Joel Fundaun, Valeria Oliva, Sandrine Bédard, Evert Onno Wesselink, Benjamin P. Lynn, Anoosha Pai S., Dario Pfyffer, Merve Kaptan, Nazrawit Berhe, John Ratliff, Serena S. Hu, Zachary A. Smith, Trevor J. Hastie, Sean Mackey, Marnee J. McKay, James M. Elliott, Scott L. Delp, Akshay S. Chaudhari, Christine S. W. Law, Andrew C. Smith, Kenneth A. Weber II
Background
Hand function is critical for daily activities and declines early in many diseases, conditions or disorders affecting the musculoskeletal and neurologic systems. Muscle health markers derived from clinically available magnetic resonance imaging (MRI) scans are strongly associated with functional capacity, may enhance clinical assessment and inform management options. However, traditional muscle MRI assessments require time-intensive manual segmentations. Here, we aim to develop and test a computer-vision model for automated forearm muscle segmentation and investigate associations between MRI-derived muscle markers and age, sex, BMI, functional grip strength and dexterity measures.
Methods
We recruited 42 healthy, right-handed adults (54.8% female, median age 37.3 years, median BMI: 23.0). Grip strength and dexterity were measured using the NIH Toolbox motor battery. Dixon fat-water MRI of the right forearm was acquired at 3.0 T, and forearm flexor and extensor muscle compartments were manually segmented for model training. A 2D U-Net convolutional neural network model was trained and tested for segmentation of the forearm flexors and extensors for the assessment of muscle volume and intramuscular fat. Testing accuracy and reliability were assessed using Sørensen–Dice indices, intraclass correlation coefficients (ICCs) and Bland–Altman analyses. Associations between the MRI-derived muscle markers, demographic factors, muscle metrics and hand function were evaluated using partial correlations and regression models.
Results
The segmentation model showed high test accuracy, achieving mean Sørensen–Dice indices of 0.89 (flexors) and 0.85 (extensors) and ICCs of 0.75–0.99 for muscle volume and intramuscular fat. Muscle volume was positively correlated with BMI (p < 0.001) but not age (p > 0.249). Males had larger muscle volumes than females (p < 0.001), with no sex differences in intramuscular fat (p > 0.141), and no association between intramuscular fat and grip strength or dexterity (p > 0.350). We observed strong positive correlations between grip strength and both flexor (p = 0.004) and extensor (p = 0.001) muscle volumes, while dexterity showed no significant associations.
Conclusions
Our findings highlight the accuracy and reliability of automated forearm muscle segmentation using computer vision. BMI emerged as a key determinant of m
{"title":"Automated Segmentation of Forearm Muscles: Clinical Associations With Hand Function, Muscle Volume and Intramuscular Fat","authors":"Joel Fundaun, Valeria Oliva, Sandrine Bédard, Evert Onno Wesselink, Benjamin P. Lynn, Anoosha Pai S., Dario Pfyffer, Merve Kaptan, Nazrawit Berhe, John Ratliff, Serena S. Hu, Zachary A. Smith, Trevor J. Hastie, Sean Mackey, Marnee J. McKay, James M. Elliott, Scott L. Delp, Akshay S. Chaudhari, Christine S. W. Law, Andrew C. Smith, Kenneth A. Weber II","doi":"10.1002/rco2.70015","DOIUrl":"https://doi.org/10.1002/rco2.70015","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Hand function is critical for daily activities and declines early in many diseases, conditions or disorders affecting the musculoskeletal and neurologic systems. Muscle health markers derived from clinically available magnetic resonance imaging (MRI) scans are strongly associated with functional capacity, may enhance clinical assessment and inform management options. However, traditional muscle MRI assessments require time-intensive manual segmentations. Here, we aim to develop and test a computer-vision model for automated forearm muscle segmentation and investigate associations between MRI-derived muscle markers and age, sex, BMI, functional grip strength and dexterity measures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We recruited 42 healthy, right-handed adults (54.8% female, median age 37.3 years, median BMI: 23.0). Grip strength and dexterity were measured using the NIH Toolbox motor battery. Dixon fat-water MRI of the right forearm was acquired at 3.0 T, and forearm flexor and extensor muscle compartments were manually segmented for model training. A 2D U-Net convolutional neural network model was trained and tested for segmentation of the forearm flexors and extensors for the assessment of muscle volume and intramuscular fat. Testing accuracy and reliability were assessed using Sørensen–Dice indices, intraclass correlation coefficients (ICCs) and Bland–Altman analyses. Associations between the MRI-derived muscle markers, demographic factors, muscle metrics and hand function were evaluated using partial correlations and regression models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The segmentation model showed high test accuracy, achieving mean Sørensen–Dice indices of 0.89 (flexors) and 0.85 (extensors) and ICCs of 0.75–0.99 for muscle volume and intramuscular fat. Muscle volume was positively correlated with BMI (<i>p</i> < 0.001) but not age (<i>p</i> > 0.249). Males had larger muscle volumes than females (<i>p</i> < 0.001), with no sex differences in intramuscular fat (<i>p</i> > 0.141), and no association between intramuscular fat and grip strength or dexterity (<i>p</i> > 0.350). We observed strong positive correlations between grip strength and both flexor (<i>p</i> = 0.004) and extensor (<i>p</i> = 0.001) muscle volumes, while dexterity showed no significant associations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our findings highlight the accuracy and reliability of automated forearm muscle segmentation using computer vision. BMI emerged as a key determinant of m","PeriodicalId":73544,"journal":{"name":"JCSM rapid communications","volume":"8 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/rco2.70015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145317774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Reza Lahiji, Gregory Palmateer, Edouard H. Nicaise, Taylor Goodstein, Dattatraya Patil, Benjamin N. Schmeusser, Eric Midenberg, Samay Patel, Ethan Kearns, Kenneth Ogan, Mehmet Asim Bilen, Viraj Master
Introduction
Sarcopenia, defined as the loss of skeletal muscle mass and function, is associated with worse postoperative outcomes and reduced survival in patients undergoing surgery for solid tumours, including renal cell carcinoma (RCC). Although radiographic assessment using the skeletal muscle index (SMI) at the L3 vertebral level has emerged as a method for quantifying sarcopenia, a consensus on optimal sarcopenia thresholds, especially in non-metastatic RCC, remains lacking. This study aims to evaluate which of the existing published SMI thresholds can be utilized to predict overall survival (OS) in a racially diverse non-metastatic (nmRCC) cohort.
Methods
We retrospectively reviewed 343 patients with any T-stage nmRCC who underwent nephrectomy between 2007 and 2022 at our institution. SMI (cm2/m2) values were calculated using cross-sectional imaging at the L3 level. Six published sarcopenia thresholds were applied. Associations between threshold-defined sarcopenia and OS were evaluated using Kaplan–Meier curves and Cox proportional hazards models adjusted for confounding variables.
Results
Three hundred forty-three patients met inclusion criteria, 62.7% were White, and 33.2% were Black. Median follow-up time was 41.5 months (IQR 17.8–61.7 months), during which there were 62 (18.1%) mortality events. Median SMI measurements for males and females in our cohort were 51.1 and 42.4 cm/m2, respectively. Patients defined as radiographically sarcopenic using thresholds by Derstine et al. (HR 2.11 [95% CI 1.14–3.91], p = 0.018) and Tonnesen et al. (HR 2.11 [95% CI 1.15–4.53], p = 0.028) had independently associated worse OS. Notably, these thresholds were constructed from healthy adult populations.
Conclusions
SMI thresholds derived from healthy cohorts, as proposed by Derstine et al., are associated with OS in patients with nmRCC and may serve as clinically practical tools for identifying high-risk patients. Incorporating radiographic sarcopenia assessment into preoperative workflows may facilitate targeted prehabilitation interventions aimed at improving survival outcomes in this population.
骨骼肌减少症，定义为骨骼肌质量和功能的丧失，与包括肾细胞癌（RCC）在内的实体肿瘤手术患者的术后预后恶化和生存率降低有关。尽管在L3椎体水平使用骨骼肌指数（SMI）进行影像学评估已成为量化肌肉减少症的一种方法，但关于最佳肌肉减少症阈值的共识仍然缺乏，特别是在非转移性RCC中。本研究旨在评估现有公布的SMI阈值中哪些可用于预测种族不同的非转移性（nmRCC）队列的总生存（OS）。方法回顾性分析了2007年至2022年在我院接受肾切除术的343例t期nmRCC患者。SMI （cm2/m2）值通过L3水平的横断面成像计算。应用6个已公布的肌肉减少阈值。阈值定义的肌肉减少症与OS之间的关联使用Kaplan-Meier曲线和Cox比例风险模型进行评估，校正了混杂变量。结果343例患者符合纳入标准，白人占62.7%，黑人占33.2%。中位随访时间为41.5个月（IQR为17.8 ~ 61.7个月），随访期间死亡62例（18.1%）。在我们的队列中，男性和女性的SMI测量值中位数分别为51.1和42.4 cm/m2。Derstine等人（风险比2.11 [95% CI 1.14-3.91], p = 0.018）和Tonnesen等人（风险比2.11 [95% CI 1.15-4.53], p = 0.028）使用放射学阈值定义为肌肉减少的患者与较差的OS独立相关。值得注意的是，这些阈值是从健康的成年人群中构建的。Derstine等人提出的来自健康队列的SMI阈值与nmRCC患者的OS相关，可以作为识别高风险患者的临床实用工具。将骨骼肌减少症的影像学评估纳入术前工作流程可能有助于有针对性的康复干预，旨在改善这一人群的生存结果。
{"title":"Sarcopenia Thresholds Derived From Healthy Adult Populations Predict Survival in Patients With Cancer","authors":"Reza Lahiji, Gregory Palmateer, Edouard H. Nicaise, Taylor Goodstein, Dattatraya Patil, Benjamin N. Schmeusser, Eric Midenberg, Samay Patel, Ethan Kearns, Kenneth Ogan, Mehmet Asim Bilen, Viraj Master","doi":"10.1002/rco2.70014","DOIUrl":"https://doi.org/10.1002/rco2.70014","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Sarcopenia, defined as the loss of skeletal muscle mass and function, is associated with worse postoperative outcomes and reduced survival in patients undergoing surgery for solid tumours, including renal cell carcinoma (RCC). Although radiographic assessment using the skeletal muscle index (SMI) at the L3 vertebral level has emerged as a method for quantifying sarcopenia, a consensus on optimal sarcopenia thresholds, especially in non-metastatic RCC, remains lacking. This study aims to evaluate which of the existing published SMI thresholds can be utilized to predict overall survival (OS) in a racially diverse non-metastatic (nmRCC) cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively reviewed 343 patients with any T-stage nmRCC who underwent nephrectomy between 2007 and 2022 at our institution. SMI (cm<sup>2</sup>/m<sup>2</sup>) values were calculated using cross-sectional imaging at the L3 level. Six published sarcopenia thresholds were applied. Associations between threshold-defined sarcopenia and OS were evaluated using Kaplan–Meier curves and Cox proportional hazards models adjusted for confounding variables.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Three hundred forty-three patients met inclusion criteria, 62.7% were White, and 33.2% were Black. Median follow-up time was 41.5 months (IQR 17.8–61.7 months), during which there were 62 (18.1%) mortality events. Median SMI measurements for males and females in our cohort were 51.1 and 42.4 cm/m<sup>2</sup>, respectively. Patients defined as radiographically sarcopenic using thresholds by Derstine et al. (HR 2.11 [95% CI 1.14–3.91], <i>p</i> = 0.018) and Tonnesen et al. (HR 2.11 [95% CI 1.15–4.53], <i>p</i> = 0.028) had independently associated worse OS. Notably, these thresholds were constructed from healthy adult populations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>SMI thresholds derived from healthy cohorts, as proposed by Derstine et al., are associated with OS in patients with nmRCC and may serve as clinically practical tools for identifying high-risk patients. Incorporating radiographic sarcopenia assessment into preoperative workflows may facilitate targeted prehabilitation interventions aimed at improving survival outcomes in this population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":73544,"journal":{"name":"JCSM rapid communications","volume":"8 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/rco2.70014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145272171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Guillaume Henin, Alexis Goffaux, Salomé Declerck, Stéphanie André-Dumont, Etienne Pendeville, Maxime Valet, Thierry Lejeune, Géraldine Dahlqvist, Audrey Loumaye, Bernd Schnabl, Peter Stärkel, Nicolas Lanthier
Background
Impaired muscle function is frequent in cirrhosis and potentially participates in liver disease progression. Data from non-cirrhotic patients with steatotic liver disease (SLD) are lacking. Our aims were to determine if muscle function was impaired in a non-cirrhotic cohort of patients with SLD and if the SLD subtype and severity were associated with impaired muscle function.
Methods
Patients with SLD and controls were prospectively recruited. Liver disease was assessed by imaging, vibration-controlled transient elastography and non-invasive tests. Muscle function was assessed by the liver frailty index (LFI) and isokinetic dynamometer. Diet and physical activity habits were recorded using dedicated questionnaires to measure the energetic balance.
Results
One-hundred and fifty patients with non-cirrhotic SLD (75 patients with metabolic dysfunction-associated steatotic liver disease [MASLD] and 75 patients with alcohol-related liver disease [ALD]) and 30 non-SLD controls were prospectively recruited. The LFI negatively correlated to lower limb muscle strength assessed by isokinetic dynamometer in all participant groups (r = 0.82 in the control group; r = 0.69 in the pooled SLD group—p < 0.0001). Both SLD groups showed muscle strength impairment assessed by the LFI compared to age- and gender-matched controls. In multivariate analysis, the presence of SLD was associated with impaired muscle function independently of age, BMI and energetic balance, with a higher risk related to ALD.
Conclusions
Patients with SLD already show impaired muscle function compared to controls independently of age, gender and energetic balance. Taken together, our data support a potential disruption of the liver–muscle axis already occurring in SLD prior to cirrhosis.
Trial Registration
ClinicalTrials.gov identifier: NCT06514300
背景：肝硬化患者经常出现肌肉功能受损，并可能参与肝脏疾病的进展。缺乏非肝硬化脂肪变性肝病（SLD）患者的数据。我们的目的是确定非肝硬化SLD患者队列中肌肉功能是否受损，以及SLD亚型和严重程度是否与肌肉功能受损有关。方法前瞻性招募SLD患者和对照组。肝脏疾病通过影像学、振动控制瞬态弹性成像和非侵入性检查进行评估。采用肝衰弱指数（LFI）和等速测功仪评估肌肉功能。研究人员使用专门的问卷记录了饮食和体育活动习惯，以测量能量平衡。结果150例非肝硬化SLD患者（75例代谢功能障碍相关脂肪变性肝病[MASLD]和75例酒精相关性肝病[ALD]）和30例非SLD对照组被前瞻性招募。在所有参与者组中，LFI与等速肌力计评估的下肢肌力呈负相关（对照组r = 0.82，合并SLD组r = 0.69, p < 0.0001）。与年龄和性别匹配的对照组相比，两个SLD组都表现出LFI评估的肌肉力量损伤。在多变量分析中，SLD的存在与肌肉功能受损相关，与年龄、BMI和能量平衡无关，与ALD相关的风险更高。结论：与对照组相比，SLD患者已经表现出肌肉功能受损，与年龄、性别和能量平衡无关。综上所述，我们的数据支持肝硬化前SLD中已经发生的肝肌轴的潜在破坏。试验注册ClinicalTrials.gov标识符：NCT06514300
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Ahad M. Azimuddin, Andrea M. Meinders, Jerica Podrat, Kelvin C. Allenson, Joy Yoo, Enshuo Hsu, Linda W. Moore, Kayla Callaway, Nestor F. Esnaola, Elijah Rockers, Atiya F. Dhala
Background
Variance in skeletal muscle area (SMA), visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) negatively impacts outcomes after pancreas surgery. We aim to incorporate an existing deep learning algorithm automating body composition segmentation from computed tomography (CT) for accurate and rapid risk identification.
Methods
We conducted a retrospective study of patients having pancreatic surgery at a high-volume centre (2016–2021). Using a deep learning algorithm, we analysed preoperative CT images at the L3 level for SMA, VAT, SAT and IMAT (AutoMATiCA, Cambridge, MA, USA). Two board-certified radiologists validated the analysis. Skeletal muscle index (SMI), VAT and VAT/SAT ratio were calculated. We then evaluated the incidence of pancreas surgery-specific, pulmonary, noninfectious and infectious outcomes.
Results
We reviewed 158 patients: median (IQR) age 67.6 (61.6, 75.3) years; female (52.5%); pancreatic cancer diagnoses (65.8%); and Whipple procedure (81%). Automated body composition calculation time for all patients was 553 s. Patients experiencing composite sepsis complications had higher VAT (193.7 [IQR 132.7, 249.7] vs. 146.2 [IQR 87.3, 220.5], p = 0.029). Additionally, patients experiencing composite infectious complications had higher VAT (193.7 [IQR 133.4, 277.5] vs. 143.1 [IQR 72.2, 202.8], p = 0.041). VAT was also higher in patients with noninfectious complications (274.9 [IQR 228.0, 329.8] vs. 148.7 [IQR 90.9, 221.0]; p = 0.020). Other anthropomorphic features, such as SMA, SAT and IMAT, did not have any relation to postoperative composite outcomes.
Conclusions
Higher visceral adipose tissue was associated with worse outcomes after pancreas surgery. Deep learning applied to CT scans may be valuable for identifying at-risk body compositions associated with adverse surgical outcomes. Further studies are needed to confirm these findings.
背景：骨骼肌面积（SMA）、内脏脂肪组织（VAT）和皮下脂肪组织（SAT）的差异会对胰腺手术后的预后产生负面影响。我们的目标是结合现有的深度学习算法，自动从计算机断层扫描（CT）中分割身体成分，以准确快速地识别风险。方法：我们对2016-2021年在大容量中心进行胰腺手术的患者进行回顾性研究。使用深度学习算法，我们分析了SMA、VAT、SAT和IMAT （AutoMATiCA, Cambridge， MA， USA）的L3层术前CT图像。两名委员会认证的放射科医生证实了分析结果。计算骨骼肌指数（SMI）、VAT和VAT/SAT比值。然后我们评估胰腺手术特异性、肺部、非感染性和感染性结局的发生率。结果158例患者：中位（IQR）年龄67.6（61.6,75.3）岁；女性(52.5%);胰腺癌诊断（65.8%）；惠普尔手术（81%）。所有患者的自动体成分计算时间为553秒。合并脓毒症并发症的患者VAT较高（193.7 [IQR 132.7, 249.7] vs. 146.2 [IQR 87.3, 220.5], p = 0.029）。此外，出现复合感染并发症的患者VAT更高（193.7 [IQR 133.4, 277.5]比143.1 [IQR 72.2, 202.8], p = 0.041）。非感染性并发症患者的VAT也更高（274.9 [IQR 228.0, 329.8]比148.7 [IQR 90.9, 221.0]; p = 0.020）。其他拟人化特征，如SMA、SAT和IMAT，与术后综合结果没有任何关系。结论胰腺手术后较高的内脏脂肪组织与较差的预后相关。将深度学习应用于CT扫描对于识别与不良手术结果相关的高危身体成分可能很有价值。需要进一步的研究来证实这些发现。
{"title":"Deep Learning to Detect Body Composition and Its Role in Developing Postoperative Pancreatic Surgery Complications","authors":"Ahad M. Azimuddin, Andrea M. Meinders, Jerica Podrat, Kelvin C. Allenson, Joy Yoo, Enshuo Hsu, Linda W. Moore, Kayla Callaway, Nestor F. Esnaola, Elijah Rockers, Atiya F. Dhala","doi":"10.1002/rco2.70013","DOIUrl":"https://doi.org/10.1002/rco2.70013","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Variance in skeletal muscle area (SMA), visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) negatively impacts outcomes after pancreas surgery. We aim to incorporate an existing deep learning algorithm automating body composition segmentation from computed tomography (CT) for accurate and rapid risk identification.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective study of patients having pancreatic surgery at a high-volume centre (2016–2021). Using a deep learning algorithm, we analysed preoperative CT images at the L3 level for SMA, VAT, SAT and IMAT (AutoMATiCA, Cambridge, MA, USA). Two board-certified radiologists validated the analysis. Skeletal muscle index (SMI), VAT and VAT/SAT ratio were calculated. We then evaluated the incidence of pancreas surgery-specific, pulmonary, noninfectious and infectious outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We reviewed 158 patients: median (IQR) age 67.6 (61.6, 75.3) years; female (52.5%); pancreatic cancer diagnoses (65.8%); and Whipple procedure (81%). Automated body composition calculation time for all patients was 553 s. Patients experiencing composite sepsis complications had higher VAT (193.7 [IQR 132.7, 249.7] vs. 146.2 [IQR 87.3, 220.5], <i>p</i> = 0.029). Additionally, patients experiencing composite infectious complications had higher VAT (193.7 [IQR 133.4, 277.5] vs. 143.1 [IQR 72.2, 202.8], <i>p</i> = 0.041). VAT was also higher in patients with noninfectious complications (274.9 [IQR 228.0, 329.8] vs. 148.7 [IQR 90.9, 221.0]; <i>p</i> = 0.020). Other anthropomorphic features, such as SMA, SAT and IMAT, did not have any relation to postoperative composite outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Higher visceral adipose tissue was associated with worse outcomes after pancreas surgery. Deep learning applied to CT scans may be valuable for identifying at-risk body compositions associated with adverse surgical outcomes. Further studies are needed to confirm these findings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":73544,"journal":{"name":"JCSM rapid communications","volume":"8 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/rco2.70013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145146582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Joshua J. S. Wall, Luke Matupi, Melanie Paul, Brett Doleman, Jon N. Lund, Bethan E. Phillips
Background
Colorectal cancer (CRC) is the fourth most common cancer in the United Kingdom, accounting for ~11% of new cancer diagnoses. CRC is predominantly a disease of ageing, and its occurrence often coincides with an age-associated decline in physiological performance. The stress of surgery can also leave cancer survivors functionally limited. Exercise-based prehabilitation may ameliorate some of the functional decline seen after surgery for CRC, with resistance exercise training (RET) increasingly recognised as an important driver of physiological adaptation in this context. Although prehabilitation with a RET component in operable CRC has been studied, no systematic review exists. This systematic review and meta-analysis aims to delineate the effects of prehabilitation with a RET component in patients with CRC treated with surgery with curative intent, on clinical and functional outcomes.
Methods
This systematic review and meta-analysis (PROSPERO: CRD42023421372) was performed in accordance with the PRISMA 2020 statement and PERSiST guidelines. Studies on adults with histologically confirmed or clinically suspected colorectal neoplasia scheduled for surgery with curative intent, undergoing short-course (< 12-week) pre-operative RET were sought via searches on CINAHL, CENTRAL, Embase, Medline, PubMed, Clinicaltrials.gov and ICTRP.
After eligibility review, risk of bias assessment was undertaken and data extracted. Meta-analysis was undertaken on clinical and functional outcomes.
Results
Database searches revealed 5808 reports including 1910 duplicates. Citation searching detected nine reports, and a final 18 were discovered after searching clinical trial databases. After exclusions, eight reports representing 324 (n = 136 female; 42.0%) individuals with CRC were included for systematic review and considered for meta-analysis. All studies were found to carry ‘high’ or ‘critical’ risk of bias. Criteria for meta-analysis was reached for four outcomes: postoperative complications, length-of-stay, 6-min walk test (6MWT) and handgrip strength (HGS). Prehabilitation with a RET component demonstrated statistical and clinically significant increases in 6MWT distance (mean difference [MD]: 34.14 m, 95% confidence intervals [CI]: 16 to 52.27 m). There was no significant difference in postoperative complications (odds ratio: 0.77, 95% CI: 0.47 to 1.29), length-of-stay (MD: 3.02 days, 95% CI: −6.26 days to 0.21 days) or HGS (MD: 0.22 kg, 95% CI: −0.83 kg to 1.27 kg).
{"title":"Clinical and Functional Effects of Resistance Exercise Prehabilitation in Colorectal Cancer: Systematic Review and Meta-Analysis","authors":"Joshua J. S. Wall, Luke Matupi, Melanie Paul, Brett Doleman, Jon N. Lund, Bethan E. Phillips","doi":"10.1002/rco2.70010","DOIUrl":"https://doi.org/10.1002/rco2.70010","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Colorectal cancer (CRC) is the fourth most common cancer in the United Kingdom, accounting for ~11% of new cancer diagnoses. CRC is predominantly a disease of ageing, and its occurrence often coincides with an age-associated decline in physiological performance. The stress of surgery can also leave cancer survivors functionally limited. Exercise-based prehabilitation may ameliorate some of the functional decline seen after surgery for CRC, with resistance exercise training (RET) increasingly recognised as an important driver of physiological adaptation in this context. Although prehabilitation with a RET component in operable CRC has been studied, no systematic review exists. This systematic review and meta-analysis aims to delineate the effects of prehabilitation with a RET component in patients with CRC treated with surgery with curative intent, on clinical and functional outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This systematic review and meta-analysis (PROSPERO: CRD42023421372) was performed in accordance with the PRISMA 2020 statement and PERSiST guidelines. Studies on adults with histologically confirmed or clinically suspected colorectal neoplasia scheduled for surgery with curative intent, undergoing short-course (< 12-week) pre-operative RET were sought via searches on CINAHL, CENTRAL, Embase, Medline, PubMed, Clinicaltrials.gov and ICTRP.</p>\u0000 \u0000 <p>After eligibility review, risk of bias assessment was undertaken and data extracted. Meta-analysis was undertaken on clinical and functional outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Database searches revealed 5808 reports including 1910 duplicates. Citation searching detected nine reports, and a final 18 were discovered after searching clinical trial databases. After exclusions, eight reports representing 324 (<i>n</i> = 136 female; 42.0%) individuals with CRC were included for systematic review and considered for meta-analysis. All studies were found to carry ‘high’ or ‘critical’ risk of bias. Criteria for meta-analysis was reached for four outcomes: postoperative complications, length-of-stay, 6-min walk test (6MWT) and handgrip strength (HGS). Prehabilitation with a RET component demonstrated statistical and clinically significant increases in 6MWT distance (mean difference [MD]: 34.14 m, 95% confidence intervals [CI]: 16 to 52.27 m). There was no significant difference in postoperative complications (odds ratio: 0.77, 95% CI: 0.47 to 1.29), length-of-stay (MD: 3.02 days, 95% CI: −6.26 days to 0.21 days) or HGS (MD: 0.22 kg, 95% CI: −0.83 kg to 1.27 kg).</p>\u0000 </section>\u0000 ","PeriodicalId":73544,"journal":{"name":"JCSM rapid communications","volume":"8 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/rco2.70010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144935243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<div> <section> <h3> Background</h3> <p>Frailty is a significant predictor of death in patients with atrial fibrillation (AF), with the frailty index (FI) acting as an effective severity classification tool. However, even in patients with a similar FI, the underlying clinical profiles can differ substantially. As the severity classification relies solely on the number of deficits without considering their interaction, distinct clinical subgroups with differing prognoses and care needs may remain unrecognized within the same frailty category. We aimed to identify novel phenotypes based on the deficit patterns in older AF patients.</p> </section> <section> <h3> Methods</h3> <p>Using data from a comprehensive claims database in Shizuoka (2012–2018), we extracted patients aged ≥ 65 years with AF and frailty who initiated oral anticoagulants. Latent class analysis (LCA) was conducted for each frailty status using 34 variables incorporated in the electronic FI (eFI), which is determined through a coding-based algorithm. We performed multivariable Cox proportional hazards to evaluate the associations between the latent classes and all-cause death within each frailty status.</p> </section> <section> <h3> Results</h3> <p>Among 11 533 patients (mean age: 79.3 ± 8.03 years; women: <i>N</i> = 5359 [46.5%]) categorized as mildly (eFI > 0.12–0.24; <i>N</i> = 3967), moderately (> 0.24–0.36; <i>N</i> = 4385) and severely frail (> 0.36–0.60; <i>N</i> = 3181), LCA identified three to four classes within each category: mildly frail, Class 1: high prevalence of hypotension (<i>N</i> = 326), Class 2: high prevalence of heart failure (<i>N</i> = 1404), Class 3: high prevalence of polypharmacy (<i>N</i> = 2237); moderately frail, Class 1: high prevalence of hypotension (<i>N</i> = 966), Class 2: high prevalence of heart failure (<i>N</i> = 1521), Class 3: high prevalence of polypharmacy (<i>N</i> = 1598), Class 4: high prevalence of mobility problems (<i>N</i> = 300); and severely frail, Class 1: high prevalence of hypotension (<i>N</i> = 1378), Class 2: high prevalence of heart failure (<i>N</i> = 1198), Class 3: high prevalence of mobility problems (<i>N</i> = 605). After multivariable adjustment, the other classes exhibited lower mortality risks than in the class characterized by high prevalence of mobility problems in the moderately (HR [95% CI]; Class 1: 0.59 [0.45–0.79], <i>p</i> < 0.001; Class 2: 0.71 [0.55–0.93], <i>p</i> = 0.013; Class 3: 0.68 [0.52–0.88], <i>p</i> = 0.003) and severely frail (Class 1: 0.89 [0.74–1.07], <i>p</i> = 0.22; Class 2: 0.77 [0.63–0.94], <i>p</i> = 0.010), whereas there was no difference among the classes in the mildly frail
{"title":"Patterns of Frailty in Newly Diagnosed Older Patients With Nonvalvular Atrial Fibrillation Initiating Oral Anticoagulation","authors":"Ryo Nakamaru, Shiori Nishimura, Hiraku Kumamaru, Hiroyuki Yamamoto, Hiroaki Miyata, Eiji Nakatani, Yoshiki Miyachi, Shun Kohsaka","doi":"10.1002/rco2.70009","DOIUrl":"https://doi.org/10.1002/rco2.70009","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Frailty is a significant predictor of death in patients with atrial fibrillation (AF), with the frailty index (FI) acting as an effective severity classification tool. However, even in patients with a similar FI, the underlying clinical profiles can differ substantially. As the severity classification relies solely on the number of deficits without considering their interaction, distinct clinical subgroups with differing prognoses and care needs may remain unrecognized within the same frailty category. We aimed to identify novel phenotypes based on the deficit patterns in older AF patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using data from a comprehensive claims database in Shizuoka (2012–2018), we extracted patients aged ≥ 65 years with AF and frailty who initiated oral anticoagulants. Latent class analysis (LCA) was conducted for each frailty status using 34 variables incorporated in the electronic FI (eFI), which is determined through a coding-based algorithm. We performed multivariable Cox proportional hazards to evaluate the associations between the latent classes and all-cause death within each frailty status.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 11 533 patients (mean age: 79.3 ± 8.03 years; women: <i>N</i> = 5359 [46.5%]) categorized as mildly (eFI > 0.12–0.24; <i>N</i> = 3967), moderately (> 0.24–0.36; <i>N</i> = 4385) and severely frail (> 0.36–0.60; <i>N</i> = 3181), LCA identified three to four classes within each category: mildly frail, Class 1: high prevalence of hypotension (<i>N</i> = 326), Class 2: high prevalence of heart failure (<i>N</i> = 1404), Class 3: high prevalence of polypharmacy (<i>N</i> = 2237); moderately frail, Class 1: high prevalence of hypotension (<i>N</i> = 966), Class 2: high prevalence of heart failure (<i>N</i> = 1521), Class 3: high prevalence of polypharmacy (<i>N</i> = 1598), Class 4: high prevalence of mobility problems (<i>N</i> = 300); and severely frail, Class 1: high prevalence of hypotension (<i>N</i> = 1378), Class 2: high prevalence of heart failure (<i>N</i> = 1198), Class 3: high prevalence of mobility problems (<i>N</i> = 605). After multivariable adjustment, the other classes exhibited lower mortality risks than in the class characterized by high prevalence of mobility problems in the moderately (HR [95% CI]; Class 1: 0.59 [0.45–0.79], <i>p</i> < 0.001; Class 2: 0.71 [0.55–0.93], <i>p</i> = 0.013; Class 3: 0.68 [0.52–0.88], <i>p</i> = 0.003) and severely frail (Class 1: 0.89 [0.74–1.07], <i>p</i> = 0.22; Class 2: 0.77 [0.63–0.94], <i>p</i> = 0.010), whereas there was no difference among the classes in the mildly frail","PeriodicalId":73544,"journal":{"name":"JCSM rapid communications","volume":"8 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/rco2.70009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144905413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marion Guerrero-Wyss, Carla Villagran, Sofía Gálvez-Tejeda, Ana Hernández-Peregrina, Stuart Johnston, Bhautesh D. Jani, Frederick K. Ho, Stuart R. Gray, Carlos A. Celis-Morales
<div> <section> <h3> Background</h3> <p>Frailty and sarcopenia are common conditions among older adults and may also be highly prevalent among adults with long-term conditions (LTCs). This study investigates associations between individual LTCs and multimorbidity with the prevalence of frailty and sarcopenia in a large community-based adult cohort.</p> </section> <section> <h3> Methods</h3> <p>A cross-sectional analysis of 155 639 UK Biobank participants examined the 25 most common self-reported LTCs. Frailty was defined using the Fried criteria, and sarcopenia by the European Working Group on Sarcopenia in Older People (EWGSOP2) criteria. Poisson regression was used to estimate prevalence ratios (PRs) for frailty and sarcopenia by individual LTCs and multimorbidity, adjusting for age, Townsend deprivation index, alcohol intake, smoking, ethnicity, physical activity and sedentarism. Participants without LTCs were the reference group.</p> </section> <section> <h3> Results</h3> <p>Frailty (4.54% vs. 2.63%) and sarcopenia (2.27% vs. 1.28%) were higher in women. Compared to individuals without LTCs, the top three LTCs most strongly associated with frailty in men were rheumatoid arthritis (PR: 8.16, 95% CI: 3.95–16.9), Type 2 diabetes (PR: 5.37, 95% CI: 4.46–6.46) and stroke (PR: 4.23, 95% CI: 2.85–6.28). In women, the strongest associations were observed for type 2 diabetes (PR: 4.16, 95% CI: 3.39–5.11), rheumatoid arthritis (PR: 3.59, 95% CI: 2.37–5.45) and osteoarthritis (PR: 2.94, 95% CI: 2.57–3.36). For sarcopenia, the strongest associations in men were for rheumatoid arthritis (PR: 18.5, 95% CI: 12.6–27.1), osteoporosis (PR: 6.97, 95% CI: 3.44–14.1) and stroke (PR: 5.29, 95% CI: 3.69–7.59). In women, the strongest associations were observed for rheumatoid arthritis (PR: 15.2, 95% CI: 12.6–18.3), osteoporosis (PR: 7.47, 95% CI: 6.46–8.60) and osteoarthritis (PR: 2.87, 95% CI: 2.44–3.37). There was a positive gradient between the number of LTCs and the risk of frailty and sarcopenia, with higher risks observed in men than in women (<i>p</i>-interaction < 0.0001). Compared to individuals without LTCs, those with five or more LTCs had 10.1 and 7.51 times higher prevalence of frailty and 27.2 and 13.8 times higher prevalence of sarcopenia in men and women, respectively.</p> </section> <section> <h3> Conclusions</h3> <p>These findings highlight the significant association between LTCs, particularly stroke, rheumatoid arthritis, Type 2 diabetes and osteoporosis, with frailty and sarcopenia prevalence. The observed trend of increased risk with higher L
{"title":"Association of Long-Term Conditions and Multimorbidity With Frailty and Sarcopenia: Evidence From the UK Biobank","authors":"Marion Guerrero-Wyss, Carla Villagran, Sofía Gálvez-Tejeda, Ana Hernández-Peregrina, Stuart Johnston, Bhautesh D. Jani, Frederick K. Ho, Stuart R. Gray, Carlos A. Celis-Morales","doi":"10.1002/rco2.70008","DOIUrl":"https://doi.org/10.1002/rco2.70008","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Frailty and sarcopenia are common conditions among older adults and may also be highly prevalent among adults with long-term conditions (LTCs). This study investigates associations between individual LTCs and multimorbidity with the prevalence of frailty and sarcopenia in a large community-based adult cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional analysis of 155 639 UK Biobank participants examined the 25 most common self-reported LTCs. Frailty was defined using the Fried criteria, and sarcopenia by the European Working Group on Sarcopenia in Older People (EWGSOP2) criteria. Poisson regression was used to estimate prevalence ratios (PRs) for frailty and sarcopenia by individual LTCs and multimorbidity, adjusting for age, Townsend deprivation index, alcohol intake, smoking, ethnicity, physical activity and sedentarism. Participants without LTCs were the reference group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Frailty (4.54% vs. 2.63%) and sarcopenia (2.27% vs. 1.28%) were higher in women. Compared to individuals without LTCs, the top three LTCs most strongly associated with frailty in men were rheumatoid arthritis (PR: 8.16, 95% CI: 3.95–16.9), Type 2 diabetes (PR: 5.37, 95% CI: 4.46–6.46) and stroke (PR: 4.23, 95% CI: 2.85–6.28). In women, the strongest associations were observed for type 2 diabetes (PR: 4.16, 95% CI: 3.39–5.11), rheumatoid arthritis (PR: 3.59, 95% CI: 2.37–5.45) and osteoarthritis (PR: 2.94, 95% CI: 2.57–3.36). For sarcopenia, the strongest associations in men were for rheumatoid arthritis (PR: 18.5, 95% CI: 12.6–27.1), osteoporosis (PR: 6.97, 95% CI: 3.44–14.1) and stroke (PR: 5.29, 95% CI: 3.69–7.59). In women, the strongest associations were observed for rheumatoid arthritis (PR: 15.2, 95% CI: 12.6–18.3), osteoporosis (PR: 7.47, 95% CI: 6.46–8.60) and osteoarthritis (PR: 2.87, 95% CI: 2.44–3.37). There was a positive gradient between the number of LTCs and the risk of frailty and sarcopenia, with higher risks observed in men than in women (<i>p</i>-interaction < 0.0001). Compared to individuals without LTCs, those with five or more LTCs had 10.1 and 7.51 times higher prevalence of frailty and 27.2 and 13.8 times higher prevalence of sarcopenia in men and women, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings highlight the significant association between LTCs, particularly stroke, rheumatoid arthritis, Type 2 diabetes and osteoporosis, with frailty and sarcopenia prevalence. The observed trend of increased risk with higher L","PeriodicalId":73544,"journal":{"name":"JCSM rapid communications","volume":"8 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/rco2.70008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144681101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Konstantinos Prokopidis, Heli Koivumaa-Honkanen, Parisa Jan Mohammad, Reijo Sund, Heikki Kröger, Toni Rikkonen, Arja T. Lyytinen, Masoud Isanejad
Background
Sarcopenia leads to a decrease in muscle mass, strength and physical performance. Dietary fibre and its exogenous biomarker acetate may be linked to measures of sarcopenia. Thus, we explored the relationships of dietary (soluble/insoluble) fibre and serum acetate with skeletal muscle health and body composition in women aged > 65 years.
Methods
In this cross-sectional Osteoporosis Risk Factor and Prevention-Fracture Prevention Study (OSTPRE-FPS) study, we analysed with linear regression the associations of dietary fibre and serum acetate (measured by nuclear magnetic resonance spectroscopy) with measures of sarcopenia such as body mass index (BMI), total lean mass, fat mass, appendicular skeletal muscle index, gait speed, grip strength, chair stand test, leg extension strength and grip strength-to-BMI ratio.
Results
In model 3, adjusted for energy and protein intake, age, hormonal therapy, type 2 diabetes, physical activity and smoking, a negative association between dietary soluble fibre and BMI (β = −0.113, p = 0.04) and a positive association between serum acetate concentrations and grip strength-to-BMI ratio (β = 0.093, p = 0.04) were detected. Dietary fibre and serum acetate as a combined independent variable were linked with both BMI (β = −0.101, p = 0.04) and grip strength-to-BMI ratio (β = 0.136, p < 0.01). BMI was more strongly influenced by soluble fibre (β = −0.107, p = 0.03), whereas grip strength-to-BMI ratio predominantly by insoluble fibre (β = 0.138, p < 0.01).
Conclusions
Future longitudinal studies are warranted to explore links between dietary fibre intake and serum or muscle acetate with muscle health in older adults.
背景：肌肉减少症会导致肌肉量、力量和体能的下降。膳食纤维及其外源性生物标志物醋酸盐可能与肌肉减少症有关。因此，我们探讨了膳食（可溶性/不可溶性）纤维和血清醋酸盐与65岁妇女骨骼肌健康和身体成分的关系。方法在这项骨质疏松危险因素和预防-骨折预防研究（OSTPRE-FPS）的横断研究中，我们用线性回归分析了膳食纤维和血清醋酸盐（通过核磁共振波谱测量）与肌肉减少症的相关性，如身体质量指数（BMI）、总瘦质量、脂肪质量、阑尾骨骼肌指数、步态速度、握力、椅子站立测试、腿部伸展力量和握力与身体质量指数之比。结果在模型3中，校正了能量和蛋白质摄入、年龄、激素治疗、2型糖尿病、体力活动和吸烟等因素后，膳食可溶性纤维与BMI呈负相关（β = - 0.113, p = 0.04），血清醋酸盐浓度与握力与BMI之比呈正相关（β = 0.093, p = 0.04）。膳食纤维和血清醋酸盐作为组合自变量与体重指数（β = - 0.101, p = 0.04）和握力与体重指数之比（β = 0.136, p < 0.01）均相关。可溶性纤维对BMI的影响更大（β = - 0.107, p = 0.03），而握力与BMI的比值主要受不溶性纤维的影响（β = 0.138, p < 0.01）。结论：未来的纵向研究有必要探索膳食纤维摄入量、血清或肌肉醋酸盐与老年人肌肉健康之间的联系。
{"title":"Association of Fibre Intake and Serum Acetate With Measures of Sarcopenia in Postmenopausal Women: The OSTPRE-FPS Study","authors":"Konstantinos Prokopidis, Heli Koivumaa-Honkanen, Parisa Jan Mohammad, Reijo Sund, Heikki Kröger, Toni Rikkonen, Arja T. Lyytinen, Masoud Isanejad","doi":"10.1002/rco2.70007","DOIUrl":"https://doi.org/10.1002/rco2.70007","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Sarcopenia leads to a decrease in muscle mass, strength and physical performance. Dietary fibre and its exogenous biomarker acetate may be linked to measures of sarcopenia. Thus, we explored the relationships of dietary (soluble/insoluble) fibre and serum acetate with skeletal muscle health and body composition in women aged > 65 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this cross-sectional Osteoporosis Risk Factor and Prevention-Fracture Prevention Study (OSTPRE-FPS) study, we analysed with linear regression the associations of dietary fibre and serum acetate (measured by nuclear magnetic resonance spectroscopy) with measures of sarcopenia such as body mass index (BMI), total lean mass, fat mass, appendicular skeletal muscle index, gait speed, grip strength, chair stand test, leg extension strength and grip strength-to-BMI ratio.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In model 3, adjusted for energy and protein intake, age, hormonal therapy, type 2 diabetes, physical activity and smoking, a negative association between dietary soluble fibre and BMI (β = −0.113, <i>p</i> = 0.04) and a positive association between serum acetate concentrations and grip strength-to-BMI ratio (β = 0.093, <i>p</i> = 0.04) were detected. Dietary fibre and serum acetate as a combined independent variable were linked with both BMI (β = −0.101, <i>p</i> = 0.04) and grip strength-to-BMI ratio (β = 0.136, <i>p</i> < 0.01). BMI was more strongly influenced by soluble fibre (β = −0.107, <i>p</i> = 0.03), whereas grip strength-to-BMI ratio predominantly by insoluble fibre (β = 0.138, <i>p</i> < 0.01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Future longitudinal studies are warranted to explore links between dietary fibre intake and serum or muscle acetate with muscle health in older adults.</p>\u0000 </section>\u0000 </div>","PeriodicalId":73544,"journal":{"name":"JCSM rapid communications","volume":"8 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/rco2.70007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144472917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In an aging society, it is important to intervene and prevent sarcopenia and dynapenia from an early stage. However, biochemical markers for screening sarcopenia and dynapenia have not yet been established. In this study, we hypothesized that the urinary titin level in participants undergoing health checkups would be a useful marker for sarcopenia/dynapenia.
Methods
This study included 445 individuals who participated in a health checkup in Okinoshima Town, Shimane Prefecture, Japan, in June 2023. Skeletal muscle mass (SMI/skeletal muscle index), muscle strength (handgrip strength), and physical performance (usual gait speed) were measured. Urinary titin levels were determined using enzyme-linked immunosorbent assay (ELISA) and corrected for creatinine.
Results
The participants' mean age was 75.3 ± 8.4 years, and 40% were men. The median urinary titin levels (interquartile range [IQR]) were 4.66 (2.91–8.37) pmol/mg Cr, and no difference was observed between men and women. Although urinary titin levels were not significantly correlated with SMI (r = 0.061, p = 0.199), they were negatively correlated with gait speed significantly (r = −0.201, p < 0.001) and handgrip strength, albeit at a borderline level (r = −0.093, p = 0.051). When classified into non-sarcopenia, mild sarcopenia, and severe sarcopenia, urinary titin levels (IQR) were 4.60 (2.84–7.84), 4.36 (3.12–7.32), and 8.68 (4.74–11.70), respectively. Participants with severe sarcopenia had significantly higher levels than those in other groups (p < 0.01 vs. non-sarcopenia, p < 0.05 vs. mild sarcopenia). The receiver operating characteristic (ROC) curve for severe sarcopenia showed the area under the curve (AUC) value of 0.69 (95% confidence interval [CI] 0.57–0.80). Urinary titin levels were also significantly higher in the dynapenia than in the non-dynapenia (p < 0.001).
Conclusions
Urinary titin levels are good markers of physical performance and muscle strength. Elevated urinary titin levels were found in an elderly population with severe sarcopenia/dynapenia, suggesting that titin may be useful as a biochemical marker for a severe sarcopenia/dynapenia screening tool.
{"title":"Urinary Titin Level Is a Novel Marker of Severe Sarcopenia and Dynapenia: Shimane CoHRE Study","authors":"Kanako Hara, Shozo Yano, Ryo Miyazaki, Takafumi Abe, Masayuki Yamasaki, Minoru Isomura, Kayo Osawa, Masafumi Matsuo, Keizo Kanasaki","doi":"10.1002/rco2.70006","DOIUrl":"https://doi.org/10.1002/rco2.70006","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In an aging society, it is important to intervene and prevent sarcopenia and dynapenia from an early stage. However, biochemical markers for screening sarcopenia and dynapenia have not yet been established. In this study, we hypothesized that the urinary titin level in participants undergoing health checkups would be a useful marker for sarcopenia/dynapenia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study included 445 individuals who participated in a health checkup in Okinoshima Town, Shimane Prefecture, Japan, in June 2023. Skeletal muscle mass (SMI/skeletal muscle index), muscle strength (handgrip strength), and physical performance (usual gait speed) were measured. Urinary titin levels were determined using enzyme-linked immunosorbent assay (ELISA) and corrected for creatinine.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The participants' mean age was 75.3 ± 8.4 years, and 40% were men. The median urinary titin levels (interquartile range [IQR]) were 4.66 (2.91–8.37) pmol/mg Cr, and no difference was observed between men and women. Although urinary titin levels were not significantly correlated with SMI (<i>r</i> = 0.061, <i>p</i> = 0.199), they were negatively correlated with gait speed significantly (<i>r</i> = −0.201, <i>p</i> < 0.001) and handgrip strength, albeit at a borderline level (<i>r</i> = −0.093, <i>p</i> = 0.051). When classified into non-sarcopenia, mild sarcopenia, and severe sarcopenia, urinary titin levels (IQR) were 4.60 (2.84–7.84), 4.36 (3.12–7.32), and 8.68 (4.74–11.70), respectively. Participants with severe sarcopenia had significantly higher levels than those in other groups (<i>p</i> < 0.01 vs. non-sarcopenia, <i>p</i> < 0.05 vs. mild sarcopenia). The receiver operating characteristic (ROC) curve for severe sarcopenia showed the area under the curve (AUC) value of 0.69 (95% confidence interval [CI] 0.57–0.80). Urinary titin levels were also significantly higher in the dynapenia than in the non-dynapenia (<i>p</i> < 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Urinary titin levels are good markers of physical performance and muscle strength. Elevated urinary titin levels were found in an elderly population with severe sarcopenia/dynapenia, suggesting that titin may be useful as a biochemical marker for a severe sarcopenia/dynapenia screening tool.</p>\u0000 </section>\u0000 </div>","PeriodicalId":73544,"journal":{"name":"JCSM rapid communications","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/rco2.70006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143875585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Emma S. Garratt, Hanan Y. Sharkh, Mark A. Burton, Matthew O. Hewitt, Elie Antoun, Leo Westbury, Elaine M. Dennison, Nicholas C. Harvey, Cyrus Cooper, Harnish P. Patel, Keith M. Godfrey, Karen A. Lillycrop
<div> <section> <h3> Background</h3> <p>An adverse early-life environment is associated with impaired muscle mass and function in later life, with epigenetic processes proposed as mediators. The aim of this study was to investigate whether early-life exposures were associated with altered patterns of DNA methylation in cultured myoblasts isolated from community-dwelling older individuals and whether the changes in DNA methylation contributed to impaired muscle function and muscle-related pathologies in later life.</p> </section> <section> <h3> Methods</h3> <p>DNA methylation (Infinium HumanMethylationEPIC BeadChip) was measured in proliferating myoblast cultures from vastus lateralis biopsies (119 male/females, median age 77.8 years) from the UK Hertfordshire Sarcopenia Study extension (HSSe). Analyses examined differentially methylated CpG sites (dmCpG), regions (DMRs) and pathways associated with birthweight, weight at 1 year, conditional growth during infancy and frequency of contemporaneously recorded childhood illnesses from birth to age 1 year and from age 1 to 5 years. RT-PCR was used to examine the correlation between methylation and expression. Associations between dmCpGs and muscle-related pathologies including sarcopenia, its definitional components (grip strength, appendicular lean mass index [ALMi] and gait speed) and impaired glucose-insulin metabolism were also examined.</p> </section> <section> <h3> Results</h3> <p>Seven myoblast dmCpGs were associated (FDR ≤ 0.05) with birthweight, eight with weight at 1 year and six with conditional growth during infancy, with dmCpGs enriched in metabolic and nutrient sensing pathways. One differentially methylated region (DMR) (Stouffer ≤ 0.05) was associated with birthweight, located within the Branched Chain Amino Acid Transaminase 1 (<i>BCAT1</i>) gene, with two of the CpGs sites positively associated with <i>BCAT1</i> transcript levels (cg05197760: <i>p</i> = 1.73 × 10<sup>−2</sup>, cg13966241: <i>p</i> = 3.31 × 10<sup>−2</sup>). There were 16 and 53 dmCpGs significantly associated (FDR ≤ 0.05) with the frequency of childhood illnesses from birth to 1 year and from 1 to 5 years, respectively, with dmCpGs enriched in signal transduction and stress pathways. Of the 90 dmCpGs associated with early-life size or infections, five were also associated with later-life ALMi, four with grip strength, one with sarcopenia, four with HOMA2-IR and fasting insulin levels and two with fasting glucose levels (all <i>p</i> ≤ 0.05). cg13939055 (located within a long noncoding RNA) mediated the relations of increased frequency of childhood illnesses from age 1 to 5 years with HOMA2-IR (<i>p</i> = 3.3 × 10<sup>−2
{"title":"Early Life Environment Is Associated With Differential DNA Methylation of Primary Myoblasts From Older Individuals","authors":"Emma S. Garratt, Hanan Y. Sharkh, Mark A. Burton, Matthew O. Hewitt, Elie Antoun, Leo Westbury, Elaine M. Dennison, Nicholas C. Harvey, Cyrus Cooper, Harnish P. Patel, Keith M. Godfrey, Karen A. Lillycrop","doi":"10.1002/rco2.70005","DOIUrl":"https://doi.org/10.1002/rco2.70005","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>An adverse early-life environment is associated with impaired muscle mass and function in later life, with epigenetic processes proposed as mediators. The aim of this study was to investigate whether early-life exposures were associated with altered patterns of DNA methylation in cultured myoblasts isolated from community-dwelling older individuals and whether the changes in DNA methylation contributed to impaired muscle function and muscle-related pathologies in later life.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>DNA methylation (Infinium HumanMethylationEPIC BeadChip) was measured in proliferating myoblast cultures from vastus lateralis biopsies (119 male/females, median age 77.8 years) from the UK Hertfordshire Sarcopenia Study extension (HSSe). Analyses examined differentially methylated CpG sites (dmCpG), regions (DMRs) and pathways associated with birthweight, weight at 1 year, conditional growth during infancy and frequency of contemporaneously recorded childhood illnesses from birth to age 1 year and from age 1 to 5 years. RT-PCR was used to examine the correlation between methylation and expression. Associations between dmCpGs and muscle-related pathologies including sarcopenia, its definitional components (grip strength, appendicular lean mass index [ALMi] and gait speed) and impaired glucose-insulin metabolism were also examined.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seven myoblast dmCpGs were associated (FDR ≤ 0.05) with birthweight, eight with weight at 1 year and six with conditional growth during infancy, with dmCpGs enriched in metabolic and nutrient sensing pathways. One differentially methylated region (DMR) (Stouffer ≤ 0.05) was associated with birthweight, located within the Branched Chain Amino Acid Transaminase 1 (<i>BCAT1</i>) gene, with two of the CpGs sites positively associated with <i>BCAT1</i> transcript levels (cg05197760: <i>p</i> = 1.73 × 10<sup>−2</sup>, cg13966241: <i>p</i> = 3.31 × 10<sup>−2</sup>). There were 16 and 53 dmCpGs significantly associated (FDR ≤ 0.05) with the frequency of childhood illnesses from birth to 1 year and from 1 to 5 years, respectively, with dmCpGs enriched in signal transduction and stress pathways. Of the 90 dmCpGs associated with early-life size or infections, five were also associated with later-life ALMi, four with grip strength, one with sarcopenia, four with HOMA2-IR and fasting insulin levels and two with fasting glucose levels (all <i>p</i> ≤ 0.05). cg13939055 (located within a long noncoding RNA) mediated the relations of increased frequency of childhood illnesses from age 1 to 5 years with HOMA2-IR (<i>p</i> = 3.3 × 10<sup>−2","PeriodicalId":73544,"journal":{"name":"JCSM rapid communications","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/rco2.70005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143826675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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