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The utility of a portable muscle ultrasound in the assessment of muscle alterations in children with acute lymphoblastic leukaemia 便携式肌肉超声在评估急性淋巴细胞白血病儿童肌肉改变中的作用。
IF 8.9 1区 医学
Journal of Cachexia, Sarcopenia and Muscle
Pub Date : 2023-08-10 DOI: 10.1002/jcsm.13305
Emma J. Verwaaijen, Annelienke M. van Hulst, Jeroen Molinger, Annelies Hartman, Rob Pieters, Martha A. Grootenhuis, Erica L.T. van den Akker, Marry M. van den Heuvel-Eibrink

Background

During treatment for acute lymphoblastic leukaemia (ALL), children are prone to musculoskeletal deterioration. However, non-invasive tools to measure muscle mass and intramuscular alterations are limited. In this study we explored the feasibility of muscle ultrasound in children with ALL. Additionally, we analysed whether automated ultrasound outcomes of muscle size and intramuscular fat infiltration (IMAT) were associated with appendicular skeletal muscle mass (ASMM), muscle strength and physical performance.

Methods

Children with ALL, aged 3–18 years were included during maintenance therapy. Bilateral images of the rectus femoris muscle were captured using a portable linear array transducer connected to a tablet. Subsequently, an automated image annotation software (MuscleSound) was used to estimate cross-sectional area, muscle thickness and IMAT. Feasibility was assessed using acceptance (percentage of children approached who were enrolled), practicality (percentage of children that completed the ultrasound measurement after enrolment) and implementation (percentage of children that had sufficient imaging to be processed and analysed by the software). Assessments of ASMM by bioimpedance analysis, muscle strength using handheld dynamometry and timed physical performance tests were administered at the same visit. Multivariable linear models were estimated to study the associations between muscle ultrasound outcomes and ASMM, strength and physical performance, adjusted for sex, age, body mass index and ALL treatment week.

Results

Muscle ultrasound was performed in 60 out of 73 invited patients (76.9%), of which 37 were boys (61.7%), and median age was 6.1 years (range: 3–18.8 years). The acceptance was 98.7%, practicality 77.9% and implementation was 100%. Patients who refused the examination (n = 13) were younger (median: 3.6, range: 3–11.2 years) compared with the 60 examined children (P = 0.0009). In multivariable models, cross-sectional area was associated with ASMM (β = 0.49 Z-score, 95% confidence interval [CI]:0.3,2.4), knee-extension strength (β = 16.9 Newton [N], 95% CI: 4.8, 28.9), walking performance (β = −0.46 s, 95% CI: −0.75, −0.18) and rising from the floor (β = −1.07 s, 95% CI: −1.71, −0.42). Muscle thickness was associated with ASMM (β = 0.14 Z-score, 95% CI: 0.04, 0.24), knee-extension strength (β = 4.73 N, 95% CI: 0.99, 8.47), walking performance (β = −0.13 s, 95% CI: −0.22, −0.04) and rising from the floor (β = −0.28 s, 95% CI: −0.48, −0.08). IMAT was associated with knee-extension stren

背景：在急性淋巴细胞白血病（ALL）的治疗过程中，儿童的肌肉骨骼容易退化。然而，测量肌肉质量和肌内变化的非侵入性工具是有限的。在这项研究中，我们探讨了肌肉超声在ALL儿童中的可行性。此外，我们分析了肌肉大小和肌内脂肪浸润（IMAT）的自动超声结果是否与阑尾骨骼肌质量（ASMM）、肌肉力量和身体表现有关。方法：将3-18岁ALL患儿纳入维持治疗。使用连接到平板电脑的便携式线性阵列换能器拍摄股直肌的双侧图像。随后，使用自动图像注释软件（MuscleSound）来估计横截面积、肌肉厚度和IMAT。可行性评估采用接受度（被招募儿童的百分比）、实用性（在招募后完成超声波测量的儿童的比例）和实施度（有足够的图像可由软件处理和分析的儿童的比率）。在同一次访视中，通过生物阻抗分析评估ASMM，使用手持式测力仪评估肌肉力量，并进行定时身体性能测试。估计了多变量线性模型，以研究肌肉超声结果与ASMM、力量和身体表现之间的关系，并根据性别、年龄、体重指数和ALL治疗周进行了调整。结果：73名受邀患者中有60名（76.9%）进行了肌肉超声检查，其中37名为男孩（61.7%），中位年龄为6.1岁（范围：3-18.8岁）。接受率为98.7%，实用性为77.9%，实施率为100%。与60名接受检查的儿童（P=0.0009）相比，拒绝检查的患者（n=13）更年轻（中位数：3.6，范围：3-11.2岁）。在多变量模型中，截面积与ASMM（β=0.49 Z-评分，95%置信区间[CI]:0.3,2.4）、膝关节伸展强度（β=116.9 Newton[n]，95%CI:4.8,28.9）、，肌肉厚度与ASMM（β=0.14Z-score，95%CI:0.04,0.24）、伸膝强度（β=4.73N，95%CI:0.99,8.47）、，行走性能（β=0.13s，95%可信区间：-0.22，-0.04）和从地板上爬起（β=0.28s，95%置信区间：-0.48，-0.08），行走性能（β=0.2s，95%CI:0.08,0.32）和从地板上站起来（β=0.54s，95%CI:0.27,0.8）。肌肉超声结果均与握力无关。结论：便携式肌肉超声是测量ALL儿童肌肉大小和肌肉改变的一种可行和有用的工具。使用磁共振成像（金标准）的验证研究对于确认儿科人群的准确性是必要的。
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引用次数: 0
Hispidin-enriched Sanghuangporus sanghuang mycelia SS-MN4 ameliorate disuse atrophy while improving muscle endurance 富含Hispidin的桑黄孢菌丝体SS-MN4改善废用性萎缩，同时提高肌肉耐力。
IF 8.9 1区 医学
Journal of Cachexia, Sarcopenia and Muscle
Pub Date : 2023-08-10 DOI: 10.1002/jcsm.13307
I-Chen Li, Ting-Yu Lu, Ting-Wei Lin, Andy Y. Chen, Hsin-Tung Chu, Yen-Lien Chen, Tsung-Ju Li, Chin-Chu Chen

Background

Disuse atrophy is a frequent cause of muscle atrophy, which can occur in individuals of any age who have been inactive for a prolonged period or immobilization. Additionally, acute diseases such as COVID-19 can cause frequent sequelae and exacerbate muscle wasting, leading to additional fatigue symptoms. It is necessary to investigate potent functional nutrients for muscle reinforcement in both disuse atrophy and fatigue to ensure better physical performance.

Methods

The effects of Sanghuangporus sanghuang SS-MN4 mycelia were tested on two groups of 6-week-old male mice—one with disuse atrophy and the other with fatigue. The disuse atrophy group was divided into three sub-groups: a control group, a group that underwent hind limb casting for 7 days and then recovered for 7 days and a group that was administered with SS-MN4 orally for 14 days, underwent hind limb casting for 7 days and then recovered for 7 days. The fatigue group was divided into two sub-groups: a control group that received no SS-MN4 intervention and an experimental group that was administered with SS-MN4 orally for 39 days and tested for exhaustive swimming and running on Day 31 and Day 33, respectively. RNA sequencing (RNA-seq) and western blot analysis were conducted on C2C12 cell lines to identify the therapeutic effects of SS-MN4 treatment.

Results

In a disuse atrophy model induced by hind limb casting, supplementing with 250 mg/kg of SS-MN4 for 14 days led to 111.2% gastrocnemius muscle mass recovery and an 89.1% improvement in motor function on a treadmill (P < 0.05). In a fatigue animal model, equivalent SS-MN4 dosage improved swimming (178.7%) and running (162.4%) activities (P < 0.05) and reduced blood urea nitrogen levels by 18% (P < 0.05). SS-MN4 treatment also increased liver and muscle glycogen storage by 34.36% and 55.6%, respectively, suggesting a higher energy reserve for exercise. RNA-seq and western blot studies from the C2C12 myotube showed that SS-MN4 extract upregulates Myh4 and helps sustain myotube integrity against dexamethasone damage.

Conclusions

Supplementation of SS-MN4 (250-mg/kg body weight) with hispidin as active compound revealed a potential usage as a muscle nutritional supplement enhancing muscle recovery, fast-twitch fibre regrowth and fatigue resistance.

背景：滥用性萎缩是肌肉萎缩的常见原因，任何年龄段的人都可能长期不活动或不活动。此外，新冠肺炎等急性疾病会导致频繁的后遗症，并加剧肌肉萎缩，导致额外的疲劳症状。有必要研究在废用性萎缩和疲劳中增强肌肉的有效功能营养素，以确保更好的身体表现。方法：用桑黄孢SS-MN4菌丝体对6周龄雄性废用性萎缩小鼠和疲劳小鼠进行药效试验。废用性萎缩组分为三个亚组：对照组、后肢铸造7天后恢复的组和口服SS-MN4 14天后后肢铸造7天后恢复的组。疲劳组分为两个子组：对照组不接受SS-MN4干预，实验组口服SS-MN4 39天，并分别在第31天和第33天进行力竭游泳和跑步测试。对C2C12细胞系进行RNA测序（RNA-seq）和蛋白质印迹分析，以鉴定SS-MN4处理的治疗效果。结果：在后肢铸型诱导的废用性萎缩模型中，在跑步机上用250mg/kg的SS-MN4补充14天可导致111.2%的腓肠肌质量恢复和89.1%的运动功能改善（P结论：用喜斯皮丁作为活性化合物补充SS-MN4（250mg/kg体重）揭示了作为增强肌肉恢复的肌肉营养补充剂的潜在用途，快速抽动纤维再生和抗疲劳性。
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引用次数: 0
Association between the 110-kDa C-terminal agrin fragment and skeletal muscle decline among community-dwelling older women 居住在社区的老年妇女中110kDa C-末端农业蛋白片段与骨骼肌衰退之间的关系。
IF 8.9 1区 医学
Journal of Cachexia, Sarcopenia and Muscle
Pub Date : 2023-08-10 DOI: 10.1002/jcsm.13309
Kuniyasu Kamiya, Takahiro Tachiki, Yuho Sato, Katsuyasu Kouda, Etsuko Kajita, Junko Tamaki, Sadanobu Kagamimori, Masayuki Iki

Background

C-terminal agrin fragment (CAF) is a biomarker for neuromuscular junction degradation. This study aimed to investigate whether 110-kDa CAF (CAF110) was associated with the presence and incidence of low muscle mass and strength.

Methods

This cross-sectional retrospective cohort study comprised women aged ≥65 years. We measured muscle mass using a dual-energy X-ray absorptiometry scanner, hand-grip strength, and blood sampling between 2011 and 2012. A follow-up study with the same measurements was conducted between 2015 and 2017. Low muscle mass and strength were defined as an appendicular skeletal muscle mass index <5.4 kg/m2 and hand-grip strength <18 kg, respectively. The CAF110 level was measured using enzyme-linked immunosorbent assay kits.

Results

In total, 515 women (74.3 ± 6.3 years) were included in this cross-sectional analysis. Of these, 101 (19.6%) and 128 (24.9%) women presented with low muscle mass and strength, respectively. For low muscle mass, the odds ratios (ORs) of the middle and highest CAF110 tertile groups, compared with the lowest group, were 1.93 (95% confidence interval: 1.09–3.43; P = 0.024) and 2.15 (1.22–3.80; P = 0.008), respectively. After adjusting for age, the ORs remained significant: 1.98 (1.11–3.52; P = 0.020) and 2.27 (1.28–4.03; P = 0.005), respectively. Low muscle strength ORs of all the CAF110 tertile groups were not significant. In the longitudinal analysis, 292 and 289 women were assessed for incidents of low muscle mass and strength, respectively. Of those, 34 (11.6%) and 20 (6.9%) women exhibited low muscle mass and strength, respectively. For incident low muscle mass, the crude OR of the CAF110 ≥ the median value group was marginally higher than that of the CAF110 < median value group (median [interquartile range]: 1.98 [0.94–4.17] (P = 0.072). After adjusting for age and baseline muscle mass, the OR was 2.22 [0.97–5.06] (P = 0.058). All low muscle strength ORs of the median categories of CAF110 were not significant.

Conclusions

CAF110 was not associated with low muscle strength. However, CAF110 may be a potential marker for the incidence of low muscle mass.

背景：C-末端农业蛋白片段（CAF）是神经肌肉接头降解的生物标志物。本研究旨在调查110kDa CAF（CAF110）是否与低肌肉质量和力量的存在和发生率有关。方法：这项横断面回顾性队列研究包括年龄≥65岁的女性。2011年至2012年间，我们使用双能X射线吸收仪扫描仪、握力和血液采样测量了肌肉质量。2015年至2017年间进行了一项具有相同测量值的后续研究。低肌肉质量和力量被定义为阑尾骨骼肌质量指数2和握力。结果：共有515名女性（74.3±6.3岁）被纳入该横断面分析。其中，101名（19.6%）和128名（24.9%）女性的肌肉质量和力量分别较低。对于低肌肉质量，与最低组相比，中等和最高CAF110三分位数组的比值比（OR）分别为1.93（95%置信区间：1.09-3.43；P=0.024）和2.15（1.22-3.80；P=0.008）。校正年龄后，ORs仍然显著：分别为1.98（1.11-3.52；P=0.020）和2.27（1.28-4.03；P=0.005）。所有CAF110三分位组的低肌力ORs均不显著。在纵向分析中，分别对292名和289名女性的肌肉质量和力量低下事件进行了评估。其中，34名（11.6%）和20名（6.9%）女性的肌肉质量和力量分别较低。对于发生的低肌肉质量，CAF110≥中值组的粗OR略高于CAF110。结论：CAF110与低肌肉强度无关。然而，CAF110可能是低肌肉质量发生率的潜在标志物。
{"title":"Association between the 110-kDa C-terminal agrin fragment and skeletal muscle decline among community-dwelling older women","authors":"Kuniyasu Kamiya,&nbsp;Takahiro Tachiki,&nbsp;Yuho Sato,&nbsp;Katsuyasu Kouda,&nbsp;Etsuko Kajita,&nbsp;Junko Tamaki,&nbsp;Sadanobu Kagamimori,&nbsp;Masayuki Iki","doi":"10.1002/jcsm.13309","DOIUrl":"10.1002/jcsm.13309","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>C-terminal agrin fragment (CAF) is a biomarker for neuromuscular junction degradation. This study aimed to investigate whether 110-kDa CAF (CAF110) was associated with the presence and incidence of low muscle mass and strength.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cross-sectional retrospective cohort study comprised women aged ≥65 years. We measured muscle mass using a dual-energy X-ray absorptiometry scanner, hand-grip strength, and blood sampling between 2011 and 2012. A follow-up study with the same measurements was conducted between 2015 and 2017. Low muscle mass and strength were defined as an appendicular skeletal muscle mass index &lt;5.4 kg/m<sup>2</sup> and hand-grip strength &lt;18 kg, respectively. The CAF110 level was measured using enzyme-linked immunosorbent assay kits.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 515 women (74.3 ± 6.3 years) were included in this cross-sectional analysis. Of these, 101 (19.6%) and 128 (24.9%) women presented with low muscle mass and strength, respectively. For low muscle mass, the odds ratios (ORs) of the middle and highest CAF110 tertile groups, compared with the lowest group, were 1.93 (95% confidence interval: 1.09–3.43; <i>P</i> = 0.024) and 2.15 (1.22–3.80; <i>P</i> = 0.008), respectively. After adjusting for age, the ORs remained significant: 1.98 (1.11–3.52; <i>P</i> = 0.020) and 2.27 (1.28–4.03; <i>P</i> = 0.005), respectively. Low muscle strength ORs of all the CAF110 tertile groups were not significant. In the longitudinal analysis, 292 and 289 women were assessed for incidents of low muscle mass and strength, respectively. Of those, 34 (11.6%) and 20 (6.9%) women exhibited low muscle mass and strength, respectively. For incident low muscle mass, the crude OR of the CAF110 ≥ the median value group was marginally higher than that of the CAF110 &lt; median value group (median [interquartile range]: 1.98 [0.94–4.17] (<i>P</i> = 0.072). After adjusting for age and baseline muscle mass, the OR was 2.22 [0.97–5.06] (<i>P</i> = 0.058). All low muscle strength ORs of the median categories of CAF110 were not significant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>CAF110 was not associated with low muscle strength. However, CAF110 may be a potential marker for the incidence of low muscle mass.</p>\u0000 </section>\u0000 </div>","PeriodicalId":186,"journal":{"name":"Journal of Cachexia, Sarcopenia and Muscle","volume":"14 5","pages":"2253-2263"},"PeriodicalIF":8.9,"publicationDate":"2023-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jcsm.13309","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9964736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A systematic review of automated segmentation of 3D computed-tomography scans for volumetric body composition analysis 用于体积身体成分分析的3D计算机断层扫描自动分割的系统综述。
IF 8.9 1区 医学
Journal of Cachexia, Sarcopenia and Muscle
Pub Date : 2023-08-10 DOI: 10.1002/jcsm.13310
Dinh Van Chi Mai, Ioanna Drami, Edward T. Pring, Laura E. Gould, Phillip Lung, Karteek Popuri, Vincent Chow, Mirza F. Beg, Thanos Athanasiou, John T. Jenkins, the BiCyCLE Research Group

Automated computed tomography (CT) scan segmentation (labelling of pixels according to tissue type) is now possible. This technique is being adapted to achieve three-dimensional (3D) segmentation of CT scans, opposed to single L3-slice alone. This systematic review evaluates feasibility and accuracy of automated segmentation of 3D CT scans for volumetric body composition (BC) analysis, as well as current limitations and pitfalls clinicians and researchers should be aware of. OVID Medline, Embase and grey literature databases up to October 2021 were searched. Original studies investigating automated skeletal muscle, visceral and subcutaneous AT segmentation from CT were included. Seven of the 92 studies met inclusion criteria. Variation existed in expertise and numbers of humans performing ground-truth segmentations used to train algorithms. There was heterogeneity in patient characteristics, pathology and CT phases that segmentation algorithms were developed upon. Reporting of anatomical CT coverage varied, with confusing terminology. Six studies covered volumetric regional slabs rather than the whole body. One study stated the use of whole-body CT, but it was not clear whether this truly meant head-to-fingertip-to-toe. Two studies used conventional computer algorithms. The latter five used deep learning (DL), an artificial intelligence technique where algorithms are similarly organized to brain neuronal pathways. Six of seven reported excellent segmentation performance (Dice similarity coefficients > 0.9 per tissue). Internal testing on unseen scans was performed for only four of seven algorithms, whilst only three were tested externally. Trained DL algorithms achieved full CT segmentation in 12 to 75 s versus 25 min for non-DL techniques. DL enables opportunistic, rapid and automated volumetric BC analysis of CT performed for clinical indications. However, most CT scans do not cover head-to-fingertip-to-toe; further research must validate using common CT regions to estimate true whole-body BC, with direct comparison to single lumbar slice. Due to successes of DL, we expect progressive numbers of algorithms to materialize in addition to the seven discussed in this paper. Researchers and clinicians in the field of BC must therefore be aware of pitfalls. High Dice similarity coefficients do not inform the degree to which BC tissues may be under- or overestimated and nor does it inform on algorithm precision. Consensus is needed to define accuracy and precision standards for ground-truth labelling. Creation of a large international, multicentre common CT dataset with BC ground-truth labels from multiple experts could be a robust solution.

自动计算机断层扫描（CT）扫描分割（根据组织类型标记像素）现在是可能的。该技术适用于实现CT扫描的三维（3D）分割，而不是单独的L3切片。这篇系统综述评估了用于体积体成分（BC）分析的3D CT扫描自动分割的可行性和准确性，以及临床医生和研究人员应注意的当前局限性和陷阱。检索了截至2021年10月的OVID Medline、Embase和灰色文献数据库。包括研究CT自动骨骼肌、内脏和皮下AT分割的原始研究。92项研究中有7项符合纳入标准。执行用于训练算法的地面实况分割的专业知识和人数存在差异。在患者特征、病理学和CT分期方面存在异质性，分割算法是基于这些异质性开发的。解剖CT覆盖范围的报告各不相同，术语混乱。六项研究涉及体积区域板块，而不是整个板块。一项研究表明使用全身CT，但尚不清楚这是否真的意味着从头到指尖到脚趾。两项研究使用了传统的计算机算法。后五种方法使用了深度学习（DL），这是一种人工智能技术，算法的组织方式与大脑神经元通路类似。七个中有六个报告了出色的分割性能（每个组织的骰子相似系数>0.9）。在七种算法中，只有四种算法对看不见的扫描进行了内部测试，而只有三种算法进行了外部测试。经过训练的DL算法在12到75秒内实现了完整的CT分割，而非DL技术为25分钟。DL能够对临床适应症的CT进行机会性、快速和自动化的体积BC分析。然而，大多数CT扫描不包括从头到指尖到脚趾；进一步的研究必须验证使用普通CT区域来估计真实的全身BC，并与单个腰椎切片进行直接比较。由于DL的成功，除了本文讨论的七种算法之外，我们还希望实现渐进数量的算法。因此，BC领域的研究人员和临床医生必须意识到陷阱。高Dice相似性系数并不能告知BC组织可能被低估或高估的程度，也不能告知算法的精度。需要达成共识来确定基本真相标签的准确性和精密度标准。使用多位专家的BC基本事实标签创建一个大型国际多中心通用CT数据集可能是一个稳健的解决方案。
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引用次数: 2
One-year change in sarcopenia was associated with cognitive impairment among haemodialysis patients 血液透析患者少肌症一年的变化与认知障碍有关。
IF 8.9 1区 医学
Journal of Cachexia, Sarcopenia and Muscle
Pub Date : 2023-08-09 DOI: 10.1002/jcsm.13311
Yuqi Yang, Jingjing Da, Jing Yuan, Yan Zha

Background

Our study aimed to evaluate change in sarcopenia, its defining components over 1 year follow-up and investigate associations with subsequent cognitive decline, incident mild cognitive impairment (MCI) and dementia among patients undergoing haemodialysis (HD).

Methods

In the multicentre, longitudinal study, 1117 HD patients aged 56.8 ± 14.3 years (654 men; and 463 women) from 17 dialysis centres in Guizhou Province, China, were recruited in 2019 and followed up for 1 year in 2020. Sarcopenia was diagnosed with Asian Working Group for Sarcopenia criteria using appendicular skeletal muscle mass index (ASMI) and handgrip strength (HGS). Body composition was measured using body composition monitor; body water, weight, and height were corrected to calculate ASMI. HGS was measured by mechanical handgrip dynamometer. Cognitive function was measured with Mini Mental State Examination. Multivariate linear, logistic regression models and subgroup analyses were employed to examine the associations of changes in sarcopenia, ASMI, and HGS with Mini Mental State Examination score change, and incident MCI, dementia.

Results

Four hundred fourteen (37.1%) patients had sarcopenia at baseline; during 1 year follow-up, 257 (23.0%) developed MCI and 143 (12.8%) developed dementia. According to changes in sarcopenia, patients were stratified into four groups: non-sarcopenia; non-sarcopenia to sarcopenia; sarcopenia; and sarcopenia to non-sarcopenia. HD patients in sarcopenia and non-sarcopenia to sarcopenia groups had higher risk of MCI (34.8%, 32.0%, vs. 17.4%) and dementia (20.6%, 19.8%, vs. 8.7%), compared non-sarcopenia group (P < 0.001). Multivariate linear regression analyses showed that sarcopenia [regression coefficients (β) −1.098, 95% confidence interval (CI) −1.872, −0.324, P = 0.005] and non-sarcopenia to sarcopenia (β −1.826, −2.441, −1.212, P < 0.001) were associated with faster cognitive decline compared to non-sarcopenia. HGS decline (β 0.046, 0.027–0.064, P < 0.001) and ASMI decline (β 0.236, 0.109–0.362, P < 0.001) were both positively associated with cognitive decline. Multivariate logistic regression analyses demonstrated that patients with sarcopenia and non-sarcopenia to sarcopenia were both at increased risk of developing MCI [odds ratio (OR) 1.788, 95% CI 1.115–2.870, P = 0.016 and OR 1.589, 95% CI 1.087–2.324, P = 0.017, respectively], but only non-sarcopenia to sarcopenia was at increased risk of dementia (OR 1.792, 95% CI 1.108–2.879, P

背景：我们的研究旨在评估在接受血液透析（HD）的患者中少肌症的变化及其定义成分，并调查其与随后的认知能力下降、轻度认知障碍（MCI）和痴呆的关系。方法：在多中心纵向研究中，2019年招募了来自中国贵州省17个透析中心的1117名HD患者，年龄为56.8±14.3岁（654名男性；463名女性），并于2020年随访了1年。Sarcopenia是根据亚洲Sarcoponia工作组的标准，使用阑尾骨骼肌质量指数（ASMI）和握力（HGS）诊断的。使用身体成分监测器测量身体成分；校正身体水分、体重和身高以计算ASMI。HGS采用机械握力测功机测量。认知功能采用迷你精神状态检查法进行测量。采用多变量线性、逻辑回归模型和亚组分析来检查少肌症、ASMI和HGS的变化与迷你精神状态检查分数变化以及MCI、痴呆事件的相关性。结果：414例（37.1%）患者在基线时出现少肌症；在一年的随访中，257人（23.0%）出现MCI，143人（12.8%）出现痴呆。根据少肌症的变化，将患者分为四组：非少肌症；非少肌症至少肌症；少肌症；以及少肌症至非少肌症。少肌症和非少肌症至少肌症组的HD患者患MCI（34.8%，32.0%，vs.17.4%）和痴呆（20.6%，19.8%，vs.8.7%）的风险更高，结论：HD患者新发、持续性少肌症和认知障碍之间存在纵向相关性，应及早发现和干预，以延缓少肌症的发作，改善认知健康。
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引用次数: 1
Cdon ablation in motor neurons causes age-related motor neuron degeneration and impaired sciatic nerve repair 运动神经元中的Cdon消融导致与年龄相关的运动神经元变性和坐骨神经修复受损。
IF 8.9 1区 医学
Journal of Cachexia, Sarcopenia and Muscle
Pub Date : 2023-08-09 DOI: 10.1002/jcsm.13308
Sunghee Kim, Subin An, Jinwoo Lee, Yideul Jeong, Chang-Lim You, Hyebeen Kim, Ju-Hyeon Bae, Chae-Eun Yun, Dongryul Ryu, Gyu-Un Bae, Jong-Sun Kang

Background

The functional deterioration and loss of motor neurons are tightly associated with degenerative motor neuron diseases and aging-related muscle wasting. Motor neuron diseases or aging-related muscle wasting in turn contribute to increased risk of adverse health outcomes in the elderly. Cdon (cell adhesion molecule-downregulated oncogene) belongs to the immunoglobulin superfamily of cell adhesion molecule and plays essential roles in multiple signalling pathways, including sonic hedgehog (Shh), netrin, and cadherin-mediated signalling. Cdon as a Shh coreceptor plays a critical role in motor neuron specification during embryonic development. However, its role in adult motor neuron function is unknown.

Methods

Hb9-Cre recombinase-driven motor neuron-specific Cdon deficient mice (mnKO) and a compound mutant mice (mnKO::SOD1G93A) were generated to investigate the role of Cdon in motor neuron degeneration. Motor neuron regeneration was examined by using a sciatic nerve crush injury model. To investigate the phenotype, physical activity, compound muscle action potential, immunostaining, and transmission electron microscopy were carried out. In the mechanism study, RNA sequencing and RNA/protein analyses were employed.

Results

Mice lacking Cdon in motor neurons exhibited middle age onset lethality and aging-related decline in motor function. In the sciatic nerve crush injury model, mnKO mice exhibited an impairment in motor function recovery evident by prolonged compound muscle action potential duration (4.63 ± 0.35 vs. 3.93 ± 0.22 s for f/f, P < 0.01) and physical activity. Consistently, neuromuscular junctions of mnKO muscles were incompletely occupied (49.79 ± 5.74 vs. 79.39 ± 3.77% fully occupied neuromuscular junctions for f/f, P < 0.0001), suggesting an impaired reinnervation. The transmission electron microscopy analysis revealed that mnKO sciatic nerves had smaller axon diameter (0.88 ± 0.13 vs. 1.43 ± 0.48 μm for f/f, P < 0.0001) and myelination defects. RNA sequencing of mnKO lumbar spinal cords showed alteration in genes related to neurogenesis, inflammation and cell death. Among the altered genes, ErbB4 and FgfR expressions were significantly altered in mnKO as well as in Cdon-depleted NSC34 motor neuron cells. Consistently, Cdon-depleted NSC34 cells exhibited elevated levels of cleaved Caspase3 and γH2AX proteins, as well as Bax transcription. Cdon-depleted NSC34 cells also exhibited impaired activation of Akt in response to neuregulin-1 (NRG1) treatment.

背景：运动神经元的功能退化和丧失与退行性运动神经元疾病和衰老相关的肌肉萎缩密切相关。运动神经元疾病或与衰老相关的肌肉萎缩反过来会增加老年人不良健康后果的风险。Cdon（细胞粘附分子下调癌基因）属于细胞粘附分子的免疫球蛋白超家族，在多种信号通路中发挥重要作用，包括声波刺猬（Shh）、netrin和钙粘蛋白介导的信号传导。Cdon作为一种Shh辅助受体，在胚胎发育过程中对运动神经元的指定起着关键作用。然而，它在成人运动神经元功能中的作用尚不清楚。方法：用Hb9-Cre重组酶驱动的运动神经元特异性Cdon缺陷小鼠（mnKO）和复合突变小鼠（mnKO:：SOD1G93A）研究Cdon在运动神经元变性中的作用。采用坐骨神经挤压伤模型检测运动神经元的再生。为了研究表型，进行了体力活动、复合肌肉动作电位、免疫染色和透射电子显微镜检查。在机制研究中，采用了RNA测序和RNA/蛋白质分析。结果：运动神经元缺乏Cdon的小鼠表现出中年发病致死性和与衰老相关的运动功能下降。在坐骨神经挤压损伤模型中，mnKO小鼠的运动功能恢复受损，复合肌肉动作电位持续时间延长（f/f为4.63±0.35 vs.3.93±0.22s，P结论：我们目前的数据表明了Cdon在运动神经元功能和神经修复中的功能重要性。Cdon消融导致神经营养素信号改变，导致运动神经元变性。
{"title":"Cdon ablation in motor neurons causes age-related motor neuron degeneration and impaired sciatic nerve repair","authors":"Sunghee Kim,&nbsp;Subin An,&nbsp;Jinwoo Lee,&nbsp;Yideul Jeong,&nbsp;Chang-Lim You,&nbsp;Hyebeen Kim,&nbsp;Ju-Hyeon Bae,&nbsp;Chae-Eun Yun,&nbsp;Dongryul Ryu,&nbsp;Gyu-Un Bae,&nbsp;Jong-Sun Kang","doi":"10.1002/jcsm.13308","DOIUrl":"10.1002/jcsm.13308","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The functional deterioration and loss of motor neurons are tightly associated with degenerative motor neuron diseases and aging-related muscle wasting. Motor neuron diseases or aging-related muscle wasting in turn contribute to increased risk of adverse health outcomes in the elderly. Cdon (cell adhesion molecule-downregulated oncogene) belongs to the immunoglobulin superfamily of cell adhesion molecule and plays essential roles in multiple signalling pathways, including sonic hedgehog (Shh), netrin, and cadherin-mediated signalling. Cdon as a Shh coreceptor plays a critical role in motor neuron specification during embryonic development. However, its role in adult motor neuron function is unknown.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Hb9-Cre recombinase-driven motor neuron-specific Cdon deficient mice (mnKO) and a compound mutant mice (mnKO::SOD1<sup>G93A</sup>) were generated to investigate the role of Cdon in motor neuron degeneration. Motor neuron regeneration was examined by using a sciatic nerve crush injury model. To investigate the phenotype, physical activity, compound muscle action potential, immunostaining, and transmission electron microscopy were carried out. In the mechanism study, RNA sequencing and RNA/protein analyses were employed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Mice lacking Cdon in motor neurons exhibited middle age onset lethality and aging-related decline in motor function. In the sciatic nerve crush injury model, mnKO mice exhibited an impairment in motor function recovery evident by prolonged compound muscle action potential duration (4.63 ± 0.35 vs. 3.93 ± 0.22 s for f/f, <i>P</i> &lt; 0.01) and physical activity. Consistently, neuromuscular junctions of mnKO muscles were incompletely occupied (49.79 ± 5.74 vs. 79.39 ± 3.77% fully occupied neuromuscular junctions for f/f, <i>P</i> &lt; 0.0001), suggesting an impaired reinnervation. The transmission electron microscopy analysis revealed that mnKO sciatic nerves had smaller axon diameter (0.88 ± 0.13 vs. 1.43 ± 0.48 μm for f/f, <i>P</i> &lt; 0.0001) and myelination defects. RNA sequencing of mnKO lumbar spinal cords showed alteration in genes related to neurogenesis, inflammation and cell death. Among the altered genes, ErbB4 and FgfR expressions were significantly altered in mnKO as well as in Cdon-depleted NSC34 motor neuron cells. Consistently, Cdon-depleted NSC34 cells exhibited elevated levels of cleaved Caspase3 and γH2AX proteins, as well as Bax transcription. Cdon-depleted NSC34 cells also exhibited impaired activation of Akt in response to neuregulin-1 (NRG1) treatment.</p>\u0000 </section>\u0000 ","PeriodicalId":186,"journal":{"name":"Journal of Cachexia, Sarcopenia and Muscle","volume":"14 5","pages":"2239-2252"},"PeriodicalIF":8.9,"publicationDate":"2023-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jcsm.13308","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10320566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
AAV1.NT-3 gene therapy in the SOD1KO mouse model of accelerated sarcopenia AAV1.NT-3基因治疗加速少肌症SOD1KO小鼠模型。
IF 8.9 1区 医学
Journal of Cachexia, Sarcopenia and Muscle
Pub Date : 2023-08-08 DOI: 10.1002/jcsm.13303
Lingying Tong, Burcak Ozes, Kyle Moss, Morgan Myers, Alicia Ridgley, Zarife Sahenk

Background

Sarcopenia, an age-related loss of muscle mass, is a critical factor that affects the health of the older adults. The SOD1KO mouse is deficient of Cu/Zn superoxide dismutase, used as an accelerated aging model. We previously showed that NT-3 improves muscle fibre size by activating the mTOR pathway, suggesting a potential for attenuating age-related muscle loss. This study assessed the therapeutic efficacy of AAV1.NT-3 in this accelerated aging model.

Methods

Twelve 6 months old SOD1KO mice were injected intramuscularly with a 1 × 1011 vg dose of AAV1.tMCK.NT-3, and 13 age-matched SOD1KO mice were used as controls. The treatment effect was evaluated using treadmill, rotarod and gait analyses as well as histological studies assessing changes in muscle fibre, and fibre type switch, in tibialis anterior, gastrocnemius, and triceps muscles, and myelin thickness by calculating G ratio in sciatic and tibial nerves. Molecular studies involved qPCR experiments to analyse the expression levels of mitochondrial and glycolysis markers and western blot experiments to assess the activity of mTORC1 pathway.

Results

Treatment resulted in a 36% (154.9 vs. 114.1; P < 0.0001) and 76% increase (154.3 vs. 87.6; P < 0.0001) in meters ran, with treadmill test at 3 and 6 months post gene delivery. In addition, the treated cohort stayed on rotarod 30% (52.7 s vs. 40.4 s; P = 0.0095) and 54% (50.4 s vs. 32.7 s; P = 0.0007) longer, compared with untreated counterparts at 3 and 6 months post injection. Gait analysis, performed at endpoint, showed that stride width was normalized to wild type levels (29.3 mm) by an 11% decrease, compared with untreated cohort (28.6 mm vs. 32.1 mm; P = 0.0014). Compared with wild-type, SOD1KO mice showed 9.4% and 11.4% fibre size decrease in tibialis anterior and gastrocnemius muscles, respectively, which were normalized to wild type levels with treatment. Fibre diameter increase was observed prominently in FTG fibre type. G ratio analysis revealed hypomyelination in the tibial (0.721) and sciatic (0.676) nerves of SOD1KO model, which was reversed in the NT-3 cohort (0.646 and 0.634, respectively). Fibre size increase correlated with the increase in the p-S6 and p-4E-BP1 levels, and in the glycolysis markers in tibialis anterior. Alterations observed in the mitochondrial markers were not rescued with treatment. Overall, response to NT-3 was subdued in gastrocnemius muscle.

Conclu

背景：肌肉萎缩是一种与年龄相关的肌肉质量损失，是影响老年人健康的关键因素。SOD1KO小鼠缺乏Cu/Zn超氧化物歧化酶，用作加速衰老模型。我们之前表明，NT-3通过激活mTOR途径改善肌肉纤维大小，这表明它有可能减轻与年龄相关的肌肉损失。本研究评估了AAV1.NT-3在这种加速衰老模型中的治疗效果。方法：12只6个月大的SOD1KO小鼠肌肉注射1×1011vg剂量的AAV1.tMCK.NT-3，13只年龄匹配的SOD1KO小鼠作为对照。使用跑步机、旋转杆和步态分析以及组织学研究来评估治疗效果，通过计算坐骨神经和胫骨神经的G比率来评估胫骨前肌、腓肠肌和三头肌的肌肉纤维和纤维类型转换的变化，以及髓鞘厚度。分子研究包括qPCR实验来分析线粒体和糖酵解标志物的表达水平，以及蛋白质印迹实验来评估mTORC1通路的活性。结果：治疗导致36%（154.9 vs.114.1；P结论：本研究表明，AAV1.NT-3基因治疗在功能和组织学上保护SOD1KO小鼠免受加速衰老的影响。我们进一步证实，NT-3有可能激活肌肉中的mTOR和糖酵解途径。
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引用次数: 1
Comment on: ‘Triceps skinfold-albumin index significantly predicts the prognosis of cancer cachexia: A multicentre cohort study’ by Yin et al. 评论：Yin等人的“三角肌皮褶白蛋白指数显著预测癌症恶病质的预后：一项多中心队列研究”。
IF 8.9 1区 医学
Journal of Cachexia, Sarcopenia and Muscle
Pub Date : 2023-08-07 DOI: 10.1002/jcsm.13304
Ping'an Ding, Haotian Wu, Jiaxiang Wu, Chenyu Sun, Muzi Meng, Peigang Yang, Yang Liu, Lingjiao Meng, Qun Zhao

The study by Yin et al.1 is greatly appreciated for their contributions to research, particularly in developing the triceps skinfold-albumin index (TA). This new comprehensive index combines fat mass and nutritional status to evaluate malnutrition and has been identified as independently associated with the prognosis of patients with cancer cachexia. Yin et al.1 successfully identified different cut-off values of TA for each gender, which divided patients into normal and low groups. The different groups showed significant differences in prognostic effects, with normal TA patients being significantly associated with lower mortality and the opposite association found for lower TA patients. Additionally, TA demonstrated a wide discrimination performance for the prognosis of patients of all ages. This study is particularly meaningful for two main reasons. Firstly, despite being calculated by only two sample parameters, TA's accuracy for predicting the prognosis of patients with cancer cachexia is higher than that of previous predictive indices, such as NRI, PNI, and SII. Furthermore, TA is cost-effective and easy to use. Secondly, the gender-specific cut-off values of TA are consistent with the differences in nutrition between men and women. Moreover, this prospective, large sample, and geographically multi-centre cohort study ensures reliable confirmation of the results. Therefore, based on these aspects, TA may be considered a clinically meaningful and promising indicator for predicting the prognosis of patients with cancer cachexia.

Nonetheless, the generalizability of the previous findings of TA was not confirmed in patients with diverse cancer types or undergoing various treatments. To address this gap, we investigated the clinical applicability of TA as a predictive tool for cancer cachexia in patients with locally advanced gastric cancer (LAGC) across multiple prospective cohorts (NCT01516944, NCT02555358, NCT03349866, and NCT01962246) registered in our institution. The study included 1266 LAGC patients, of which 898 (70.93%) had complete serum albumin values and detailed triceps skinfold thickness (mm) data. Of these patients, 188 (20.94%) were diagnosed with cancer cachexia based on the 2011 International Consensus on Cancer Cachexia criteria outlined by Fearon et al.2 The median age of the patients diagnosed with cancerous cachexia was 60 years (interquartile range [IQR], 35–77), with 125 (66.49%) males and 63 (33.51%) females. Our analysis revealed that mean TA was lower in males than in females in the cohort (51.8 vs. 56.3). We stratified the patients into high and low TA groups based on the optimal cut-off values (male: TA < 45.6, female: TA < 49.9) established in the previous study by Yin et al.1 Out of 188 patients, 57 (30.32%) were classified in the low TA group. During a median follow-up of 65.8 months (12.9–109.7 months), 2

Yin等人的研究1因其对研究的贡献而受到高度赞赏，特别是在开发肱三头肌皮褶-白蛋白指数(TA)方面。这个新的综合指数结合了脂肪量和营养状况来评估营养不良，并已被确定为与癌症恶病质患者的预后独立相关。Yin等人1成功地识别出不同性别TA的临界值，将患者分为正常组和低组。不同组在预后效果上表现出显著差异，正常TA患者与较低的死亡率显著相关，而较低TA患者的死亡率则相反。此外，TA对所有年龄段患者的预后表现出广泛的判别性能。这项研究之所以特别有意义，主要有两个原因。首先，尽管TA仅由两个样本参数计算，但其预测癌症恶病质患者预后的准确性高于以往的预测指标，如NRI、PNI、SII。此外，TA具有成本效益和易于使用的特点。其次，TA的性别分界值与男女营养差异是一致的。此外，这项前瞻性、大样本、地理上多中心的队列研究确保了结果的可靠确认。因此，基于这些方面，TA可能被认为是预测癌症恶病质患者预后的一项具有临床意义和前景的指标。然而，在不同癌症类型或接受不同治疗的患者中，先前TA发现的普遍性尚未得到证实。为了解决这一差距，我们通过在我院注册的多个前瞻性队列(NCT01516944、NCT02555358、NCT03349866和NCT01962246)研究了TA作为局部晚期胃癌(LAGC)患者癌症恶病质预测工具的临床适用性。本研究纳入1266例LAGC患者，其中898例(70.93%)具有完整的血清白蛋白值和详细的三头肌皮褶厚度(mm)数据。根据Fearon等人提出的2011年国际癌症恶病质共识标准，其中188例(20.94%)被诊断为癌性恶病质。2诊断为癌性恶病质的患者中位年龄为60岁(四分位间距[IQR]， 35-77)，其中男性125例(66.49%)，女性63例(33.51%)。我们的分析显示，该队列中男性的平均TA低于女性(51.8比56.3)。我们根据最佳临界值将患者分为高、低TA组(男性:TA &lt;45.6，女:TA &lt;49.9)， Yin等人在之前的研究中建立1 188例患者中，57例(30.32%)被划分为低TA组。中位随访65.8个月(12.9 ~ 109.7个月)，术后病理II期患者死亡20例(36.36%)，III期患者死亡64例(48.12%)。结果显示，高TA组患者的总生存率(OS)明显高于低TA组(61.83% vs. 40.35%， P = 0.004)(图1A)。此外，高TA组患者的无病生存率(DFS)高于低TA组(56.49% vs 28.07%， P &lt;0.001)(图1D)。基于肿瘤pTNM分期的亚组分析也显示，与低TA组相比，II期和III期患者的高TA与延长的OS和DFS相关[(II期:OS: 70.59% vs. 52.38%， P = 0.044;DFS: 64.71% vs. 47.62%， P = 0.027);(III期:OS: 58.76% vs. 33.33%， P = 0.002;DFS: 53.61%对16.67%，P &lt;0.001)](图1B,C,E,F)。我们的研究结果表明，TA可以作为预测LAGC伴癌恶病质患者预后和复发情况的有用工具，这与Yin等人最初的研究结果相似。1癌症患者常并发癌恶病质，对其预后和生存时间有负面影响。3,4因此，为癌症恶病质患者确定可靠且具有成本效益的预后标志物至关重要。虽然已经研究了蛋白质和炎症生物标志物来预测LAGC恶病质患者的预后5,6，但其成本高和影响单一的方面限制了其临床应用。TA作为一种综合了脂肪量和营养状况的癌症恶病质的综合预后预测指标，提供了有意义的预后分层，已被证明对不同肿瘤病理或不同临床治疗的恶病质LAGC患者具有临床意义。我们要感谢尹良玉等人在改善癌症恶病质预后和提供临床可靠的生物标志物方面做出的宝贵贡献。
{"title":"Comment on: ‘Triceps skinfold-albumin index significantly predicts the prognosis of cancer cachexia: A multicentre cohort study’ by Yin et al.","authors":"Ping'an Ding,&nbsp;Haotian Wu,&nbsp;Jiaxiang Wu,&nbsp;Chenyu Sun,&nbsp;Muzi Meng,&nbsp;Peigang Yang,&nbsp;Yang Liu,&nbsp;Lingjiao Meng,&nbsp;Qun Zhao","doi":"10.1002/jcsm.13304","DOIUrl":"10.1002/jcsm.13304","url":null,"abstract":"<p>The study by Yin et al.<span><sup>1</sup></span> is greatly appreciated for their contributions to research, particularly in developing the triceps skinfold-albumin index (TA). This new comprehensive index combines fat mass and nutritional status to evaluate malnutrition and has been identified as independently associated with the prognosis of patients with cancer cachexia. Yin et al.<span><sup>1</sup></span> successfully identified different cut-off values of TA for each gender, which divided patients into normal and low groups. The different groups showed significant differences in prognostic effects, with normal TA patients being significantly associated with lower mortality and the opposite association found for lower TA patients. Additionally, TA demonstrated a wide discrimination performance for the prognosis of patients of all ages. This study is particularly meaningful for two main reasons. Firstly, despite being calculated by only two sample parameters, TA's accuracy for predicting the prognosis of patients with cancer cachexia is higher than that of previous predictive indices, such as NRI, PNI, and SII. Furthermore, TA is cost-effective and easy to use. Secondly, the gender-specific cut-off values of TA are consistent with the differences in nutrition between men and women. Moreover, this prospective, large sample, and geographically multi-centre cohort study ensures reliable confirmation of the results. Therefore, based on these aspects, TA may be considered a clinically meaningful and promising indicator for predicting the prognosis of patients with cancer cachexia.</p><p>Nonetheless, the generalizability of the previous findings of TA was not confirmed in patients with diverse cancer types or undergoing various treatments. To address this gap, we investigated the clinical applicability of TA as a predictive tool for cancer cachexia in patients with locally advanced gastric cancer (LAGC) across multiple prospective cohorts (NCT01516944, NCT02555358, NCT03349866, and NCT01962246) registered in our institution. The study included 1266 LAGC patients, of which 898 (70.93%) had complete serum albumin values and detailed triceps skinfold thickness (mm) data. Of these patients, 188 (20.94%) were diagnosed with cancer cachexia based on the 2011 International Consensus on Cancer Cachexia criteria outlined by Fearon et al.<span><sup>2</sup></span> The median age of the patients diagnosed with cancerous cachexia was 60 years (interquartile range [IQR], 35–77), with 125 (66.49%) males and 63 (33.51%) females. Our analysis revealed that mean TA was lower in males than in females in the cohort (51.8 vs. 56.3). We stratified the patients into high and low TA groups based on the optimal cut-off values (male: TA &lt; 45.6, female: TA &lt; 49.9) established in the previous study by Yin et al.<span><sup>1</sup></span> Out of 188 patients, 57 (30.32%) were classified in the low TA group. During a median follow-up of 65.8 months (12.9–109.7 months), 2","PeriodicalId":186,"journal":{"name":"Journal of Cachexia, Sarcopenia and Muscle","volume":"14 5","pages":"2446-2448"},"PeriodicalIF":8.9,"publicationDate":"2023-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jcsm.13304","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9945333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Weight-adjusted waist as an integrated index for fat, muscle and bone health in adults 体重调整后的腰围是成年人脂肪、肌肉和骨骼健康的综合指标。
IF 8.9 1区 医学
Journal of Cachexia, Sarcopenia and Muscle
Pub Date : 2023-08-07 DOI: 10.1002/jcsm.13302
Kyoung Jin Kim, Serhim Son, Kyeong Jin Kim, Sin Gon Kim, Nam Hoon Kim

Background

Unhealthy body composition, including high fat mass, low muscle mass and low bone mass, is a critical health issue in adults. The weight-adjusted waist index (WWI) estimates fat and muscle mass and may have implications for bone health. We examined its association with body composition outcomes in a large Korean adult cohort.

Methods

This study used data from the Korean National Health and Nutrition Examination Survey (2008–2011). WWI was calculated as waist circumference (cm) divided by the square root of body weight (kg). Dual-energy X-ray absorptiometry was used to measure bone mineral density (BMD), appendicular lean mass (ALM) and total body fat percentage. Unhealthy body composition was defined as combined presence of high fat mass, low bone mass and low muscle mass.

Results

A total of 5983 individuals (3034 men [50.7%] and 2949 women [49.3%]; mean age: 63.5 ± 8.7 years) were included. WWI was positively correlated with total body fat percentage (r = 0.478, P < 0.001) and inversely with ALM/weight (r = −0.485, P < 0.001) and BMD at the lumbar spine (r = −0.187, P < 0.001), femoral neck (r = −0.269, P < 0.001) and total hip (r = −0.255, P < 0.001). Higher WWI quartiles correlated with lower BMD, T-scores and ALM/weight, along with increased total body fat, evident in both genders and more pronounced in women, even after adjusting for confounders. This trend remained statistically significant across WWI quartiles for all analyses (P < 0.001). Higher WWI quartiles were also significantly associated with higher odds of unhealthy body composition, with adjusted odds ratio in the highest WWI group of 18.08 (95% CI, 4.32–75.61) in men and 6.36 (95% CI, 3.65–11.07) in women. The optimal cutoff values of WWI for unhealthy body composition were 10.4 cm/√kg in men and 10.5 cm/√kg in women.

Conclusions

In community-dwelling adults, high WWI values are associated with unfavourable body composition outcomes, indicating high fat mass, low muscle mass and low bone mass. WWI can potentially serve as an integrated index of body composition, underscoring the need for further research to validate its use in clinical settings.

背景：不健康的身体组成，包括高脂肪、低肌肉和低骨量，是成年人的一个关键健康问题。体重调整后的腰围指数（WWI）估计脂肪和肌肉质量，可能对骨骼健康有影响。我们在一个大型韩国成年队列中研究了它与身体成分结果的关系。方法：本研究使用了韩国国民健康和营养检查调查（2008-2011年）的数据。WWI计算为腰围（cm）除以体重（kg）的平方根。采用双能X线骨密度仪测量骨密度（BMD）、阑尾瘦块（ALM）和全身脂肪百分比。不健康的身体组成被定义为高脂肪、低骨量和低肌肉的综合存在。结果：共有5983人（3034名男性[507%]和2949名女性[49.3%]；平均年龄：63.5±8.7岁）被纳入。WWI与全身脂肪百分比呈正相关（r=0.478，P结论：在社区居住的成年人中，高WWI值与不利的身体成分结果有关，表明高脂肪量、低肌肉量和低骨量。WWI可以作为身体成分的综合指标，强调需要进一步研究来验证其在临床环境中的应用。
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引用次数: 0
Association of malignant ascites with systemic inflammation and muscle loss after treatment in advanced-stage ovarian cancer 晚期癌症治疗后恶性腹水与全身炎症和肌肉损失的相关性。
IF 8.9 1区 医学
Journal of Cachexia, Sarcopenia and Muscle
Pub Date : 2023-07-28 DOI: 10.1002/jcsm.13289
Chia-Sui Weng, Wan-Chun Huang, Chih-Long Chang, Ya-Ting Jan, Tze-Chien Chen, Jie Lee

Background

Malignant ascites is prevalent in advanced-stage ovarian cancer and may facilitate identification of the drivers of muscle loss. This study aimed to evaluate the association of ascites with changes in systemic inflammation and muscle after treatment of advanced-stage ovarian cancer.

Methods

We evaluated 307 patients with advanced-stage (III/IVA) ovarian cancer who underwent primary debulking surgery and adjuvant platinum-based chemotherapy between 2010 and 2019. The changes in skeletal muscle index (SMI) and radiodensity (SMD) were measured using pre-surgery and post-chemotherapy portal-venous phase contrast-enhanced computed tomography scans at L3. Systemic inflammation was measured using albumin levels, prognostic nutritional index (PNI), neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR). Primary endpoint was the changes in SMI and SMD after treatment. Linear regression analysis was used to test associations between muscle change and other covariates. Mediation analysis was used to determine the mediator.

Results

The median (range) age was 53 (23–83) years. The median duration (range) of follow-up was 5.2 (1.1–11.3) years. Overall, 187 (60.9%) patients had ascites. The changes in muscle and systemic inflammatory markers after treatment were significantly different between patients with and without ascites (SMI: −3.9% vs. 2.2%, P < 0.001; SMD: −4.0% vs. −0.4%, P < 0.001; albumin: −4.4% vs. 2.1%, P < 0.001; PNI: −8.4% vs. −0.1%, P < 0.001; NLR: 20.6% vs. −29.4%, P < 0.001; and PLR: 1.7% vs. −19.4%, P < 0.001). The changes in SMI and SMD were correlated with the changes in albumin, PNI, NLR, and PLR (all P < 0.001). In multiple linear regression, ascites and NLR changes were negatively while albumin change was positively correlated with SMI change (ascites: β = −3.19, P < 0.001; NLR change: β = −0.02, P = 0.003; albumin change: β = 0.37, P < 0.001). Ascites and NLR changes were negatively while PNI change was positively correlated with SMD change (ascites: β = −1.28, P = 0.02; NLR change: β = −0.02, P < 0.001; PNI change: β = 0.11, P = 0.04). In mediation analysis, ascites had a direct effect on SMI change (P < 0.001) and an indirect effect mediated by NLR change (indirect effects = −1.61, 95% confidence interval [CI]: −2.22 to −1.08) and albumin change (indirect effects = −2.92, 95% CI: −4.01 to −1.94). Ascites had a direct effect on SMD change (P < 0.001) and an indirect eff

背景：恶性腹水在晚期癌症中普遍存在，可能有助于识别肌肉损失的驱动因素。本研究旨在评估晚期癌症治疗后腹水与全身炎症和肌肉变化的关系。方法：我们评估了307例癌症晚期（III/IVA）患者，他们在2010年至2019年间接受了初级减瘤手术和辅助铂基化疗。使用术前和化疗后L3的门静脉期对比增强计算机断层扫描测量骨骼肌指数（SMI）和放射密度（SMD）的变化。使用白蛋白水平、预后营养指数（PNI）、中性粒细胞淋巴细胞比率（NLR）和血小板淋巴细胞比率（PLR）测量全身炎症。主要终点是治疗后SMI和SMD的变化。线性回归分析用于检验肌肉变化和其他协变量之间的相关性。使用中介分析来确定调解员。结果：中位（范围）年龄为53岁（23-83岁）。随访的中位持续时间（范围）为5.2年（1.1-11.3）。总的来说，187名（60.9%）患者有腹水。有腹水和无腹水患者治疗后肌肉和全身炎症标志物的变化有显著差异（SMI:3.9%vs.2.2%，P结论：晚期卵巢癌症在初次减瘤手术和辅助化疗后，恶性腹水与全身炎症增强和肌肉损失有关。腹水与肌肉损失之间的联系可能是由全身炎症介导的。
{"title":"Association of malignant ascites with systemic inflammation and muscle loss after treatment in advanced-stage ovarian cancer","authors":"Chia-Sui Weng,&nbsp;Wan-Chun Huang,&nbsp;Chih-Long Chang,&nbsp;Ya-Ting Jan,&nbsp;Tze-Chien Chen,&nbsp;Jie Lee","doi":"10.1002/jcsm.13289","DOIUrl":"10.1002/jcsm.13289","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Malignant ascites is prevalent in advanced-stage ovarian cancer and may facilitate identification of the drivers of muscle loss. This study aimed to evaluate the association of ascites with changes in systemic inflammation and muscle after treatment of advanced-stage ovarian cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We evaluated 307 patients with advanced-stage (III/IVA) ovarian cancer who underwent primary debulking surgery and adjuvant platinum-based chemotherapy between 2010 and 2019. The changes in skeletal muscle index (SMI) and radiodensity (SMD) were measured using pre-surgery and post-chemotherapy portal-venous phase contrast-enhanced computed tomography scans at L3. Systemic inflammation was measured using albumin levels, prognostic nutritional index (PNI), neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR). Primary endpoint was the changes in SMI and SMD after treatment. Linear regression analysis was used to test associations between muscle change and other covariates. Mediation analysis was used to determine the mediator.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The median (range) age was 53 (23–83) years. The median duration (range) of follow-up was 5.2 (1.1–11.3) years. Overall, 187 (60.9%) patients had ascites. The changes in muscle and systemic inflammatory markers after treatment were significantly different between patients with and without ascites (SMI: −3.9% vs. 2.2%, <i>P</i> &lt; 0.001; SMD: −4.0% vs. −0.4%, <i>P</i> &lt; 0.001; albumin: −4.4% vs. 2.1%, <i>P</i> &lt; 0.001; PNI: −8.4% vs. −0.1%, <i>P</i> &lt; 0.001; NLR: 20.6% vs. −29.4%, <i>P</i> &lt; 0.001; and PLR: 1.7% vs. −19.4%, <i>P</i> &lt; 0.001). The changes in SMI and SMD were correlated with the changes in albumin, PNI, NLR, and PLR (all <i>P</i> &lt; 0.001). In multiple linear regression, ascites and NLR changes were negatively while albumin change was positively correlated with SMI change (ascites: β = −3.19, <i>P</i> &lt; 0.001; NLR change: β = −0.02, <i>P</i> = 0.003; albumin change: β = 0.37, <i>P</i> &lt; 0.001). Ascites and NLR changes were negatively while PNI change was positively correlated with SMD change (ascites: β = −1.28, <i>P</i> = 0.02; NLR change: β = −0.02, <i>P</i> &lt; 0.001; PNI change: β = 0.11, <i>P</i> = 0.04). In mediation analysis, ascites had a direct effect on SMI change (<i>P</i> &lt; 0.001) and an indirect effect mediated by NLR change (indirect effects = −1.61, 95% confidence interval [CI]: −2.22 to −1.08) and albumin change (indirect effects = −2.92, 95% CI: −4.01 to −1.94). Ascites had a direct effect on SMD change (<i>P</i> &lt; 0.001) and an indirect eff","PeriodicalId":186,"journal":{"name":"Journal of Cachexia, Sarcopenia and Muscle","volume":"14 5","pages":"2114-2125"},"PeriodicalIF":8.9,"publicationDate":"2023-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jcsm.13289","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9881316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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