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Association of Fibre Intake and Serum Acetate With Measures of Sarcopenia in Postmenopausal Women: The OSTPRE-FPS Study 绝经后妇女纤维摄入量和血清醋酸盐与肌肉减少症的关系:ostprefps研究
Pub Date : 2025-06-24 DOI: 10.1002/rco2.70007
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。
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引用次数: 0
Urinary Titin Level Is a Novel Marker of Severe Sarcopenia and Dynapenia: Shimane CoHRE Study 尿Titin水平是严重肌肉减少和动力不足的新标志物:岛根CoHRE研究
Pub Date : 2025-04-26 DOI: 10.1002/rco2.70006
Kanako Hara, Shozo Yano, Ryo Miyazaki, Takafumi Abe, Masayuki Yamasaki, Minoru Isomura, Kayo Osawa, Masafumi Matsuo, Keizo Kanasaki

Background

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.

背景在老龄化社会中,早期干预和预防肌肉减少症和运动障碍是很重要的。然而,筛选肌肉减少症和肌肉减少症的生化标志物尚未建立。在这项研究中,我们假设接受健康检查的参与者的尿titin水平将是肌肉减少/动力不足的有用标记。方法本研究纳入了于2023年6月在日本岛根县冲之岛镇参加健康检查的445名个体。测量骨骼肌质量(SMI/骨骼肌指数)、肌肉力量(握力)和身体表现(通常的步态速度)。采用酶联免疫吸附试验(ELISA)测定尿titin水平,并校正肌酐。结果患者平均年龄75.3±8.4岁,男性占40%。尿titin水平中位数(四分位数范围[IQR])为4.66 (2.91-8.37)pmol/mg Cr,男女之间无差异。尿titin水平与SMI无显著相关(r = 0.061, p = 0.199),但与步速(r = - 0.201, p < 0.001)和握力呈显著负相关(r = - 0.093, p = 0.051)。非肌少症、轻度肌少症和重度肌少症患者的尿titin水平(IQR)分别为4.60(2.84 ~ 7.84)、4.36(3.12 ~ 7.32)和8.68(4.74 ~ 11.70)。重度肌少症患者的水平明显高于其他组(p < 0.01 vs.非肌少症,p < 0.05 vs.轻度肌少症)。重度肌少症患者的受试者工作特征(ROC)曲线显示曲线下面积(AUC)为0.69(95%可信区间[CI] 0.57 ~ 0.80)。尿急患者的尿titin水平也明显高于非尿急患者(p < 0.001)。结论尿titin水平是运动能力和肌力的良好指标。在老年严重肌少症/肌动症患者中发现尿titin水平升高,提示titin可作为严重肌少症/肌动症筛查工具的生化标志物。
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引用次数: 0
Early Life Environment Is Associated With Differential DNA Methylation of Primary Myoblasts From Older Individuals 早期生活环境与老年个体原发性成肌细胞DNA甲基化差异相关
Pub Date : 2025-04-13 DOI: 10.1002/rco2.70005
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
背景早年的不利生活环境与晚年肌肉质量和功能受损有关,而表观遗传过程被认为是介导因素。本研究旨在调查早期生活暴露是否与从社区居住的老年人体内分离出来的培养肌母细胞中 DNA 甲基化模式的改变有关,以及 DNA 甲基化的变化是否会导致晚年肌肉功能受损和肌肉相关病症。 方法 对来自英国赫特福德郡肌肉疏松症研究扩展项目(HSSe)的侧阔肌活检组织(119 名男性/女性,中位年龄 77.8 岁)的增殖肌细胞培养物进行 DNA 甲基化(Infinium HumanMethylationEPIC BeadChip)测量。分析检验了与出生体重、1 岁时体重、婴儿期条件性生长以及出生至 1 岁和 1 至 5 岁期间同时记录的儿童疾病频率相关的不同甲基化 CpG 位点(dmCpG)、区域(DMRs)和途径。采用 RT-PCR 技术检测甲基化与表达之间的相关性。此外,还研究了 dmCpGs 与肌肉相关病症的关系,包括肌肉疏松症、其定义成分(握力、关节瘦体重指数 [ALMi] 和步速)以及葡萄糖-胰岛素代谢受损。 结果 7 个肌母细胞 dmCpGs 与出生体重相关(FDR ≤ 0.05),8 个与 1 岁时的体重相关,6 个与婴儿期的条件生长相关,dmCpGs 富集在代谢和营养传感通路中。一个差异甲基化区域(DMR)(Stouffer ≤ 0.05)与出生体重相关,该区域位于支链氨基酸转氨酶 1(BCAT1)基因内,其中两个 CpGs 位点与 BCAT1 转录水平呈正相关(cg05197760:p = 1.73 × 10-2;cg13966241:p = 3.31 × 10-2)。分别有 16 和 53 个 dmCpGs 与出生至 1 岁和 1 至 5 岁儿童患病频率显著相关(FDR ≤ 0.05),这些 dmCpGs 富集在信号转导和应激途径中。在与生命早期体型或感染相关的 90 个 dmCpGs 中,有 5 个也与生命后期的 ALMi 相关,4 个与握力相关,1 个与肌肉疏松相关,4 个与 HOMA2-IR 和空腹胰岛素水平相关,2 个与空腹血糖水平相关(均 p≤0.cg13939055(位于长非编码 RNA 中)介导了 1 至 5 岁儿童疾病频率增加与日后生活中 HOMA2-IR (p = 3.3 × 10-2)和空腹胰岛素(p = 3.3 × 10-2)的关系。 结论 这些研究结果表明,婴儿的生长和生命早期的感染会影响日后肌母细胞的甲基组。这支持了一个前提,即生命早期是一个关键的发育窗口期,可通过表观遗传调节影响日后的肌肉恢复能力。
{"title":"Early Life Environment Is Associated With Differential DNA Methylation of Primary Myoblasts From Older Individuals","authors":"Emma S. Garratt,&nbsp;Hanan Y. Sharkh,&nbsp;Mark A. Burton,&nbsp;Matthew O. Hewitt,&nbsp;Elie Antoun,&nbsp;Leo Westbury,&nbsp;Elaine M. Dennison,&nbsp;Nicholas C. Harvey,&nbsp;Cyrus Cooper,&nbsp;Harnish P. Patel,&nbsp;Keith M. Godfrey,&nbsp;Karen A. Lillycrop","doi":"10.1002/rco2.70005","DOIUrl":"https://doi.org/10.1002/rco2.70005","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;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.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;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.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;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 (&lt;i&gt;BCAT1&lt;/i&gt;) gene, with two of the CpGs sites positively associated with &lt;i&gt;BCAT1&lt;/i&gt; transcript levels (cg05197760: &lt;i&gt;p&lt;/i&gt; = 1.73 × 10&lt;sup&gt;−2&lt;/sup&gt;, cg13966241: &lt;i&gt;p&lt;/i&gt; = 3.31 × 10&lt;sup&gt;−2&lt;/sup&gt;). 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 &lt;i&gt;p&lt;/i&gt; ≤ 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 (&lt;i&gt;p&lt;/i&gt; = 3.3 × 10&lt;sup&gt;−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}
引用次数: 0
Muscle Loss Is Prevalent and Severe in the ICU: An Analysis of Clinically Acquired CT Images 肌肉损失是普遍和严重的ICU:临床获得的CT图像分析
Pub Date : 2025-04-09 DOI: 10.1002/rco2.70004
Ainsley C. J. Smith, Brandon M. Hisey, Chel Hee Lee, Christopher J. Grant, Richard E. A. Walker, Kevin J. Solverson, Kirsten N. Bott, Christopher J. Doig, Sarah L. Manske

Background

Muscle loss is a common and debilitating complication of critical illness. Understanding the prevalence, severity, and risk factors associated with muscle loss is challenging. Muscle cross-sectional area obtained from computed tomography (CT) scans can be used to assess changes in muscle over the course of critical illness. The objective of this study was to investigate changes in muscle in the ICU using clinically acquired CT imaging, describe the severity and prevalence of muscle loss in the ICU, and explore the risk factors for muscle loss in the ICU.

Methods

For this multi-hospital cohort study, we acquired baseline and follow-up CT abdominal scans for 171 ICU trauma and sepsis patients from four hospitals in Calgary, Canada. We measured mean psoas muscle cross-sectional area at the level of the third lumbar vertebra using a U-Net algorithm and manual correction. Patient demographic and illness-related information were acquired using electronic medical records. Linear mixed models and regressions were used to assess risk factors.

Results

CT-derived psoas muscle index (PMI, defined as psoas cross-sectional area/height2), was calculated for 151 patients. The median [IQR] age was 55 [42, 67] years and 40% of patients were female. 71% of patients had sepsis and 29% had traumatic injuries. Patients experienced a median [IQR] 9 [1.5, 18.3]% reduction in psoas muscle index (PMI) over a median [IQR] 13 [9, 21] days in the ICU. This represents a median PMI loss rate of 0.9% [0.2, 1.6] % per day. The prevalence of substantial PMI loss (≥ 10%) was 45%. Patients with greater PMI at baseline or greater time in the ICU experienced more profound PMI loss (p < 0.001). Trauma patients experienced a greater rate of PMI loss than sepsis patients (p < 0.05). Female sepsis patients had the lowest PMI at follow-up (p < 0.001). 89% of patients survived the ICU. Greater rate of PMI loss was associated with increased ICU mortality (p < 0.05).

Conclusions

Muscle loss in trauma and sepsis patients in the ICU is common, especially among patients with longer ICU stays or greater baseline muscle. Greater rate of muscle loss occurs in trauma patients and is associated with mortality.

背景:肌肉萎缩是危重症的常见并发症。了解与肌肉损失相关的患病率、严重程度和危险因素是具有挑战性的。通过计算机断层扫描(CT)获得的肌肉横截面积可用于评估危重疾病过程中肌肉的变化。本研究的目的是通过临床获得的CT影像来研究ICU患者的肌肉变化,描述ICU患者肌肉损失的严重程度和流行程度,并探讨ICU患者肌肉损失的危险因素。方法在这项多医院队列研究中,我们获得了来自加拿大卡尔加里四家医院的171例ICU创伤和败血症患者的基线和随访CT腹部扫描。我们使用U-Net算法和人工校正测量了第三腰椎水平的腰大肌平均横截面积。使用电子病历获取患者人口统计和疾病相关信息。使用线性混合模型和回归来评估危险因素。结果计算了151例患者的ct腰肌指数(PMI,定义为腰肌横截面积/高度2)。中位[IQR]年龄为55岁[42,67]岁,40%的患者为女性。71%的患者有败血症,29%的患者有外伤性损伤。患者在ICU的中位[IQR] 13[9,21]天内腰肌指数(PMI)下降了9[1.5,18.3]%。这意味着平均每天的PMI损失率为0.9%[0.2,1.6]%。PMI大幅下降(≥10%)的发生率为45%。基线时PMI较高或在ICU住院时间较长的患者会经历更严重的PMI损失(p < 0.001)。创伤患者的PMI丢失率高于脓毒症患者(p < 0.05)。女性脓毒症患者随访时PMI最低(p < 0.001)。89%的患者在ICU存活。PMI失失率越高,ICU死亡率越高(p < 0.05)。结论:ICU创伤和脓毒症患者的肌肉损失是常见的,特别是在ICU住院时间较长或基线肌肉较大的患者中。创伤患者的肌肉损失率更高,并与死亡率相关。
{"title":"Muscle Loss Is Prevalent and Severe in the ICU: An Analysis of Clinically Acquired CT Images","authors":"Ainsley C. J. Smith,&nbsp;Brandon M. Hisey,&nbsp;Chel Hee Lee,&nbsp;Christopher J. Grant,&nbsp;Richard E. A. Walker,&nbsp;Kevin J. Solverson,&nbsp;Kirsten N. Bott,&nbsp;Christopher J. Doig,&nbsp;Sarah L. Manske","doi":"10.1002/rco2.70004","DOIUrl":"https://doi.org/10.1002/rco2.70004","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Muscle loss is a common and debilitating complication of critical illness. Understanding the prevalence, severity, and risk factors associated with muscle loss is challenging. Muscle cross-sectional area obtained from computed tomography (CT) scans can be used to assess changes in muscle over the course of critical illness. The objective of this study was to investigate changes in muscle in the ICU using clinically acquired CT imaging, describe the severity and prevalence of muscle loss in the ICU, and explore the risk factors for muscle loss in the ICU.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>For this multi-hospital cohort study, we acquired baseline and follow-up CT abdominal scans for 171 ICU trauma and sepsis patients from four hospitals in Calgary, Canada. We measured mean psoas muscle cross-sectional area at the level of the third lumbar vertebra using a U-Net algorithm and manual correction. Patient demographic and illness-related information were acquired using electronic medical records. Linear mixed models and regressions were used to assess risk factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>CT-derived psoas muscle index (PMI, defined as psoas cross-sectional area/height<sup>2</sup>), was calculated for 151 patients. The median [IQR] age was 55 [42, 67] years and 40% of patients were female. 71% of patients had sepsis and 29% had traumatic injuries. Patients experienced a median [IQR] 9 [1.5, 18.3]% reduction in psoas muscle index (PMI) over a median [IQR] 13 [9, 21] days in the ICU. This represents a median PMI loss rate of 0.9% [0.2, 1.6] % per day. The prevalence of substantial PMI loss (≥ 10%) was 45%. Patients with greater PMI at baseline or greater time in the ICU experienced more profound PMI loss (<i>p</i> &lt; 0.001). Trauma patients experienced a greater rate of PMI loss than sepsis patients (<i>p</i> &lt; 0.05). Female sepsis patients had the lowest PMI at follow-up (p &lt; 0.001). 89% of patients survived the ICU. Greater rate of PMI loss was associated with increased ICU mortality (<i>p</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Muscle loss in trauma and sepsis patients in the ICU is common, especially among patients with longer ICU stays or greater baseline muscle. Greater rate of muscle loss occurs in trauma patients and is associated with mortality.</p>\u0000 </section>\u0000 </div>","PeriodicalId":73544,"journal":{"name":"JCSM rapid communications","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/rco2.70004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143809705","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}
引用次数: 0
Muscle atrophy in osteoarthritis: clinical features, pathological changes, underlying mechanisms, and exercise-based interventions 骨关节炎的肌肉萎缩:临床特征、病理改变、潜在机制和基于运动的干预
Pub Date : 2025-03-29 DOI: 10.1002/rco2.99
Tongyi Zhang, Bin Zhang, Jinhui Wu, Song Li, Yunquan Gong, Shunzheng Fang, Daibo Feng, Bo Huang, Jiqin Lian, Wei Xiang, Lin Chen, Zhenhong Ni

Background

Osteoarthritis (OA) is a common degenerative disease with cartilage injury as the core pathological phenotype, which has become the leading cause of disability in the elderly. Skeletal muscle is an important organ to maintain the structure and motor function of joints, which is highly related to OA progress. Patients with OA typically exhibit abnormalities in the skeletal muscles surrounding the joints, such as reduced muscle mass and strength. We refer to this condition as OA-related muscle atrophy (hereafter referred to as OAMA). The mechanisms of OAMA are multifactorial and unclear.

Methods

In this narrative review, we summarized relevant research progress of OAMA (i) to review the changes in skeletal muscle of patients with OA, (ii) to review the underlying biological mechanisms of OAMA, (iii) to review the effects of skeletal muscle on OA, and (iv) to provide perspectives on current and potential strategies of OA clinical treatment based on skeletal muscle, especially exercise training.

Results

OAMA may lead to the destruction of joint stability and cartilage homeostasis and then promote the occurrence and development of OA. Clinical manifestations of OAMA are a decline in muscle mass and strength and an abnormal movement pattern. The underlying biological mechanisms of OAMA include chronic inflammation, oxidative stress, ion metabolism, glycolipid metabolism, and epigenetics. The effects of skeletal muscle on OA are skeletal muscle-mediated cartilage damage via biomechanics, muscle-derived secretions, and muscle-derived stem cells.

Conclusions

More preclinical and clinical studies are imperative to study the mechanisms of OAMA and develop potential strategies. We hope that more studies can focus on the skeletal muscle during the OA process, which will be beneficial for delaying OA progression and improving the motor function of OA patients in the future.

骨关节炎(Osteoarthritis, OA)是一种常见的以软骨损伤为核心病理表型的退行性疾病,已成为老年人致残的首要原因。骨骼肌是维持关节结构和运动功能的重要器官,与骨关节炎的进展密切相关。骨性关节炎患者通常表现为关节周围骨骼肌异常,如肌肉质量和力量减少。我们将这种情况称为oa相关性肌肉萎缩(以下简称OAMA)。OAMA的机制是多因素的,目前尚不清楚。方法在本文中,我们对骨骼肌的相关研究进展进行综述(1)综述骨骼肌在OA患者中的变化,(2)综述骨骼肌在OA中的潜在生物学机制,(3)综述骨骼肌在OA中的作用,(4)对骨骼肌在OA临床治疗中的现有和潜在策略进行展望。尤其是运动训练。结果骨性关节炎可导致关节稳定性和软骨稳态的破坏,进而促进骨性关节炎的发生和发展。OAMA的临床表现是肌肉质量和力量的下降以及异常的运动模式。OAMA的潜在生物学机制包括慢性炎症、氧化应激、离子代谢、糖脂代谢和表观遗传学。骨骼肌对骨性关节炎的影响是通过生物力学、肌肉源性分泌物和肌肉源性干细胞介导的骨骼肌介导的软骨损伤。结论需要更多的临床前和临床研究来研究OAMA的机制和制定潜在的策略。我们希望更多的研究关注OA过程中的骨骼肌,这将有利于未来延缓OA进展,改善OA患者的运动功能。
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引用次数: 0
Effects of Pemafibrate on Serum Carnitine and Plasma Myostatin in Patients With Metabolic Dysfunction Associated Steatotic Liver Disease 培马巴贝特对代谢功能障碍相关脂肪变性肝病患者血清肉碱和血浆肌生长抑制素的影响
Pub Date : 2025-03-26 DOI: 10.1002/rco2.70002
Ryohei Tanigawa, Atsushi Nakajima, Yuichiro Eguchi, Hirokazu Takahashi, Rohit Loomba, Hideki Suganami, Masaya Tanahashi, Hidenori Arai
<div> <section> <h3> Background</h3> <p>Pemafibrate, a selective peroxisome proliferator-activated receptor alpha (PPARα) modulator (SPPARMα), has positive effects on liver-related markers (e.g., liver stiffness determined by magnetic resonance elastography and alanine aminotransferase) in the PEMA-FL study in patients with metabolic dysfunction-associated steatotic liver disease (MASLD). Patients with MASLD reportedly have a high rate of muscle mass loss; hence, the prevention and treatment of sarcopenia is important for patients with MASLD. PPARα may be involved in the expression of carnitine and myostatin, which are known muscle-related markers. We conducted a post-hoc analysis of the PEMA-FL study to investigate the effects of pemafibrate on carnitine and myostatin levels.</p> </section> <section> <h3> Methods</h3> <p>The PEMA-FL study, a double-blind, placebo-controlled, randomized, multicenter, Phase 2 trial, randomized 118 patients to either Pemafibrate 0.4 mg/day or placebo (1:1) group (orally, twice daily for 72 weeks). This post-hoc analysis examined the percentage change in total carnitine, free carnitine, acylcarnitine, and myostatin in the pemafibrate group compared to those in the placebo group. We examined the correlation between percentage changes in carnitine and myostatin levels.</p> </section> <section> <h3> Results</h3> <p>Pmafibrate significantly increased serum total carnitine and free carnitine levels from baseline compared to placebo at Week 48 (treatment difference 24.2%; <i>p</i> < 0.001, 27.3%; <i>p</i> < 0.001, respectively) with similar trends for serum acylcarnitine (treatment difference 10.7%). Pemafibrate significantly reduced plasma myostatin levels at Week 72 (treatment difference −11.0%; <i>p</i> < 0.01) from baseline. Analysis of the significant changes in free carnitine and myostatin levels by subgroups showed similar changes in almost all subgroups. The percent changes in the serum total carnitine, free carnitine and acylcarnitine, and plasma myostatin levels at 12 weeks demonstrated no obvious correlations (<i>r</i> = 0.337, <i>r</i> = 0.358, <i>r</i> = 0.077, respectively).</p> </section> <section> <h3> Conclusions</h3> <p>Pemafibrate increased the serum carnitine and decreased plasma myostatin levels in patients with MASLD, which may have potential application in the development and progression of sarcopenia, but there are no results on the effect on muscle mass. Further research is warranted to determine whether these changes in physiology can lead to clinical benefits in the prevention or treatmen
背景:在代谢功能障碍相关脂肪变性肝病(MASLD)患者的pama - fl研究中,Pemafibrate是一种选择性过氧化物酶体增殖物激活受体α (PPARα)调节剂(SPPARMα),对肝脏相关标志物(例如,通过磁共振弹性成像和丙氨酸转氨酶测定的肝脏硬度)具有积极作用。据报道,MASLD患者的肌肉质量损失率很高;因此,预防和治疗肌少症对MASLD患者至关重要。PPARα可能参与肉碱和肌肉生长抑制素的表达,这是已知的肌肉相关标志物。我们对pama - fl研究进行了事后分析,以调查培马布特对肉碱和肌肉生长抑制素水平的影响。poma - fl研究是一项双盲、安慰剂对照、随机、多中心、2期试验,118例患者随机分为poma - fl组(0.4 mg/d)和安慰剂组(1:1)(口服,每日2次,持续72周)。这个事后分析检查了与安慰剂组相比,培马哌特组中总肉毒碱、游离肉毒碱、酰基肉毒碱和肌肉生长抑制素的百分比变化。我们检查了肉毒碱和肌肉生长抑制素水平百分比变化之间的相关性。结果在第48周,与安慰剂相比,pmafitate显著增加了血清总肉毒碱和游离肉毒碱水平(治疗差异24.2%;P < 0.001, 27.3%;P < 0.001),血清酰基肉碱的趋势相似(治疗差异为10.7%)。在第72周,培马哌特显著降低血浆肌生长抑制素水平(治疗差异为- 11.0%;P < 0.01)。分析各组游离肉碱和肌肉生长抑制素水平的显著变化,发现几乎所有亚组的变化都相似。血清总肉毒碱、游离肉毒碱和酰基肉毒碱与血浆肌生长抑制素在12周的变化百分比无明显相关性(r = 0.337, r = 0.358, r = 0.077)。结论培马菲特可提高MASLD患者血清肉碱水平,降低血浆肌生成抑制素水平,可能在肌少症的发生发展中有潜在的应用价值,但对肌肉质量的影响尚无结果。需要进一步的研究来确定这些生理变化是否能在预防或治疗MASLD患者肌肉减少症方面带来临床益处。试验注册:ClinicalTrials.gov标识符:NCT03350165。
{"title":"Effects of Pemafibrate on Serum Carnitine and Plasma Myostatin in Patients With Metabolic Dysfunction Associated Steatotic Liver Disease","authors":"Ryohei Tanigawa,&nbsp;Atsushi Nakajima,&nbsp;Yuichiro Eguchi,&nbsp;Hirokazu Takahashi,&nbsp;Rohit Loomba,&nbsp;Hideki Suganami,&nbsp;Masaya Tanahashi,&nbsp;Hidenori Arai","doi":"10.1002/rco2.70002","DOIUrl":"https://doi.org/10.1002/rco2.70002","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Pemafibrate, a selective peroxisome proliferator-activated receptor alpha (PPARα) modulator (SPPARMα), has positive effects on liver-related markers (e.g., liver stiffness determined by magnetic resonance elastography and alanine aminotransferase) in the PEMA-FL study in patients with metabolic dysfunction-associated steatotic liver disease (MASLD). Patients with MASLD reportedly have a high rate of muscle mass loss; hence, the prevention and treatment of sarcopenia is important for patients with MASLD. PPARα may be involved in the expression of carnitine and myostatin, which are known muscle-related markers. We conducted a post-hoc analysis of the PEMA-FL study to investigate the effects of pemafibrate on carnitine and myostatin levels.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The PEMA-FL study, a double-blind, placebo-controlled, randomized, multicenter, Phase 2 trial, randomized 118 patients to either Pemafibrate 0.4 mg/day or placebo (1:1) group (orally, twice daily for 72 weeks). This post-hoc analysis examined the percentage change in total carnitine, free carnitine, acylcarnitine, and myostatin in the pemafibrate group compared to those in the placebo group. We examined the correlation between percentage changes in carnitine and myostatin levels.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Pmafibrate significantly increased serum total carnitine and free carnitine levels from baseline compared to placebo at Week 48 (treatment difference 24.2%; &lt;i&gt;p&lt;/i&gt; &lt; 0.001, 27.3%; &lt;i&gt;p&lt;/i&gt; &lt; 0.001, respectively) with similar trends for serum acylcarnitine (treatment difference 10.7%). Pemafibrate significantly reduced plasma myostatin levels at Week 72 (treatment difference −11.0%; &lt;i&gt;p&lt;/i&gt; &lt; 0.01) from baseline. Analysis of the significant changes in free carnitine and myostatin levels by subgroups showed similar changes in almost all subgroups. The percent changes in the serum total carnitine, free carnitine and acylcarnitine, and plasma myostatin levels at 12 weeks demonstrated no obvious correlations (&lt;i&gt;r&lt;/i&gt; = 0.337, &lt;i&gt;r&lt;/i&gt; = 0.358, &lt;i&gt;r&lt;/i&gt; = 0.077, respectively).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Pemafibrate increased the serum carnitine and decreased plasma myostatin levels in patients with MASLD, which may have potential application in the development and progression of sarcopenia, but there are no results on the effect on muscle mass. Further research is warranted to determine whether these changes in physiology can lead to clinical benefits in the prevention or treatmen","PeriodicalId":73544,"journal":{"name":"JCSM rapid communications","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/rco2.70002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699005","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}
引用次数: 0
Correction to “Overexpression of thioredoxin-2 attenuates age-related muscle loss by suppressing mitochondrial oxidative stress and apoptosis” 更正“硫氧还蛋白-2的过度表达通过抑制线粒体氧化应激和细胞凋亡来减轻与年龄相关的肌肉损失”
Pub Date : 2025-03-24 DOI: 10.1002/rco2.70003

Tang, H., Kim, M., Lee, M., Baumann, K., Olguin, F., He, H., Wang, Y., Jiang, B., Fang, S., Zhu, J., Wang, K., Xia, H., Gao, Y., Konsker, H. B., Fatodu, E. A., Quarta, M., Blonigan, J., Rando, T. A., and Shrager, J. B. (2022) Overexpression of thioredoxin-2 attenuates age-related muscle loss by suppressing mitochondrial oxidative stress and apoptosis. JCSM Rapid Communications, 5: 130145, https://doi.org/10.1002/rco2.57.

We failed to include funding from the National Institute of Arthritis and Musculoskeletal and Skin Diseases (R01 AR73248) to TAR in the Acknowledgements.

We apologize for this error.

Tang, H., Kim, M., Lee, M., Baumann, K., Olguin, F., He, H., Wang, Y., Jiang, B., Fang, S., Zhu, J., Wang, K., Xia, H., Gao, Y., Konsker, H. B., Fatodu, E. A., Quarta, M., Blonigan, J., Rando, T. A., Shrager, J.(2022)过表达的硫氧还蛋白-2通过抑制线粒体氧化应激和细胞凋亡来减轻年龄相关的肌肉损失。快速通信,5:130-145,https://doi.org/10.1002/rco2.57。我们没有在致谢中包括来自国家关节炎、肌肉骨骼和皮肤疾病研究所(R01 AR73248)对TAR的资助。我们为这个错误道歉。
{"title":"Correction to “Overexpression of thioredoxin-2 attenuates age-related muscle loss by suppressing mitochondrial oxidative stress and apoptosis”","authors":"","doi":"10.1002/rco2.70003","DOIUrl":"https://doi.org/10.1002/rco2.70003","url":null,"abstract":"<p>\u0000 <span>Tang, H.</span>, <span>Kim, M.</span>, <span>Lee, M.</span>, <span>Baumann, K.</span>, <span>Olguin, F.</span>, <span>He, H.</span>, <span>Wang, Y.</span>, <span>Jiang, B.</span>, <span>Fang, S.</span>, <span>Zhu, J.</span>, <span>Wang, K.</span>, <span>Xia, H.</span>, <span>Gao, Y.</span>, <span>Konsker, H. B.</span>, <span>Fatodu, E. A.</span>, <span>Quarta, M.</span>, <span>Blonigan, J.</span>, <span>Rando, T. A.</span>, and <span>Shrager, J. B.</span> (<span>2022</span>) <span>Overexpression of thioredoxin-2 attenuates age-related muscle loss by suppressing mitochondrial oxidative stress and apoptosis</span>. <i>JCSM Rapid Communications</i>, <span>5</span>: <span>130</span>–<span>145</span>, https://doi.org/10.1002/rco2.57.\u0000 </p><p>We failed to include funding from the National Institute of Arthritis and Musculoskeletal and Skin Diseases (R01 AR73248) to TAR in the Acknowledgements.</p><p>We apologize for this error.</p>","PeriodicalId":73544,"journal":{"name":"JCSM rapid communications","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/rco2.70003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143689275","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}
引用次数: 0
Malnutrition Risk and the Psychological Burden of Anorexia and Cachexia in Patients With Advanced Cancer 晚期癌症患者厌食症和恶病质的营养不良风险及心理负担
Pub Date : 2025-03-19 DOI: 10.1002/rco2.70001
Rony Dev, Patricia Bramati, Marvin Omar Delgado Guay, Bryan Fellman, Ahsan Azhar, Michael Tang, Jegy Tennison, Josue Becerra, Sonal Admane, Shalini Dalal, David Hui, Egidio Del Fabbro, Eduardo Bruera

Background

Patients with advanced cancer are at risk for malnutrition and anorexia-cachexia syndrome. The study objective was to determine the frequency of these conditions in patients evaluated in an outpatient supportive care clinic (SCC).

Methods

One hundred patients with cancer were prospectively enrolled to complete a cross-sectional one-time survey. We collected patient demographics, cancer diagnosis, weight history and height and Zubrod performance status from electronic health records. Patients completed the Functional Assessment of Anorexia Therapy–Anorexia/Cachexia Subscale (FAACT-A/CS) questionnaire, the Edmonton Symptom Assessment Scale (ESAS), the Patient-Generated Subjective Global Assessment–Short Form (PG-SGA-SF), the Hospital Anxiety and Depression Scale (HADS) and a Body Image Scale (BIS). A PG-SGA-SF cut-off of ≥ 6 indicated malnutrition risk, and loss of appetite was defined as either ESAS ≥ 3 or FAACT-ACS ≤ 37.

Results

Of the 165 patients approached, 100 (61%) completed the survey. The average (SD) age was 61.6 years old (11.5). The majority were female (52%), White (75%) and married (80%). The most common cancers were gastrointestinal (22%) and genitourinary (21%). Sixty-one per cent (61%) screened positive for risk of malnutrition (PG-SGA-SF ≥ 6), anorexia was noted in 60% (ESAS ≥ 3) and 53% (FAACT-A/CS ≤ 37) of patients, 10% of patients were noted to have a body mass index < 18.5, and 28% had body image dissatisfaction (BIS ≥ 10). Documented > 5% weight loss over the past 6 months was noted in 49%; 61% noted > 10% lifetime weight loss, relative to usual adult body weight or at time of diagnosis. Patients with anorexia (FAACT-ACS ≤ 37) compared with no anorexia reported significantly higher HADS anxiety score (4.4 vs. 3.2, p = 0.04), depression (5.9 vs. 3.5, p = 0.001), body image distress (BIS 7.2 vs. 4.9, p = 0.03) and worse appetite (ESAS 1.4 vs. 0.6, p = 0.02). Symptoms including depression, anxiety and body image distress were not significantly different between patients with either a history of > 10% lifetime weight loss or > 5% weight loss over 6 months.

Conclusions

Malnutrition risk was noted in roughly 60% of patients with advanced cancer. Inclusion of patients' body mass index to malnutrition or cachexia criteria resulted in underdiagnosis. Subjective symptoms of anorexia, but not objective weight loss, was significantly associated w

晚期癌症患者存在营养不良和厌食症-恶病质综合征的风险。研究目的是确定在门诊支持护理诊所(SCC)评估的患者中这些情况的频率。方法对100例癌症患者进行前瞻性横断面一次性调查。我们从电子健康记录中收集患者人口统计资料、癌症诊断、体重史、身高和Zubrod性能状态。患者完成厌食症治疗功能评估-厌食症/恶病质子量表(FAACT-A/CS)问卷、埃德蒙顿症状评估量表(ESAS)、患者主观整体评估简表(PG-SGA-SF)、医院焦虑抑郁量表(HADS)和身体形象量表(BIS)。PG-SGA-SF临界值≥6表明存在营养不良风险,而食欲减退定义为ESAS≥3或FAACT-ACS≤37。结果165例患者中,100例(61%)完成了调查。平均(SD)年龄为61.6岁(11.5岁)。大多数是女性(52%),白人(75%)和已婚(80%)。最常见的癌症是胃肠道(22%)和泌尿生殖系统(21%)。61%(61%)的筛查结果为营养不良(PG-SGA-SF≥6),60% (ESAS≥3)和53% (FAACT-A/CS≤37)的患者存在厌食症,10%的患者存在体重指数18.5,28%的患者存在身体形象不满意(BIS≥10)。49%的人在过去6个月内体重减轻了5%;61%的患者表示,与正常成人体重或诊断时相比,终生体重减轻10%。与无厌食症患者相比,厌食症患者(FAACT-ACS≤37)的HADS焦虑评分(4.4比3.2,p = 0.04)、抑郁评分(5.9比3.5,p = 0.001)、身体形象困扰评分(BIS 7.2比4.9,p = 0.03)和食欲差评分(ESAS 1.4比0.6,p = 0.02)显著高于无厌食症患者。包括抑郁、焦虑和身体形象困扰在内的症状在终生体重减轻10%或6个月内体重减轻5%的患者之间没有显著差异。结论:大约60%的晚期癌症患者存在营养不良风险。将患者的体重指数纳入营养不良或恶病质标准导致诊断不足。主观厌食症症状与焦虑和抑郁显著相关,而非客观体重减轻。应将PG-SGA-SF常规营养不良筛查纳入所有门诊SCC就诊,并将当前体重与记录的病前基线体重进行比较,以确定恶病质的严重程度。
{"title":"Malnutrition Risk and the Psychological Burden of Anorexia and Cachexia in Patients With Advanced Cancer","authors":"Rony Dev,&nbsp;Patricia Bramati,&nbsp;Marvin Omar Delgado Guay,&nbsp;Bryan Fellman,&nbsp;Ahsan Azhar,&nbsp;Michael Tang,&nbsp;Jegy Tennison,&nbsp;Josue Becerra,&nbsp;Sonal Admane,&nbsp;Shalini Dalal,&nbsp;David Hui,&nbsp;Egidio Del Fabbro,&nbsp;Eduardo Bruera","doi":"10.1002/rco2.70001","DOIUrl":"https://doi.org/10.1002/rco2.70001","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Patients with advanced cancer are at risk for malnutrition and anorexia-cachexia syndrome. The study objective was to determine the frequency of these conditions in patients evaluated in an outpatient supportive care clinic (SCC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>One hundred patients with cancer were prospectively enrolled to complete a cross-sectional one-time survey. We collected patient demographics, cancer diagnosis, weight history and height and Zubrod performance status from electronic health records. Patients completed the Functional Assessment of Anorexia Therapy–Anorexia/Cachexia Subscale (FAACT-A/CS) questionnaire, the Edmonton Symptom Assessment Scale (ESAS), the Patient-Generated Subjective Global Assessment–Short Form (PG-SGA-SF), the Hospital Anxiety and Depression Scale (HADS) and a Body Image Scale (BIS). A PG-SGA-SF cut-off of ≥ 6 indicated malnutrition risk, and loss of appetite was defined as either ESAS ≥ 3 or FAACT-ACS ≤ 37.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 165 patients approached, 100 (61%) completed the survey. The average (SD) age was 61.6 years old (11.5). The majority were female (52%), White (75%) and married (80%). The most common cancers were gastrointestinal (22%) and genitourinary (21%). Sixty-one per cent (61%) screened positive for risk of malnutrition (PG-SGA-SF ≥ 6), anorexia was noted in 60% (ESAS ≥ 3) and 53% (FAACT-A/CS ≤ 37) of patients, 10% of patients were noted to have a body mass index &lt; 18.5, and 28% had body image dissatisfaction (BIS ≥ 10). Documented &gt; 5% weight loss over the past 6 months was noted in 49%; 61% noted &gt; 10% lifetime weight loss, relative to usual adult body weight or at time of diagnosis. Patients with anorexia (FAACT-ACS ≤ 37) compared with no anorexia reported significantly higher HADS anxiety score (4.4 vs. 3.2, <i>p</i> = 0.04), depression (5.9 vs. 3.5, <i>p</i> = 0.001), body image distress (BIS 7.2 vs. 4.9, <i>p</i> = 0.03) and worse appetite (ESAS 1.4 vs. 0.6, <i>p</i> = 0.02). Symptoms including depression, anxiety and body image distress were not significantly different between patients with either a history of &gt; 10% lifetime weight loss or &gt; 5% weight loss over 6 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Malnutrition risk was noted in roughly 60% of patients with advanced cancer. Inclusion of patients' body mass index to malnutrition or cachexia criteria resulted in underdiagnosis. Subjective symptoms of anorexia, but not objective weight loss, was significantly associated w","PeriodicalId":73544,"journal":{"name":"JCSM rapid communications","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/rco2.70001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646230","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}
引用次数: 0
Linking Circulating Irisin and Type 2 Diabetes: A Systematic Review and Meta-Analysis 循环鸢尾素与2型糖尿病的联系:一项系统综述和荟萃分析
Pub Date : 2025-03-13 DOI: 10.1002/rco2.70000
E. Aminov, P. Folan, A. Pisconti
<div> <section> <h3> Background</h3> <p>Type II diabetes (T2DM) is one of the most prevalent metabolic disorders, and its multisystemic health consequences are widely known. Due to skeletal muscle's ability to sequester a vast amount of glucose, muscle function and exercise have become a subject of much research into strategies to prevent and treat T2DM. Myokines are bioactive molecules released by muscle during contraction and involved in several biological processes such as metabolism, inflammation and behaviour. Irisin, a recently discovered myokine, has been implicated in a vast array of physiological roles, including the ability to induce fat beiging. Since beige and brown fat both serve important roles in metabolic regulation, irisin's role in the context of T2DM is the subject of ongoing investigations.</p> </section> <section> <h3> Methods</h3> <p>We systematically reviewed articles indexed in PubMed, Scopus and Web of Science that were published between 2011 and 2024 and compared circulating irisin levels in patients affected by T2DM and healthy subjects. As part of our systematic review of the literature, we performed meta-analysis of the data across all included articles, as well as stratified by body mass index (BMI), country of origin and by average irisin concentration in the control group.</p> </section> <section> <h3> Results</h3> <p>We discovered great variability across the included studies in the average irisin levels detected, which spanned four orders of magnitude, hence the attempt at reducing variability by stratifying based on average levels in the control group. While the statistical power of our meta-analysis was decreased by the great variability in reported irisin concentrations, we nonetheless detected a consistent trend of decreased irisin concentration in T2DM patients compared with healthy controls, regardless of BMI, country of origin or average irisin concentration in the control group.</p> </section> <section> <h3> Conclusions</h3> <p>With almost 60 articles included, ours is the first extensive systematic review and meta-analysis of irisin in T2DM, yet a highly statistically significant association between circulating irisin levels and T2DM could not be established due to the great variability of the data across include articles. Nonetheless, we noticed a trend that is independent of BMI, suggesting a direct relationship between T2DM and irisin that is likely not secondary to diabetic sarcopenia. While our work encourages further research into irisin's potential role in T2DM pathogenesis, the reproducibility of i
2型糖尿病(T2DM)是最常见的代谢性疾病之一,其多系统健康后果已广为人知。由于骨骼肌具有隔离大量葡萄糖的能力,肌肉功能和锻炼已成为预防和治疗2型糖尿病策略研究的主题。肌因子是肌肉在收缩过程中释放的生物活性分子,参与多种生物过程,如代谢、炎症和行为。鸢尾素是最近发现的一种肌肉生长因子,与一系列生理作用有关,包括诱导脂肪增加的能力。由于米色和棕色脂肪都在代谢调节中起重要作用,因此鸢尾素在T2DM中的作用是正在进行的研究的主题。方法系统回顾2011年至2024年间发表在PubMed、Scopus和Web of Science上的文章,比较T2DM患者和健康受试者的循环鸢尾素水平。作为文献系统回顾的一部分,我们对所有纳入文章的数据进行了荟萃分析,并按体重指数(BMI)、原产国和对照组的平均鸢尾素浓度进行了分层。结果我们发现,在所纳入的研究中,鸢尾素的平均检测水平存在很大的可变性,这跨越了四个数量级,因此我们试图通过基于对照组的平均水平分层来减少可变性。虽然我们的荟萃分析的统计能力因报告的鸢尾素浓度的巨大差异而降低,但我们仍然发现,与健康对照组相比,T2DM患者的鸢尾素浓度下降的趋势是一致的,而与对照组的BMI、原产国或平均鸢尾素浓度无关。我们的研究纳入了近60篇文章,这是第一次对鸢尾素在T2DM中的作用进行广泛的系统回顾和荟萃分析,但由于所纳入文章的数据差异很大,因此无法确定循环鸢尾素水平与T2DM之间具有高度统计学意义的关联。尽管如此,我们注意到一种独立于BMI的趋势,表明2型糖尿病和鸢尾素之间存在直接关系,而这种关系可能不是继发于糖尿病性肌肉减少症。虽然我们的工作鼓励进一步研究鸢尾素在2型糖尿病发病机制中的潜在作用,但鸢尾素检测方法在生物样本中的可重复性应该确定,并且应该为研究和临床社区提供标准化的方案。
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引用次数: 0
Low Muscle Mass and Treatment Tolerance in Patients With Upper Gastrointestinal Cancer: A Systematic Review and Meta-Analysis 上消化道肿瘤患者的低肌肉量和治疗耐受性:一项系统综述和荟萃分析
Pub Date : 2025-02-17 DOI: 10.1002/rco2.115
E. N. Stanhope, S. N. Thomsen, J. E. Turner, C. M. Fairman, I. M. Lahart

Background

Upper gastrointestinal (GI) cancers carry notable mortality risks. While systemic therapies are vital for their management, they are often hindered by adverse events (AE), which can compromise their effectiveness. The presence of low skeletal muscle mass (LSMM) may be linked with the prevalence of AE and could potentially undermine treatment tolerance by impacting drug metabolism. The primary objective of this systematic review and meta-analysis was to evaluate the association between LSMM and the risk of grades 3 and 4 AE and treatment discontinuation.

Methods

Studies investigating the association between skeletal muscle mass and AE or treatment tolerability in adult patients diagnosed with upper GI cancer scheduled to undergo systemic treatment were eligible. The primary outcomes were grades 3 and 4 AE and treatment discontinuations. Four electronic databases were systematically searched with no date restrictions on 10 October 2022. Data were analysed via random-effects meta-analyses, and the risk of bias was assessed using the risk of bias in non-randomised studies—of exposure (ROBINS-E) appraisal tool.

Results

We identified 50 eligible publications from 49 studies. Our meta-analyses revealed evidence of a higher risk of grades 3 and 4 AE (RR 1.44, 95% CI 1.23–1.68, N = 13) and treatment discontinuation (RR 2.39, 95% CI 1.87–3.07, N = 11) in LSMM versus non-LSMM. Secondary analyses revealed an increased risk of fatigue, febrile neutropenia, intestinal pneumonia, stomatitis and thrombocytopenia in LSMM. However, 92% of studies assessing grades 3 and 4 AE and 73% of studies examining treatment discontinuation had a very high risk of bias.

Conclusions

LSMM in patients with upper GI cancer is associated with a higher risk of grades 3 and 4 AE and the discontinuation of systemic cancer treatment. The high risk of bias should be considered in the interpretation of these findings. Further evaluation of the association between LSMM and treatment tolerability in confirmatory, prospective studies is needed.

背景:上胃肠道(GI)癌症具有显著的死亡风险。虽然全身治疗对其治疗至关重要,但它们经常受到不良事件(AE)的阻碍,这可能会损害其有效性。低骨骼肌质量(LSMM)的存在可能与AE的流行有关,并可能通过影响药物代谢而潜在地破坏治疗耐受性。本系统综述和荟萃分析的主要目的是评估LSMM与3级和4级AE风险和停止治疗之间的关系。方法研究骨骼肌质量与计划接受全身治疗的成年上消化道癌症患者AE或治疗耐受性之间的关系。主要结局是3级和4级AE和停止治疗。在2022年10月10日系统地检索了四个电子数据库,没有日期限制。通过随机效应荟萃分析分析数据,并使用非随机暴露研究(ROBINS-E)评估工具评估偏倚风险。结果:我们从49项研究中筛选出50篇符合条件的出版物。我们的荟萃分析显示,与非LSMM相比,LSMM患者发生3级和4级AE的风险更高(RR 1.44, 95% CI 1.23-1.68, N = 13),停药风险更高(RR 2.39, 95% CI 1.87-3.07, N = 11)。二次分析显示,LSMM患者出现疲劳、发热性中性粒细胞减少症、肠道肺炎、口炎和血小板减少症的风险增加。然而,92%评估3级和4级AE的研究和73%检查停止治疗的研究具有非常高的偏倚风险。结论:上消化道肿瘤患者的LSMM与3级和4级AE及停止全身癌症治疗的高风险相关。在解释这些发现时应考虑到高偏倚风险。需要在验证性的前瞻性研究中进一步评估LSMM与治疗耐受性之间的关系。
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引用次数: 0
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JCSM rapid communications
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