Seung Hun Lee, Jinhwan Jo, Jeong Hoon Yang, Sung Mok Kim, Ki Hong Choi, Young Bin Song, Dong Seop Jeong, Joo Myung Lee, Taek Kyu Park, Joo‐Yong Hahn, Seung‐Hyuk Choi, Su Ryeun Chung, Yang Hyun Cho, Kiick Sung, Wook Sung Kim, Hyeon‐Cheol Gwon, Young Tak Lee
BackgroundSarcopenia is an aging‐related condition characterized by loss of skeletal muscle mass and is an indicator of subclinical atherosclerosis. The relationship between reduced muscle mass and long‐term clinical outcomes in patients with advanced coronary artery disease who have undergone coronary artery bypass grafting (CABG) is not fully understood. This study is sought to evaluate the prognostic implications of sarcopenia screening in patients undergoing CABG.MethodsA total of 2810 patients who underwent CABG were analysed and classified according to presence of reduced muscle mass. The skeletal muscle index (SMI) was calculated as L3 muscle area (cm2)/height (m)2 on computed tomography. Reduced SMI was defined as SMI ≤ 45 cm2/m2 in male and ≤ 38 cm2/m2 in female. The primary outcome was all‐cause mortality, and survival analysis was performed using the Kaplan–Meier method and compared with the log‐rank test.ResultsThe median follow‐up was 8.7 years, and 924 patients (32.9%) had reduced SMI. Patients with reduced SMI were older (67.7 ± 8.8 vs. 62.2 ± 9.8 years; p < 0.001) and less frequently male (69.8% vs. 81.1%; p < 0.001). SMI was significantly associated with risk of death on a restricted cubic spline curve (HR = 1.04 per‐1 decrease; 95% CI 1.03–1.05; p < 0.001). Patients with reduced SMI had a higher incidence of long‐term mortality than those with preserved SMI (survival rate 41.4% vs. 62.8%; HRadj = 1.18, 95% CI 1.03–1.36, p = 0.020). Subgroup analysis showed that the prognostic implication of reduced SMI on long‐term survival was more evident in male (HRadj = 2.01, 95% CI 1.72–2.35) than female (HRadj = 1.28, 95% CI 0.98–1.68) (interaction p = 0.006).ConclusionsReduced muscle mass, defined by SMI on computed tomography, was associated with long‐term mortality after CABG. These results provide contemporary data to allow the evaluation of physical frailty in patients with advanced coronary artery disease before surgery.Trial Registration: Long‐Term Outcomes and Prognostic Factors in Patients Undergoing CABG or PCI: NCT03870815
背景肌肉疏松症是一种与衰老有关的疾病，其特点是骨骼肌量减少，是亚临床动脉粥样硬化的一个指标。接受冠状动脉旁路移植术（CABG）的晚期冠状动脉疾病患者肌肉质量下降与长期临床预后之间的关系尚未完全明了。本研究旨在评估肌肉疏松症筛查对接受冠状动脉旁路移植术患者预后的影响。方法：本研究共分析了 2810 名接受冠状动脉旁路移植术的患者，并根据肌肉质量是否减少进行了分类。骨骼肌指数（SMI）根据计算机断层扫描的 L3 肌肉面积（平方厘米）/身高（米）2 计算得出。男性骨骼肌指数≤45 cm2/m2，女性骨骼肌指数≤38 cm2/m2，即为骨骼肌指数降低。主要结果是全因死亡率，采用 Kaplan-Meier 法进行生存分析，并用对数秩检验进行比较。结果中位随访时间为 8.7 年，924 名患者（32.9%）的 SMI 降低。SMI降低的患者年龄较大（67.7 ± 8.8 岁 vs. 62.2 ± 9.8 岁；p < 0.001），男性较少（69.8% vs. 81.1%；p < 0.001）。在限制性立方样条曲线上，SMI 与死亡风险明显相关（HR = 1.04 per-1 decrease; 95% CI 1.03-1.05; p <0.001）。与保留 SMI 的患者相比，SMI 降低的患者的长期死亡率更高（存活率为 41.4% 对 62.8%；HRadj = 1.18，95% CI 1.03-1.36，p = 0.020）。亚组分析显示，SMI降低对长期生存的预后影响在男性（HRadj = 2.01，95% CI 1.72-2.35）比女性（HRadj = 1.28，95% CI 0.98-1.68）更明显（交互作用 p = 0.006）。这些结果为晚期冠状动脉疾病患者在手术前评估体质虚弱程度提供了现代数据：接受 CABG 或 PCI 患者的长期结果和预后因素：NCT03870815
{"title":"Clinical Impact of Sarcopenia Screening on Long‐Term Mortality in Patients Undergoing Coronary Bypass Grafting","authors":"Seung Hun Lee, Jinhwan Jo, Jeong Hoon Yang, Sung Mok Kim, Ki Hong Choi, Young Bin Song, Dong Seop Jeong, Joo Myung Lee, Taek Kyu Park, Joo‐Yong Hahn, Seung‐Hyuk Choi, Su Ryeun Chung, Yang Hyun Cho, Kiick Sung, Wook Sung Kim, Hyeon‐Cheol Gwon, Young Tak Lee","doi":"10.1002/jcsm.13645","DOIUrl":"https://doi.org/10.1002/jcsm.13645","url":null,"abstract":"BackgroundSarcopenia is an aging‐related condition characterized by loss of skeletal muscle mass and is an indicator of subclinical atherosclerosis. The relationship between reduced muscle mass and long‐term clinical outcomes in patients with advanced coronary artery disease who have undergone coronary artery bypass grafting (CABG) is not fully understood. This study is sought to evaluate the prognostic implications of sarcopenia screening in patients undergoing CABG.MethodsA total of 2810 patients who underwent CABG were analysed and classified according to presence of reduced muscle mass. The skeletal muscle index (SMI) was calculated as L3 muscle area (cm<jats:sup>2</jats:sup>)/height (m)<jats:sup>2</jats:sup> on computed tomography. Reduced SMI was defined as SMI ≤ 45 cm<jats:sup>2</jats:sup>/m<jats:sup>2</jats:sup> in male and ≤ 38 cm<jats:sup>2</jats:sup>/m<jats:sup>2</jats:sup> in female. The primary outcome was all‐cause mortality, and survival analysis was performed using the Kaplan–Meier method and compared with the log‐rank test.ResultsThe median follow‐up was 8.7 years, and 924 patients (32.9%) had reduced SMI. Patients with reduced SMI were older (67.7 ± 8.8 vs. 62.2 ± 9.8 years; <jats:italic>p</jats:italic> < 0.001) and less frequently male (69.8% vs. 81.1%; <jats:italic>p</jats:italic> < 0.001). SMI was significantly associated with risk of death on a restricted cubic spline curve (HR = 1.04 per‐1 decrease; 95% CI 1.03–1.05; <jats:italic>p</jats:italic> < 0.001). Patients with reduced SMI had a higher incidence of long‐term mortality than those with preserved SMI (survival rate 41.4% vs. 62.8%; HR<jats:sub>adj</jats:sub> = 1.18, 95% CI 1.03–1.36, <jats:italic>p</jats:italic> = 0.020). Subgroup analysis showed that the prognostic implication of reduced SMI on long‐term survival was more evident in male (HR<jats:sub>adj</jats:sub> = 2.01, 95% CI 1.72–2.35) than female (HR<jats:sub>adj</jats:sub> = 1.28, 95% CI 0.98–1.68) (interaction <jats:italic>p</jats:italic> = 0.006).ConclusionsReduced muscle mass, defined by SMI on computed tomography, was associated with long‐term mortality after CABG. These results provide contemporary data to allow the evaluation of physical frailty in patients with advanced coronary artery disease before surgery.Trial Registration: Long‐Term Outcomes and Prognostic Factors in Patients Undergoing CABG or PCI: NCT03870815","PeriodicalId":186,"journal":{"name":"Journal of Cachexia, Sarcopenia and Muscle","volume":"34 1","pages":""},"PeriodicalIF":8.9,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142597132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BackgroundThe diagnosis of sarcopenia relies extensively on human and equipment resources and requires individuals to personally visit medical institutions. The objective of this study was to develop a test‐free, self‐assessable approach to identify sarcopenia by utilizing artificial intelligence techniques and representative real‐world data.MethodsThis multicentre study enrolled 11 661 middle‐aged and older adults from a national survey initialized in 2011. Follow‐up data from the baseline cohort collected in 2013 (<jats:italic>n</jats:italic> = 9403) and 2015 (<jats:italic>n</jats:italic> = 10 356) were used for validation. Sarcopenia was retrospectively diagnosed using the Asian Working Group for Sarcopenia 2019 framework. Baseline age, sex, height, weight and 20 functional capacity (FC)–related binary indices (activities of daily living = 6, instrumental activities of daily living = 5 and other FC indices = 9) were considered as predictors. Multiple machine learning (ML) models were trained and cross‐validated using 70% of the baseline data to predict sarcopenia. The remaining 30% of the baseline data, along with two follow‐up datasets (<jats:italic>n</jats:italic> = 9403 and <jats:italic>n</jats:italic> = 10 356, respectively), were used to assess model performance.ResultsThe study included 5634 men and 6027 women (median age = 57.0 years). Sarcopenia was identified in 1288 (11.0%) individuals. Among the 20 FC indices, the running/jogging 1 km item showed the highest predictive value for sarcopenia (AUC [95%CI] = 0.633 [0.620–0.647]). From the various ML models assessed, a 24‐variable gradient boosting classifier (GBC) model was selected. This GBC model demonstrated favourable performance in predicting sarcopenia in the holdout data (AUC [95%CI] = 0.831 [0.808–0.853], accuracy = 0.889, recall = 0.441, precision = 0.475, F1 score = 0.458, Kappa = 0.396 and Matthews correlation coefficient = 0.396). Further model validation on the temporal scale using two longitudinal datasets also demonstrated good performance (AUC [95%CI]: 0.833 [0.818–0.848] and 0.852 [0.840–0.865], respectively). The model's built‐in feature importance ranking and the SHapley Additive exPlanations method revealed that lifting 5 kg and running/jogging 1 km were relatively important variables among the 20 FC items contributing to the model's predictive capacity, respectively. The calibration curve of the model indicated good agreement between predictions and actual observations (Hosmer and Lemeshow <jats:italic>p</jats:italic> = 0.501, 0.451 and 0.374 for the three test sets, respectively), and decision curve analysis supported its clinical usefulness. The model was implemented as an online web application and exported as a deployable binary file, allowing for flexible, individualized risk assessment.ConclusionsWe developed an artificial intelligence model that can assist in the identification of sarcopenia, particularly in settings lacking the necessary resources for a comp
{"title":"An Artificial Intelligence Approach for Test‐Free Identification of Sarcopenia","authors":"Liangyu Yin, Jinghong Zhao","doi":"10.1002/jcsm.13627","DOIUrl":"https://doi.org/10.1002/jcsm.13627","url":null,"abstract":"BackgroundThe diagnosis of sarcopenia relies extensively on human and equipment resources and requires individuals to personally visit medical institutions. The objective of this study was to develop a test‐free, self‐assessable approach to identify sarcopenia by utilizing artificial intelligence techniques and representative real‐world data.MethodsThis multicentre study enrolled 11 661 middle‐aged and older adults from a national survey initialized in 2011. Follow‐up data from the baseline cohort collected in 2013 (<jats:italic>n</jats:italic> = 9403) and 2015 (<jats:italic>n</jats:italic> = 10 356) were used for validation. Sarcopenia was retrospectively diagnosed using the Asian Working Group for Sarcopenia 2019 framework. Baseline age, sex, height, weight and 20 functional capacity (FC)–related binary indices (activities of daily living = 6, instrumental activities of daily living = 5 and other FC indices = 9) were considered as predictors. Multiple machine learning (ML) models were trained and cross‐validated using 70% of the baseline data to predict sarcopenia. The remaining 30% of the baseline data, along with two follow‐up datasets (<jats:italic>n</jats:italic> = 9403 and <jats:italic>n</jats:italic> = 10 356, respectively), were used to assess model performance.ResultsThe study included 5634 men and 6027 women (median age = 57.0 years). Sarcopenia was identified in 1288 (11.0%) individuals. Among the 20 FC indices, the running/jogging 1 km item showed the highest predictive value for sarcopenia (AUC [95%CI] = 0.633 [0.620–0.647]). From the various ML models assessed, a 24‐variable gradient boosting classifier (GBC) model was selected. This GBC model demonstrated favourable performance in predicting sarcopenia in the holdout data (AUC [95%CI] = 0.831 [0.808–0.853], accuracy = 0.889, recall = 0.441, precision = 0.475, F1 score = 0.458, Kappa = 0.396 and Matthews correlation coefficient = 0.396). Further model validation on the temporal scale using two longitudinal datasets also demonstrated good performance (AUC [95%CI]: 0.833 [0.818–0.848] and 0.852 [0.840–0.865], respectively). The model's built‐in feature importance ranking and the SHapley Additive exPlanations method revealed that lifting 5 kg and running/jogging 1 km were relatively important variables among the 20 FC items contributing to the model's predictive capacity, respectively. The calibration curve of the model indicated good agreement between predictions and actual observations (Hosmer and Lemeshow <jats:italic>p</jats:italic> = 0.501, 0.451 and 0.374 for the three test sets, respectively), and decision curve analysis supported its clinical usefulness. The model was implemented as an online web application and exported as a deployable binary file, allowing for flexible, individualized risk assessment.ConclusionsWe developed an artificial intelligence model that can assist in the identification of sarcopenia, particularly in settings lacking the necessary resources for a comp","PeriodicalId":186,"journal":{"name":"Journal of Cachexia, Sarcopenia and Muscle","volume":"13 1","pages":""},"PeriodicalIF":8.9,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142598032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gunju Song, Hyun‐Ji Oh, Heegu Jin, Hyein Han, Boo‐Yong Lee
BackgroundSarcopenia is the gradual decrease in skeletal muscle mass, strength and function in elderly individuals. Gamma‐aminobutyric acid (GABA) is a neurotransmitter naturally produced from glutamate by the enzyme glutamic acid decarboxylase. Age‐related decline in GABA is linked to age‐related motor and sensory decline and seems to affect sarcopenia, yet no detailed study has been conducted. In this study, we aimed to investigate the effect of GABA on improving sarcopenia by suppressing muscle protein degradation through supplementing decreased GABA in old mice.MethodsGABA (10 or 30 mg/kg/day) was orally administered daily to young (3 months) and old (21–23 months) C57BL/6 mice for 7 weeks. The body weight and grip strength of the mice were measured weekly at the same time. After sacrificing the mice, the quadriceps and gastrocnemius muscles were excised from their hind limbs, and the spleen and serum were collected. Histological, biochemical and molecular analyses were conducted in various experiments.ResultsThe administration of GABA increased muscle strength (+41%, +70% compared to the aged mouse control group, GABA at doses of 10 or 30 mg/kg/day respectively, p < 0.05) and muscle mass (quadriceps: +28%, +46%; gastrocnemius: +12%, +19%, p < 0.05) in old mice. This increase was accompanied by a cross‐sectional area (CSA) increase in the quadriceps and gastrocnemius muscle (p < 0.05). The administration of GABA increased IGF‐1 levels in serum (p < 0.05), leading to the activation of muscle protein synthesis. We found that GABA inhibits sarcopenia by regulating muscle protein degradation through the activation of Akt/mTOR/FoxO3a signalling pathways. GABA also regulates inflammaging, which is a hallmark of age‐related muscle atrophy. There was a significant increase in the F4/80 + CD11b + total macrophage ratio in gastrocnemius and spleen, especially the M1 macrophage ratio increased in old mice. However, GABA administration was effective in suppressing M1 macrophages (gastrocnemius: −40%, − 53%; spleen: −22%, −26%, p < 0.05). Pro‐inflammatory cytokines such as TNF‐α and IL‐6, primarily secreted by M1 macrophages, are also decreased by treatment with GABA (TNF‐α: −24%, −27%; IL‐6: −45%, −59%, p < 0.05).ConclusionsTogether, this study demonstrates the importance of GABA in maintaining muscle and low‐chronic inflammation during ageing. We suggest that GABA shows potential as a substance that can effectively address sarcopenia and enhance the overall lifespan and well‐being of older individuals.
{"title":"GABA Prevents Sarcopenia by Regulation of Muscle Protein Degradation and Inflammaging in 23‐ to 25‐Month‐Old Female Mice","authors":"Gunju Song, Hyun‐Ji Oh, Heegu Jin, Hyein Han, Boo‐Yong Lee","doi":"10.1002/jcsm.13646","DOIUrl":"https://doi.org/10.1002/jcsm.13646","url":null,"abstract":"BackgroundSarcopenia is the gradual decrease in skeletal muscle mass, strength and function in elderly individuals. Gamma‐aminobutyric acid (GABA) is a neurotransmitter naturally produced from glutamate by the enzyme glutamic acid decarboxylase. Age‐related decline in GABA is linked to age‐related motor and sensory decline and seems to affect sarcopenia, yet no detailed study has been conducted. In this study, we aimed to investigate the effect of GABA on improving sarcopenia by suppressing muscle protein degradation through supplementing decreased GABA in old mice.MethodsGABA (10 or 30 mg/kg/day) was orally administered daily to young (3 months) and old (21–23 months) C57BL/6 mice for 7 weeks. The body weight and grip strength of the mice were measured weekly at the same time. After sacrificing the mice, the quadriceps and gastrocnemius muscles were excised from their hind limbs, and the spleen and serum were collected. Histological, biochemical and molecular analyses were conducted in various experiments.ResultsThe administration of GABA increased muscle strength (+41%, +70% compared to the aged mouse control group, GABA at doses of 10 or 30 mg/kg/day respectively, <jats:italic>p</jats:italic> < 0.05) and muscle mass (quadriceps: +28%, +46%; gastrocnemius: +12%, +19%, <jats:italic>p</jats:italic> < 0.05) in old mice. This increase was accompanied by a cross‐sectional area (CSA) increase in the quadriceps and gastrocnemius muscle (<jats:italic>p</jats:italic> < 0.05). The administration of GABA increased IGF‐1 levels in serum (<jats:italic>p</jats:italic> < 0.05), leading to the activation of muscle protein synthesis. We found that GABA inhibits sarcopenia by regulating muscle protein degradation through the activation of Akt/mTOR/FoxO3a signalling pathways. GABA also regulates inflammaging, which is a hallmark of age‐related muscle atrophy. There was a significant increase in the F4/80 + CD11b + total macrophage ratio in gastrocnemius and spleen, especially the M1 macrophage ratio increased in old mice. However, GABA administration was effective in suppressing M1 macrophages (gastrocnemius: −40%, − 53%; spleen: −22%, −26%, <jats:italic>p</jats:italic> < 0.05). Pro‐inflammatory cytokines such as TNF‐α and IL‐6, primarily secreted by M1 macrophages, are also decreased by treatment with GABA (TNF‐α: −24%, −27%; IL‐6: −45%, −59%, <jats:italic>p</jats:italic> < 0.05).ConclusionsTogether, this study demonstrates the importance of GABA in maintaining muscle and low‐chronic inflammation during ageing. We suggest that GABA shows potential as a substance that can effectively address sarcopenia and enhance the overall lifespan and well‐being of older individuals.","PeriodicalId":186,"journal":{"name":"Journal of Cachexia, Sarcopenia and Muscle","volume":"10 1","pages":""},"PeriodicalIF":8.9,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142598033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Comment on 'Diagnosis of Sarcopenia by Evaluating Skeletal Muscle Mass by Adjusted Bioimpedance Analysis Validated With Dual-Energy X-Ray Absorptiometry' by Cheng et al.","authors":"Hyunjee Kim","doi":"10.1002/jcsm.13587","DOIUrl":"https://doi.org/10.1002/jcsm.13587","url":null,"abstract":"","PeriodicalId":186,"journal":{"name":"Journal of Cachexia, Sarcopenia and Muscle","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Comment on 'Detection of Cancer-Associated Cachexia in Lung Cancer Patients Using Whole-Body [<sup>18</sup>F]FDG-PET/CT Imaging: A Multicentre Study' by Ferrara et al.","authors":"Hao Chen, Xiangyu Shen, Xiaodong Chen","doi":"10.1002/jcsm.13656","DOIUrl":"https://doi.org/10.1002/jcsm.13656","url":null,"abstract":"","PeriodicalId":186,"journal":{"name":"Journal of Cachexia, Sarcopenia and Muscle","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142581454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Comment on 'Overall Mortality for Community-Dwelling Adults Over 50 Years at Risk of Malnutrition' by Gittins et al.","authors":"Yizhuan Huang, Han Wang","doi":"10.1002/jcsm.13632","DOIUrl":"https://doi.org/10.1002/jcsm.13632","url":null,"abstract":"","PeriodicalId":186,"journal":{"name":"Journal of Cachexia, Sarcopenia and Muscle","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142581516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Comment on 'Association Between Dynapenic Obesity and Risk of Cardiovascular Disease: The Hisayama Study' by Setoyama et al.","authors":"Han Wang, Yizhuan Huang","doi":"10.1002/jcsm.13658","DOIUrl":"https://doi.org/10.1002/jcsm.13658","url":null,"abstract":"","PeriodicalId":186,"journal":{"name":"Journal of Cachexia, Sarcopenia and Muscle","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142581447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Comment on 'Factors Associated With Skeletal Muscle Mass in Middle-Aged Men Living With HIV' by Xu et al.","authors":"Wanfeng Qian, Xiaodong Zhou","doi":"10.1002/jcsm.13655","DOIUrl":"https://doi.org/10.1002/jcsm.13655","url":null,"abstract":"","PeriodicalId":186,"journal":{"name":"Journal of Cachexia, Sarcopenia and Muscle","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142581511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Comment on 'Impact of Cachexia and First-Line Systemic Therapy for Previously Untreated Advanced Non-Small Cell Lung Cancer: NEJ050A' by Miura et al.","authors":"Wei-Zhen Tang, Wei-Ze Xu, Tai-Hang Liu","doi":"10.1002/jcsm.13657","DOIUrl":"https://doi.org/10.1002/jcsm.13657","url":null,"abstract":"","PeriodicalId":186,"journal":{"name":"Journal of Cachexia, Sarcopenia and Muscle","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142581514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: The Asian Working Group for Cachexia (AWGC) proposed a new definition of cachexia; however, its impact on cachexia prevalence and overlaps with other conditions, such as sarcopenia and malnutrition, are unclear. We investigated these aspects and the prognostic value of cachexia based on the AWGC on mortality in older patients with heart failure (HF).
Methods: This study was a secondary analysis of a prospective multicentre cohort, namely, the FRAGILE-HF cohort study. Older (≥ 65 years) patients who had been hospitalized due to decompensated HF were enrolled. We assessed the presence/absence of cachexia based on the AWGC and Evans' criteria. Sarcopenia and malnutrition based on the Asian Working Group for Sarcopenia 2014 and the Global Leadership Initiative on Malnutrition criteria were also assessed to compare their prevalence and the overlaps between them. Patients were stratified in relation to the presence/absence of cachexia based on the AWGC criteria, and their mortality rates were compared.
Results: Of the 861 enrolled patients (median [interquartile range] age, 80 years [73-85 years]; male, 58.9%), cachexia, as evaluated based on the AWGC and Evans' criteria, sarcopenia and malnutrition, was present in 74.1%, 36.2%, 20.6% and 55.2% of patients, respectively. AWGC-defined cachexia was most common in the four conditions. All-cause death events occurred in 153 (18.1%) patients in 2 years. AWGC-defined cachexia (adjusted hazard ratio [aHRs], 1.442; 95% confidence interval [95% CI], 0.931-2.233; p = 0.101) was not associated with all-cause mortality in older patients with HF after adjusting for other HF prognosis factors, such as the B-type natriuretic peptide and the Meta-Analysis Global Group in Chronic risk score, whereas cachexia evaluated based on Evans's criteria (aHRs, 1.547; 95% CI, 1.118-2.141; p = 0.009), sarcopenia (aHRs, 1.737; 95% CI, 1.214-2.485; p = 0.003), and malnutrition (aHRs, 1.581; 95% CI, 1.094-2.284; p = 0.015) was associated with all-cause mortality.
Conclusions: Three-quarters of older patients with HF had cachexia as evaluated by the AWGC criteria, and this was not associated with a worse prognosis. As the new AWGC cachexia criteria will result in a significantly larger proportion of patients being diagnosed with cachexia, the implementation of the criteria in clinical practice requires further consideration.
{"title":"Prevalence and Prognostic Value of Cachexia Diagnosed by New Definition for Asian People in Older Patients With Heart Failure.","authors":"Takumi Noda, Emi Maekawa, Daichi Maeda, Shota Uchida, Masashi Yamashita, Nobuaki Hamazaki, Kohei Nozaki, Hiroshi Saito, Kazuya Saito, Yuki Ogasahara, Masaaki Konishi, Takeshi Kitai, Kentaro Iwata, Kentaro Jujo, Hiroshi Wada, Takatoshi Kasai, Hirofumi Nagamatsu, Tetsuya Ozawa, Katsuya Izawa, Shuhei Yamamoto, Naoki Aizawa, Ryusuke Yonezawa, Kazuhiro Oka, Junya Ako, Shin-Ichi Momomura, Nobuyuki Kagiyama, Yuya Matsue, Kentaro Kamiya","doi":"10.1002/jcsm.13610","DOIUrl":"https://doi.org/10.1002/jcsm.13610","url":null,"abstract":"<p><strong>Background: </strong>The Asian Working Group for Cachexia (AWGC) proposed a new definition of cachexia; however, its impact on cachexia prevalence and overlaps with other conditions, such as sarcopenia and malnutrition, are unclear. We investigated these aspects and the prognostic value of cachexia based on the AWGC on mortality in older patients with heart failure (HF).</p><p><strong>Methods: </strong>This study was a secondary analysis of a prospective multicentre cohort, namely, the FRAGILE-HF cohort study. Older (≥ 65 years) patients who had been hospitalized due to decompensated HF were enrolled. We assessed the presence/absence of cachexia based on the AWGC and Evans' criteria. Sarcopenia and malnutrition based on the Asian Working Group for Sarcopenia 2014 and the Global Leadership Initiative on Malnutrition criteria were also assessed to compare their prevalence and the overlaps between them. Patients were stratified in relation to the presence/absence of cachexia based on the AWGC criteria, and their mortality rates were compared.</p><p><strong>Results: </strong>Of the 861 enrolled patients (median [interquartile range] age, 80 years [73-85 years]; male, 58.9%), cachexia, as evaluated based on the AWGC and Evans' criteria, sarcopenia and malnutrition, was present in 74.1%, 36.2%, 20.6% and 55.2% of patients, respectively. AWGC-defined cachexia was most common in the four conditions. All-cause death events occurred in 153 (18.1%) patients in 2 years. AWGC-defined cachexia (adjusted hazard ratio [aHRs], 1.442; 95% confidence interval [95% CI], 0.931-2.233; p = 0.101) was not associated with all-cause mortality in older patients with HF after adjusting for other HF prognosis factors, such as the B-type natriuretic peptide and the Meta-Analysis Global Group in Chronic risk score, whereas cachexia evaluated based on Evans's criteria (aHRs, 1.547; 95% CI, 1.118-2.141; p = 0.009), sarcopenia (aHRs, 1.737; 95% CI, 1.214-2.485; p = 0.003), and malnutrition (aHRs, 1.581; 95% CI, 1.094-2.284; p = 0.015) was associated with all-cause mortality.</p><p><strong>Conclusions: </strong>Three-quarters of older patients with HF had cachexia as evaluated by the AWGC criteria, and this was not associated with a worse prognosis. As the new AWGC cachexia criteria will result in a significantly larger proportion of patients being diagnosed with cachexia, the implementation of the criteria in clinical practice requires further consideration.</p><p><strong>Trial registration: </strong>UMIN-CTR unique identifier: UMIN000023929.</p>","PeriodicalId":186,"journal":{"name":"Journal of Cachexia, Sarcopenia and Muscle","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142581518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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