the highest vs. lowest quartile of Cr/CysC ratio were 0.40 (95% CI, 0.34–0.47; P < 0.001) for all-cause mortality, 0.68 (95% CI, 0.52–0.88; P < 0.001) for cardiovascular mortality, and 0.51 (95% CI, 0.36–0.71; P < 0.001) for cancer mortality. Nonlinear association was observed for Cr/CysC ratio and all-cause mortality (P = 0.018 for nonlinearity), and linear associations were observed for Cr/CysC ratio and cardiovascular (P = 0.212 for nonlinearity) and cancer (P = 0.550 for nonlinearity) mortality. Besides, a series of sensitivity analyses ensured the robustness of the results. Conclusions: In this cohort of US adults, Cr/CysC ratio was negatively associated with all-cause, cardiovascular, and cancer mortality. Our study suggests that Cr/CysC ratio may serve as a simple and effective predictor of long-term health outcomes. [ABSTRACT FROM AUTHOR]

Tetrandrine (Tet), a well-known drug of calcium channel blocker, has been broadly applied for anti-inflammatory and anti-fibrogenetic therapy. However, due to the functional diversity of ubiquitous calcium channels, potential side-effects may be expected. Our previous report revealed an inhibitory effect of Tet on myogenesis of skeletal muscle. Here, we found that Tet induced protein degradation resulting in the myofibril atrophy. Upon administration with a relative high dose (40 mg/kg) of Tet for 28 days, the mice displayed significantly reduced muscle mass, strength force, and myosin heavy chain (MyHC) protein levels. The MyHC reduction was further detected in C2C12 myotubes after treating with Tet. Interestingly, the expression of Atrogin-1 and Murf-1, the skeletal muscle specific E3 ligases of protein ubiquitin–proteasome system (UPS), was accordingly up-regulated, and the reduced MyHC was significantly mitigated by MG132, a 26S proteasome inhibitor, indicating a key role of UPS in the protein degradation of muscle cells. Further study showed that Tet induced autophagy also participated in the protein degradation. Mechanistically, Tet treatment caused ROS production in myotubes that in turn targeted on FoxO3/AKT signaling, resulting in the activation of UPS and autophagy processes that were involved in the protein degradation. Our study reveals a potential side-effect of Tet on skeletal muscle atrophy, particularly when the drug dose is relatively high. [ABSTRACT FROM AUTHOR]

Background: Although pancreaticoduodenectomy (PD) for pancreatic or periampullary cancer is the gold standard treatment regardless of patient age, patients aged 80 years or older have poor postoperative short-term outcomes because of their poor functional status and many medical comorbidities. Postoperative rehabilitation in octogenarians could improve postoperative outcomes; however, its effect remains unclear. Methods: This retrospective study included patients who underwent PD at two institutions between January 2019 and December 2022. All patients were managed using the enhanced recovery after surgery (ERAS) protocol, and elderly patients or those with loss of muscle mass or frailty underwent additional perioperative rehabilitation. Postoperative short-term outcomes were compared between the octogenarians and non-octogenarians. Results: We reviewed 251 patients including 44 octogenarians (17.5%). Octogenarians had higher rates of comorbidity (78.9% vs. 55.1%, P = 0.049) and sarcopenia (31.8% vs. 16.4%, P = 0.018) and a more impaired nutritional status than non-octogenarians and received postoperative rehabilitation more frequently (86.4% vs. 44.0%, P < 0.001, respectively). Under the rehabilitation-enhanced ERAS protocol, the postoperative major complication rate (25.0% vs. 24.6%, P = 0.960), the length of hospital stay (LOS) (P = 0.435), and the length of functional recovery (LOFR) (P = 0.110) did not differ between the two groups. In the multivariate analysis, age ≥ 80 years was not determined as a risk factor for major complications. Conclusions: Despite the poor functional and nutritional status of octogenarians, their postoperative major complication rates, LOS, and LOFR after PD were comparable with those of non-octogenarians under the rehabilitation-enhanced ERAS protocol. [ABSTRACT FROM AUTHOR]

Background: Muscle atrophy caused by denervation is common in neuromuscular diseases, leading to loss of muscle mass and function. However, a comprehensive understanding of the overall molecular network changes during muscle denervation atrophy is still deficient, hindering the development of effective treatments. Method: In this study, a sciatic nerve transection model was employed in male C57BL/6 J mice to induce muscle denervation atrophy. Gastrocnemius muscles were harvested at 3 days, 2 weeks, and 4 weeks post-denervation for transcriptomic and proteomic analysis. An integrative multi-omics approach was utilized to identify key genes essential for disease progression. Targeted proteomics using PRM was then employed to validate the differential expression of central genes. Combine single-nucleus sequencing results to observe the expression levels of PRM-validated genes in different cell types within muscle tissue.Through upstream regulatory analysis, NRF2 was identified as a potential therapeutic target. The therapeutic potential of the NRF2-targeting drug Omaveloxolone was evaluated in the mouse model. Result: This research examined the temporal alterations in transcripts and proteins during muscle atrophy subsequent to denervation. A comprehensive analysis identified 54,534 transcripts and 3,218 proteins, of which 23,282 transcripts and 1,852 proteins exhibited statistically significant changes at 3 days, 2 weeks, and 4 weeks post-denervation. Utilizing multi-omics approaches, 30 hubgenes were selected, and PRM validation confirmed significant expression variances in 23 genes. The findings highlighted the involvement of mitochondrial dysfunction, oxidative stress, and metabolic disturbances in the pathogenesis of muscle atrophy, with a pronounced impact on type II muscle fibers, particularly type IIb fibers. The potential therapeutic benefits of Omaveloxolone in mitigating oxidative stress and preserving mitochondrial morphology were confirmed, thereby presenting novel strategies for addressing muscle atrophy induced by denervation. GSEA analysis results show that Autophagy, glutathione metabolism, and PPAR signaling pathways are significantly upregulated, while inflammation-related and neurodegenerative disease-related pathways are significantly inhibited in the Omaveloxolone group.GSR expression and the GSH/GSSG ratio were significantly higher in the Omaveloxolone group compared to the control group, while MuSK expression was significantly lower than in the control group. Conclusion: In our study, we revealed the crucial role of oxidative stress, glucose metabolism, and mitochondrial dysfunction in denervation-induced muscle atrophy, identifying NRF2 as a potential therapeutic target. Omaveloxolone was shown to stabilize mitochondrial function, enhance antioxidant capacity, and protect neuromuscular junctions, thereby offering promising therapeutic potential for treating denervation-induced muscle atrophy. [ABSTRACT FROM AUTHOR]

Background: In recent years, the African spiny mouse Acomys cahirinus has been shown to regenerate a remarkable array of severe internal and external injuries in the absence of a fibrotic response, including the ability to regenerate full-thickness skin excisions, ear punches, severe kidney injuries, and complete transection of the spinal cord. While skeletal muscle is highly regenerative in adult mammals, Acomys displays superior muscle regeneration properties compared with standard laboratory mice following several injuries, including serial cardiotoxin injections of skeletal muscle and volumetric muscle loss (VML) of the panniculus carnosus muscle following full-thickness excision injuries. VML is an extreme muscle injury defined as the irrecoverable ablation of muscle mass, most commonly resulting from combat injuries or surgical debridement. Barriers to the treatment of VML injury include early and prolonged inflammatory responses that promote fibrotic repair and the loss of structural and mechanical cues that promote muscle regeneration. While the regeneration of the panniculus carnosus in Acomys is impressive, its direct relevance to the study of VML in patients is less clear as this muscle has largely been lost in humans, and, while striated, is not a true skeletal muscle. We therefore sought to test the ability of Acomys to regenerate a skeletal muscle more commonly used in VML injury models. Methods: We performed two different VML injuries of the Acomys tibialis anterior muscle and compared the regenerative response to a standard laboratory mouse strain, Mus C57BL6/J. Results: Neither Acomys nor Mus recovered lost muscle mass or myofiber number within three months following VML injury, and Acomys also failed to recover force production better than Mus. In contrast, Acomys continued to express eMHC within the injured area even three months following injury, whereas Mus ceased expressing eMHC less than one-month post-injury, suggesting that Acomys muscle was primed, but failed, to regenerate. Conclusions: While the panniculus carnosus muscle in Acomys regenerates following VML injury in the context of full-thickness skin excision, this regenerative ability does not translate to regenerative repair of a skeletal muscle. [ABSTRACT FROM AUTHOR]

Background: Sarcopenia, the progressive loss of muscle mass and strength, is common among patients with chronic kidney disease, especially those on maintenance hemodialysis. This condition often arises from factors like reduced physical activity and metabolic changes associated with chronic kidney disease. This study aims to assess the prevalence and severity of sarcopenia in patients on maintenance hemodialysis (MHD), focusing on probable sarcopenia and its correlations with physical activity, body mass index, and inorganic phosphorus levels. Methods: This cross-sectional study involved 220 patients on MHD who visited to West China Hospital of Sichuan University between February and April 2023. The demographic data, body measurements, and laboratory results were retrospectively collected. Sarcopenia was assessed using the 2019 criteria from the Asian Working Group and the European Working Group on Sarcopenia in Older People, and physical activity was measured via the International Physical Activity Questionnaire. Results: Of the study participants, 141 (64.1%) were diagnosed with probable [110 (50.0%) or confirmed sarcopenia [31 (14.1%)], including 22 (10%) with severe sarcopenia. Multivariable logistic regression analysis revealed that physical activity (International Physical Activity Questionnaire score, OR = 0.998, 95% CI: 0.998–0.999, P < 0.001), body mass index (OR = 0.868, 95% CI: 0.788–0.957, P = 0.004), and inorganic phosphorus levels (OR = 0.513, 95% CI: 0.270–0.975, P = 0.042) independently influenced the likelihood of sarcopenia. Within the sarcopenic group, physical activity and BMI significantly correlated with the condition's severity. Conclusion: The prevalence of probable or confirmed sarcopenia in patients on MHD is significant. Factors such as physical activity, body mass index, and inorganic phosphorus levels are independently associated the presence and severity of sarcopenia in this population. Trial registration: Chinese Clinical Trial Registry (ChiCTR2100051111), registered on 2021–09–13. [ABSTRACT FROM AUTHOR]

Background: Sarcopenia has been shown to be an important condition with the ability to predict negative health outcomes, especially in hospitalized older adults; hence, its accurate identification has an important role in the prognosis of older patients. Aim: The prevalence of sarcopenia among hospitalized older adults was assessed by employing three distinct diagnostic methods. Methods: Older adults who were hospitalized were recruited. Bioelectrical impedance analysis was used to assess muscle mass and body composition. Sarcopenia was diagnosed via the European and Asian criteria and via a modified approach in which the Colombian cutoff points for handgrip and gait speed were used. Finally, a cluster analysis was performed to classify the population. Results: The prevalence rates of sarcopenia and severe sarcopenia ranged from 7.3 to 31.6%. The agreement between approaches revealed substantial or almost perfect agreement in 30% of the sarcopenia comparisons and 46.6% of the severe sarcopenia comparisons. The cluster analysis defined three different clusters. The first cluster was associated with increased age, BMI and body fat and poorer functional status and muscle. The second cluster was the healthiest, with high functional status and muscle mass. The third cluster had intermediate characteristics. Discussion: This study highlights the requirements for standardized diagnostic criteria and precise body composition assessment tools in acute geriatric units and highlights the heterogeneity of older adults. Accurate assessment and well-defined diagnostic criteria will facilitate the implementation of appropriate management and interventions. Conclusion: Sarcopenia is highly prevalent in hospitalized older adults, but the adjusted criteria and the inclusion of other parameters must be considered in the assessment. [ABSTRACT FROM AUTHOR]

Background: Sarcopenia is a common condition in women with breast cancer, however still presents limitations for an effective diagnosis. This study aimed to evaluate the agreement and diagnostic accuracy of an anthropometric equation in diagnosing sarcopenia in women with breast cancer based on different constructs. Methods: Cross-sectional study carried out with women with breast cancer aged ≥ 20 years. Sarcopenia was identified according to the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) criteria. Muscle strength was obtained by the handgrip strength test (HGS) and muscle mass (MM) by dual-energy x-ray absorptiometry (DXA) and by the anthropometric predictive equation. For the diagnosis of sarcopenia, eight constructs were proposed based on the MM assessment method (equation or DXA) and different cutoff points. Agreement analyses using Cohen's Kappa test and diagnostic performance measures were performed. The significance level for all tests was 5%. Results: A total of 122 women, with a mean age of 55.3 ± 11.4 years, were evaluated. There was a predominance of brown participants (50.8%), insufficiently active (57.4%), with diagnosis time ≤ 3 months (54.1%), and with invasive breast carcinoma (69.7%). The prevalence of sarcopenia ranged from 3.3 to 8.2%, depending on the construct used. The constructs determined from the cutoff points < 16.0 kg/< 7.58 m² and < 23.0 kg/< 7.58 m² were the ones that showed the best ability to detect sarcopenia. Conclusion: The anthropometric equation showed sufficient diagnostic capacity to be used as an alternative in identifying sarcopenia in women with breast cancer. [ABSTRACT FROM AUTHOR]

Background: Sarcopenia, characterized by the loss of skeletal muscle, is assessed using appendicular skeletal muscle mass indices (ASMI). Various international groups propose different ASMI thresholds for assessing sarcopenia. However, the optimal ASMI that correlates best with physical performance measures in older Turkish adults remains unexplored. This study aims to determine which ASMI is most closely associated with physical performance measures, particularly low handgrip strength (dynapenia), in Turkish older adults. Methods: The study included 326 individuals aged 60 and above. Comprehensive geriatric assessments were conducted on all participants, along with anthropometric evaluations and body composition analyses. ASMI was calculated by adjusting height squared, weight, and body mass index (BMI). Physical performance was assessed through handgrip strength, gait speed, and the chair stand test. Results: The mean age of the participants was 74 ± 5.77 years, with 59.8% being women and 37.5% having dynapenia. Height-squared adjusted ASMI was not significantly associated with gait speed or the chair stand test. Weight-adjusted ASMI correlated with handgrip strength and gait speed but not with the chair stand test. Both height and weight-adjusted ASMI did not differ significantly between participants with and without dynapenia (p > 0.05). BMI-adjusted ASMI significantly correlated with all physical performance parameters (p < 0.05). Furthermore, in multivariate regression analysis, BMI-adjusted ASMI (OR = 0.028, 95% CI = 0.01–0.31, p = 0.006) was independently associated with dynapenia. Conclusion: The study indicates that ASMI adjusted for BMI shows stronger correlations with all physical performance parameters and is independently associated with dynapenia. Utilizing ASMI adjusted for BMI may improve sarcopenia diagnosis in Turkish older adults. [ABSTRACT FROM AUTHOR]

Background: Sarcopenia is a geriatric disease characterized by loss of muscle mass and strength. Although combined exercise and nutrition intervention are known to be effective for sarcopenia, clinical trials involving outpatients with sarcopenia in primary care are scarce. We describe a protocol for a trial to examine the effects of a 12-week combined exercise and nutrition intervention in Korean older adults with possible sarcopenia in community-based primary care. Methods: This multicenter, randomized, controlled trial will include 94 community-dwelling older outpatients aged 65–85 years with possible sarcopenia (47 participants in the intervention and control groups each). Resistance exercises, which incorporate concentric and eccentric exercises, will consist of an introductory phase (3 weeks: twice-weekly supervised exercise sessions and once-weekly home exercises; contraction exercises), an expanded phase (3 weeks: twice-weekly supervised exercise sessions and once-weekly home exercises; eccentric exercises), and a maintenance phase (6 weeks: once-weekly supervised exercise sessions and twice-weekly home exercises; power/eccentric exercises). Nutritional supplementation will be provided according to the nutritional status of the participants using a Mini-Nutritional Assessment. Participants will be assessed at baseline, 12 and 24 weeks, and the primary outcome will be the 5-times chair stand test results. Discussion: To the best of our knowledge, this will be the first clinical trial to evaluate the efficacy of a combined exercise and nutritional supplementation intervention in older outpatients with possible sarcopenia in community-based primary care clinics. These findings will provide new insights to clinicians regarding the long-term usability for doctors and outpatients with possible sarcopenia in community-based primary care. Trial registration: This trial was prospectively registered at ClinicalTrials.gov on September 16, 2023 (registration number: NCT06049914). [ABSTRACT FROM AUTHOR]

Background: Individuals with class II/III obesity have a high percentage of body fat. Assessing body composition in cases of severe obesity can be difficult and controversial both in clinical practice and scientific research. Thus, it is essential to explore the different aspects of evaluating body composition and to discuss the available methods to assess it in this population. Aims: To summarise and discuss the methods used to measure body composition in adults with class II/III obesity and their potential in clinical practice and scientific research. Methods: This is a narrative review using data from PubMed, Scielo, and Lilacs databases. Original articles on body composition analysis in adults with class II/III obesity i.e., a BMI ≥ 35 kg/m2 were eligible. Body composition assessment methods were analysed and described. Results: Some imaging methods produced significantly accurate results. Dual-energy X-ray absorptiometry (DXA) significantly produces accurate results and has been used in clinical studies. However, due to its high cost, it is not applicable in clinical practice. Multifrequency bioelectrical impedance analysis (BIA) has good accuracy and is more appropriate for clinical practice than other methods. We have highlighted several aspects of the importance and applicability of performing body composition analysis in individuals with class II/III obesity. Conclusion: DXA has been considered the most adequate method for clinical research. Multifrequency BIA may be a viable alternative to DXA for use in clinical practice. Assessing body composition and its components is important for people with class II/III obesity. It can help improve the effectiveness of interventions and clinical treatments, especially in reducing the risk of losing muscle mass. Muscle loss can cause sarcopenic obesity and other clinical complications, so understanding body composition is crucial. Assessing body composition can also help understand the impact of interventions on bones and avoid clinical complications. [ABSTRACT FROM AUTHOR]

Background: Adults with cerebral palsy (CP) have a high risk of cardiometabolic diseases. It is unknown whether this risk is elevated in young people with CP and whether exercise can reduce this risk. Therefore, we investigated the effects of the EXErcise for Cerebral Palsy (EXECP) intervention on cardiometabolic risk in children and young adults with CP and compared this risk to typically developing children and young adults (TDs). Methods: Ambulatory male and female participants with spastic CP, aged 9–24 years, and age- and sex-matched TDs without musculoskeletal disorders were recruited. Participants with CP were measured at baseline, after a three-month control period manifesting normal development, and after the three-month strength, gait, and flexibility training intervention. TDs were measured at baseline and after the control period. They did not attend the intervention. Cardiometabolic risk factors included body weight, body fat percentage, and skeletal muscle mass index assessed with bioimpedance; resting systolic and diastolic blood pressure and aortic pulse wave velocity assessed with a non-invasive oscillometric device; fasting plasma high-density and low-density lipoprotein cholesterol, triglyceride, and glucose levels. Data were analyzed with independent samples t-tests and linear mixed-effects models adjusted for sex and age. Results: The study involved 18 participants with CP (13 males, 9–22 year, mean 14.2 ± 4.4) and 17 TDs (12 males, 9–22 year, mean 14.6 ± 4.3). At baseline, participants with CP had a 1.0 (95% confidence interval (CI) [-2.0, -0.0]) kg/m2 lower skeletal muscle mass index than TDs. During the control period, no statistically significant between-group differences were observed in the change of any outcome. In the CP group, body weight (β = 1.87, 95% CI [1.04, 2.70]), fat percentage (β = 1.22 [0.07, 2.37], and blood glucose (β = 0.19, 95% CI [0.01, 0.37]) increased, while diastolic blood pressure (β=-2.31, 95% CI [-4.55, -0.06]) and pulse wave velocity (β=-0.44, 95% CI [-0.73, -0.16]) decreased. In the TD group, only body weight increased (β = 0.85, 95% CI [0.01, 1.68]) statistically significantly. In the CP group, no changes were observed during the intervention. Conclusions: Young people with and without CP do not exhibit significant differences in most cardiometabolic risk factors. EXECP intervention may attenuate some adverse development trajectories occurring without the intervention but greater volume and intensity of aerobic exercise may be needed to reduce cardiometabolic risk. Trial registration: ISRCTN69044459; Registration date 21/04/2017. [ABSTRACT FROM AUTHOR]

Purpose: Muscle Quality Index (MQI), defined as the muscle strength per unit of muscle mass, is considered an emerging indicator of health and physical function. This study aims to explore the relationship between MQI and the risk of depression among non-elderly US adults. Methods: This cross-sectional study collected data from participants aged between 20 and 59 years old, utilizing the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2014. The MQI was calculated by dividing the handgrip strength (HGS, kg) by the arm and appendicular skeletal muscle mass (ASM, kg). Depression assessments were conducted using the Patient Health Questionnaire (PHQ-9). The relationship between MQI and the risk of depression was explored by weighted logistic regression, smooth curve fitting, and subgroup analyses. Results: A total of 4773 participants were included in this study. After adjusting for confounding factors, low MQI levels were identified as an independent risk factor for depression (OR = 0.800, 95%CI:0.668–0.957, P = 0.015). Smooth curve fitting analysis indicated a nonlinear relationship. Subgroup analysis did not identify any specific populations. Conclusions: Higher MQI levels were closely associated with a lower risk of depression among non-elderly US adults. MQI could enhance our understanding of the link between muscle and depression and might serve as a simple functional measure for evaluating and predicting depression. [ABSTRACT FROM AUTHOR]

Background: Cachexia a multifactorial syndrome is a common sequala in patients with cancer. It varies from 42 to 80% depending upon the oncological stage and is directly responsible for 30% of deaths in these patients. Previous research from our laboratory demonstrated that peritoneal ovarian cancer generated in NSG mice resulted in skeletal and cardiac muscle atrophy - leading to loss of skeletal muscle mass and strength, and cardiac dysfunction (cachexia). Treatment of mice bearing i.p. tumors with withaferin A (WFA) showed reversal of skeletal muscle and cardiac cachexia. The present study is focused on determining effects of peritoneal ovarian tumors on kidney damage and effects of WFA treatment on ameliorating kidney damage. Methods: We generated intraperitoneal ovarian cancer by injecting female NSG mice with ovarian cancer cell line (A2780). After one week of injecting cancer cells, mice were treated with WFA (4 mg/kg) every third day, for three weeks. After 4 weeks of injection of cancer cells, the mice were sacrificed and various tissues including kidney and blood were collected, snap-frozen in liquid nitrogen, and stored at -800C. The presence of kidney biomarker creatinine, was measured in the plasma by an ELISA. The mRNA was isolated from mouse kidneys and was used to examine the expression levels of signaling proteins, inflammatory cytokines, and genes responsible for inducing cachexia (IL-1β, IL-6, TNF-α, TGF-β, GDF-15, and MYD88). Results: Our results showed a significant increase in levels of expression of inflammatory cytokine IL-1 β (p < 0.01), IL-6 (p < 0.001), TNF-α (p < 0.001), and other related genes including TRAF6 (p < 0.01), MYD88 (p < 0.01), and GDF-15 (p = 0.005) in tumor-bearing mice compared to controls. Treatment of mice bearing tumors with WFA attenuated the increase in expression of each gene. In addition, our results showed a significant increase in creatinine levels in circulation in tumor-bearing mice compared to control mice. Treatment of tumor-bearing mice with WFA resulted in a significant decrease in plasma creatinine levels compared to tumor-bearing mice. Conclusions: Our results conclude that ovarian tumors in NSG mice caused kidney damage and renal dysfunction, which was effectively ameliorated by WFA treatment, suggesting a protective effect of WFA on kidney injury induced by ovarian cancer. [ABSTRACT FROM AUTHOR]

Background: The Global Leadership Initiative on Malnutrition criteria (GLIM) was established to build a global consensus on the diagnostic criteria for malnutrition. The study aimed to assess the prevalence of the malnutrition diagnosed by GLIM criteria for patients with hepatocellular carcinoma (HCC), and to determine the role of the reduced muscle mass defined by CT scans in the GLIM criteria. Methods: This cohort research was conducted on adult cirrhotic patients with HCC. The risk of malnutrition was screened by Nutritional Risk Screening 2002 (NRS-2002), and malnutrition was diagnosed by GLIM criteria. The third lumbar vertebrae (L3-SMI) were used to represent the muscle mass in GLIM criteria. The variables associated with overall mortality were assessed by multivariate Cox regression analyses. Results: The incidence of malnutrition diagnosed by GLIM criteria was 49.7% (179/360) in patients with HCC. If reduced muscle mass was not included in GLIM criteria, the prevalence of malnutrition was 31.7% (114/360). GLIM-defined malnutrition (HR = 1.979, 95%CI 1.019–3.841, P = 0.044) was independently associated with overall mortality in patients with HCC. However, the GLIM-defined malnutrition (without muscle mass) was not associated with overall mortality (HR = 0.863, 95%CI 0.399–1.867, P = 0.709). Conclusions: Skeletal muscle mass is an integral component of the GLIM criteria for patients with HCC. The malnutrition is common in patients with HCC, and malnourishment is associated with higher overall mortality. GLIM criteria are recommended to assess the nutritional status of hospitalized patients with HCC, which is recommended and can be used as the basis for nutritional interventions. [ABSTRACT FROM AUTHOR]

Background: Despite recent reports, the effectiveness of postoperative oral nutritional supplementation (ONS) on body weight loss and malnutrition after gastrectomy remains controversial. We aimed to elucidate the effectiveness of ONS especially in octogenarian patients undergoing oncological gastrectomy. Methods: A total of 286 consecutive patients who underwent gastrectomy for gastric cancer were eligible. Postoperative body weight loss, malnutrition, and sarcopenia were compared between patients with and without postoperative ONS among octogenarian patients aged ≥ 80 years and non-octogenarian patients aged < 80 years. Results: In this study, 36 (62.1%) octogenarian and 121 (53.1%) non-octogenarian patients continued postoperative ONS for three months. The clinicopathologic characteristics were not different between the ONS (−) and ONS (+) groups among the octogenarian and non-octogenarian patients. The changes in body weight and serum albumin levels at postoperative 1 year were different between the ONS (−) and ONS (+) groups (P = 0.03 and P = 0.04, respectively) among the octogenarian patients, but not between the two groups among the non-octogenarian patients (P = 0.99 and P = 0.29, respectively). Also, the decline in psoas muscle mass index at postoperative 6 months and 1 year was significantly lower in the ONS (+) group than in the ONS (−) group (P < 0.01 and P < 0.01, respectively). In addition, similar results were found in octogenarian patients who underwent distal gastrectomy. Conclusions: Postoperative ONS could prevent body weight loss, malnutrition, and sarcopenia especially in octogenarian patients who underwent gastrectomy for gastric cancer. [ABSTRACT FROM AUTHOR]

Introduction: In patients admitted to the intensive care unit (ICU), muscle mass is inversely associated with mortality. Although muscle mass can be estimated with 24-h urinary creatinine excretion (UCE), its use for risk prediction in individual patients is limited because age-, sex-, weight- and length-specific reference values for UCE are lacking. The ratio between measured creatinine clearance (mCC) and estimated glomerular filtration rate (eGFR) might circumvent this constraint. The main goal was to assess the association of the mCC/eGFR ratio in ICU patients with all-cause hospital and long-term mortality. Methods: The mCC/eGFR ratio was determined in patients admitted to our ICU between 2005 and 2021 with KDIGO acute kidney injury (AKI) stage 0–2 and an ICU stay ≥ 24 h. mCC was calculated from UCE and plasma creatinine and indexed to 1.73 m2. mCC/eGFR was analyzed by categorizing patients in mCC/eGFR quartiles and as continuous variable. Results: Seven thousand five hundred nine patients (mean age 61 ± 15 years; 38% female) were included. In-hospital mortality was 27% in the lowest mCC/eGFR quartile compared to 11% in the highest quartile (P < 0.001). Five-year post-hospital discharge actuarial mortality was 37% in the lowest mCC/eGFR quartile compared to 19% in the highest quartile (P < 0.001). mCC/eGFR ratio as continuous variable was independently associated with in-hospital mortality in multivariable logistic regression (odds ratio: 0.578 (95% CI: 0.465—0.719); P < 0.001). mCC/eGFR ratio as continuous variable was also significantly associated with 5-year post-hospital discharge mortality in Cox regression (hazard ratio: 0.27 (95% CI: 0.22—0.32); P < 0.001). Conclusions: The mCC/eGFR ratio is associated with both in-hospital and long-term mortality and may be an easily available index of muscle mass in ICU patients. [ABSTRACT FROM AUTHOR]

Background: Aging leads to a decline in muscle mass and strength, contributing to frailty and decreased quality of life. Sirolimus (rapamycin) , an mTOR inhibitor, has shown potential in preclinical studies to extend lifespan and improve health span. This study evaluates the safety and efficacy of once-weekly sirolimus (rapamycin) administration on muscle strength and endurance in older adults engaged in a 13-week exercise program. Methods: This randomized, double-blind, placebo-controlled trial will enroll 40 participants aged 65–85. Participants will be randomly assigned to receive either sirolimus (rapamycin) 6 mg/week or placebo for 13 weeks, in conjunction with an at-home exercise program. The primary outcome measure is the change in muscle strength and endurance, assessed by the 30-Second Chair-Stand Test. Secondary outcome measures include adverse events, changes in muscle strength and endurance as measured by the 6-min walk test, handgrip strength, and participant-reported outcomes using the SF-36 survey. Assessments will be conducted at baseline, mid-intervention (week 6), and post-intervention (week 13). Blood samples will be collected for hematology and biochemistry analyses, including full blood count, urea and electrolytes, liver function tests, HbA1c, lipids, serum IGF-1, and hs-CRP. DNA methylation will be analyzed using TruDiagnostic™ to explore changes in biological age. Discussion: This study aims to provide insights into the potential benefits of intermittent sirolimus (rapamycin) administration on muscle performance in older adults. By alternating periods of mTOR inhibition through rapamycin and activation via exercise, this study will explore a novel approach to enhancing muscle strength and endurance in the aging population. The results could have significant implications for developing interventions to improve physical function and overall health outcomes in older adults. Safety and tolerability will also be closely monitored to ensure the feasibility of this regimen for wider application. Trial registration: Australia New Zealand Clinical Trials Registry, ACTRN12624000790549. Registered on 26 June 2024 https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12624000790549. [ABSTRACT FROM AUTHOR]

Background: Osteo-sarcopenia (OS) has become a global public health problem and a frontier research problem, as a combination of sarcopenia (SP) and osteoporosis (OP) diseases. The clinical performances include muscle weakness, systemic bone pain, standing difficulty, even falls and fractures, etc., which seriously affect the patient's life and work. The pathological mechanism of the OS may be the abnormal metabolism which disrupts the equilibrium stability of the musculoskeletal system. Therefore, this study combined vitamin D (Vit. D) and whole-body vibration training (WBVT) to intervene in subjects of OS, aiming to evaluate the effectiveness and safety of the diagnosis and treatment protocol and to explore the efficacy mechanism. Methods: We propose a multicenter, parallel-group clinical trial to evaluate the efficacy and safety of Vit. D combined with WBVT intervention in OS. Subjects who met the inclusion or exclusion criteria and signed the informed consent form would be randomly assigned to the WBVT group, Vit. D group, or WBVT+ Vit. D group. All subjects will be treated for 1 month and followed up after 3 and 6 months. The primary outcomes are lumbar bone mineral density (BMD) and appendicular skeletal muscle mass (ASM) measured by dual-energy X-ray absorptiometry (DXA) and handgrip strength measured by grip strength meter. Secondary outcomes include serum markers of myostatin (MSTN), irisin and bone turnover markers (BTM), SARC-CalF questionnaire, 1-min test question of osteoporosis risk, patient health status (evaluated by the SF-36 health survey), physical performance measurement that includes 5-time chair stand test, 6-m walk, and the short physical performance battery (SPPB). Discussion: If Vit. D combined with WBVT can well relieve OS symptoms without adverse effects, this protocol may be a new treatment strategy for OS. After therapeutic intervention, if the serum marker MSTN/irisin is significant, both have the potential to become sensitive indicators for screening OS effective drugs and treatments, which also indicates that WBVT combined with Vit. D plays a role in improving OS by regulating MSTN/irisin. Trial registration: Chinese Clinical Trial Registry ChiCTR2400082269. Registered on March 26, 2024. [ABSTRACT FROM AUTHOR]

Background: Pneumonia remains the leading cause of mortality among children under 5 years. Poor nutritional status increases pneumonia mortality. Nutritional status assessed by anthropometry alone does not provide information on which body composition element predicts survival. Body composition proxy measures including arm-fat-area (AFA), arm-muscle-area (AMA), and arm-muscle-circumference (AMC) could be useful predictors. Objective: To compare the ability of fat and muscle mass indices to predict 6-month survival among children with severe pneumonia. Methods: This prospective cohort study was nested in the COAST-Nutrition trial (ISRCTN10829073, 06/06/2018) conducted between June 2020 and October 2022 in Uganda and Kenya. We included children aged 6–59 months hospitalized for severe pneumonia with hypoxemia. Children with severe malnutrition, known chronic lung or cardiac diseases were excluded. Anthropometry and clinical status were assessed at enrolment and at follow-up to day 180. We examined Receiver Operator Characteristic (ROC) curves of fat and muscle mass indices with 6-month survival as the outcome, and compared the areas under the curve (AUCs) using chi-square tests. Cox survival analysis models assessed time-to-mortality. Results: We included 369 participants. The median age was 15-months (IQR 9, 26), and 59.4% (219/369) of participants were male. The baseline measurements were: median MUAC 15.0 cm (IQR 14.0,16.0); arm-fat-area 5.6cm2 (IQR 4.7, 6.8); arm-muscle-area 11.4cm2 (IQR 10.0, 12.7); and arm-muscle-circumference 12.2 cm (IQR 11.5, 12.9). Sixteen (4.3%) participants died and 4 (1.1%) were lost-to-follow-up. The AUC for Arm-Fat-Area was not significantly higher than that for Arm-Muscle-Area and Arm-Muscle-Circumference [AUC 0.77 (95%CI 0.64–0.90) vs. 0.61 (95%CI 0.48–0.74), p = 0.09 and 0.63 (95%CI 0.51–0.75), p = 0.16 respectively], but was not statistically different from MUAC (AUC 0.73 (95%CI 0.62–0.85), p = 0.47). Increase in Arm-Fat-Area and Arm-Muscle-Circumference significantly improved survival [aHR 0.40 (95%CI 0.24–0.64), p = < 0.01 and 0.59 (95%CI 0.36–1.06), p = 0.03 respectively]. Survival prediction using Arm-Fat-Area was not statistically different from that of MUAC (p = 0.54). Conclusions: Muscle mass did not predict 6-month survival better than fat mass in children with severe pneumonia. Fat mass appears to be a better predictor. Effects of fat and muscle could be considered for prognosis and targeted interventions. [ABSTRACT FROM AUTHOR]

Background: This study aimed to assess the effects of enteral nutrition with different protein concentrations on muscle mass in severe pneumonia patients, providing insights for enteral nutrition practice in intensive care units (ICUs). Methods: A total of 120 severe pneumonia patients admitted to Dazhou Central Hospital's ICU between June 1, 2022, and February 1, 2023, meeting inclusion criteria, were randomly assigned to either a high-protein group (n = 60, 1.8 g/kg/d) or a standard-protein group (n = 60, 1.2 g/kg/d). Changes in relevant indicators were monitored on days 1, 5, and 10 of ICU admission, including quadriceps and diaphragm thickness, nutritional status (prealbumin and albumin), and adverse events such as diarrhea and constipation. Results: Autoregressive of order 1 model (AR(1)) analysis revealed a decrease in both quadriceps and diaphragm thickness over time in both groups. A significant group × time interaction was observed in quadriceps thickness. By day 10, compared to baseline, quadriceps thickness decreased in the high-protein (-0.315 cm [95% CI, -0.340 to -0.289]) and standard-protein (-0.429 cm [95% CI, -0.455 to -0.404]) groups. The high-protein group exhibited a lower quadriceps atrophy rate (13.97 ± 2.43%) compared to the standard-protein group (18.96 ± 2.61%), showing a significant difference (P < 0.001). No significant differences were found in diaphragmatic thickness between groups and over time. By day 10, both groups exhibited decreased diaphragmatic muscle thickness compared to baseline. The high-protein group (33.76 ± 5.09%) had a slightly lower phrenic atrophy rate compared to the standard-protein group (33.41 ± 4.53%). Both groups experienced enteral nutritional intolerance manifested as diarrhea, constipation, and other adverse events. Conclusion: High-protein enteral nutrition significantly improved quadriceps thickness and demonstrated good safety in severe pneumonia patients, suggesting its suitability for widespread clinical application. [ABSTRACT FROM AUTHOR]

Background: Maintenance of physical function, mobility, and independent living are important goals for older adults. However, concerns about falling (CaF) play a central role in the vicious cycle of CaF, inflammation, loss of muscle mass, and decreasing physical function ultimately resulting in negative health outcomes. CaF, like other states of chronic stress and anxiety, can be considered as enduring adverse stimuli affecting the stress systems and the inflammatory system. Therefore, the aim of this study is to investigate whether a reduction of CaF leads to a reduction of stress and therefore possibly reduces chronic low-grade inflammation. Understanding the role and directionality of the effects of inflammation on CaF increases our understanding of age-related loss of mobility and physical function. Methods: In this study, community-dwelling older adults, aged 70 years and older, will be randomly assigned to either a 4-month, multi-component intervention with exercise training and cognitive-behavioral components or to a sham control group with light stretching exercises, cognitive training, and educational health lectures. For the operationalization of specific CaF, the Falls Efficacy Scale—International will be used. Stress and related psychological symptoms will be monitored using established self-reports and by measuring salivary cortisol. Concentrations of C-reactive protein, interleukin 6, interleukin 10, and tumor-necrosis-factor-alpha, as well as gene expression of selected inflammatory transcripts, will be used as surrogate parameters of the inflammatory status at baseline, after the 4-month intervention and 8-month follow-up. Discussion: This study will be the first to test whether CaF are related with stress system activity or reactivity or with markers of inflammation in the context of a multi-component intervention with exercise training and cognitive-behavioral components addressing CaF. The reduction of specific CaF or general psychological symptoms should reverse alterations in stress systems, and / or slow down low-grade inflammation. Changes in activity, as well as psychological and biological pathways leading from CaF to muscle loss will be measured, to disentangle the individual contribution to sarcopenia, and to provide an additional pathway to break or slow-down the vicious cycle of CaF and sarcopenia. Trial registration: German Clinical Trials Register (DRKS): DRKS00029171. Registered 22 July 2022. [ABSTRACT FROM AUTHOR]

Objective: To explore the influence of lipid metabolism on the risk of sarcopenia. Methods: Two-sample Mendelian randomization (MR) analysis was used to determine causality. A total of 179 lipid metabolism data points were used for exposure, and the data were obtained from a plasma lipid metabolite study of 7174 participants. The total muscle mass and total muscle strength, as well as the muscle strength and muscle mass of different sex groups, were selected as the relevant traits of sarcopenia. Data for outcomes were obtained from the UK Biobank, and sample sizes ranged from 135 468 to 450 243. Inverse-variance weighted (IVW), as the main method for evaluating the causal relationship between lipid metabolites and sarcopenia, uses the false discovery rate (FDR) for multiple comparisons and conducts heterogeneity, pleiotropy, and reverse causality tests. Results: Twenty-seven lipid metabolites, mainly phosphatidylcholine, phosphatidylethanolamine, ceramide, triacylglycerol, sphingomyelin, and sterol ester, were found to be associated with the risk of sarcopenia. Ceramide (d40:1), ceramide (d40:2), and sterol ester are risk factors for decreased muscle mass and strength. There is a positive causal relationship between various phosphatidylcholine lipids and muscle mass and strength. Sphingomyelin (d42:2) is a protective factor for total muscle strength and female muscle strength. There are inconsistent effects between different lipid metabolites, triacylglycerol, and muscle strength and muscle mass. Conclusions: There was a causal relationship between 27 lipid metabolites and sarcopenia traits, and targeting specific lipid metabolites may benefit sarcopenia diagnosis, disease assessment, and treatment. [ABSTRACT FROM AUTHOR]