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Objective: Diabetes mellitus is a growing disease with severe complications. Various scores predict the risk of developing this pathology. The amount of muscle mass is associated with insulin resistance, yet there is no established evidence linking muscle mass with diabetes risk. This work aims to study that relationship. Research methods and procedures: This cross-sectional study included 1,388 employees. The FINDRISC score was used to assess type 2 diabetes risk, and bioimpedance was used for body composition analysis. Appendicular skeletal muscle mass adjusted by body mass index (ASM/BMI) was analyzed. Sociodemographic, clinical and anthropometric measures were evaluated, logistic regression models with sex stratification were conducted and ROC curves were calculated to determine the ability of ASM/BMI index to predict T2D risk. Results: It was observed that patients with higher ASM/BMI had a lower FINDRISC score in both men and women (p < 0.001). A logistic regression model showed and association between ASM/BMI and diabetes risk in women [OR: 0.000 (0.000-0.900), p = 0.048], but not in men [OR: 0.267 (0.038-1.878), p = 0.185]. However, when the body mass index variable was excluded from the model, an association was found between muscle mass adjusted to BMI and diabetes risk in both men [OR: 0.000 (0.000-0.016), p < 0.001], and women [OR:0.001 (0.000-0.034), p < 0.001]. Other risk factors were having a low level of physical activity, waist circumference, age and sedentary lifestyle. A ROC curve was built and the optimal ASM/BMI cut-of value for predicting T2D risk was 0.82 with a sensitivity of 53.71% and specificity of 69.3% [AUC of 0.665 (0.64-0.69; p < 0.0001)]. Conclusion: When quantifying the risk of type 2 diabetes in both women and men, assessing muscle mass can help detect adult individuals with a high risk of developing type 2 diabetes.
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BACKGROUND: The study of dietary patterns in older adults (OA) and their association with geriatric syndromes (GS) is scarce in Latin America. OBJECTIVE: To describe the association of dietary patterns with GS in the Mexican older adult population, using data from the 2018-19 National Health and Nutrition Survey. METHODS: Dietary data were collected from 3,511 adults (≥60 years of age, both sexes) using a semi-quantitative food frequency questionnaire. Dietary patterns were derived by principal component analysis based on the consumption of 162 foods from 24 food groups. The GS studied were: frailty, depressive symptoms (DS), low appendicular skeletal muscle mass (ASMM); additionally, we studied inflammation (serum CRP>5 mg/L). Logistic regression models were used. RESULTS: Four major dietary patterns were identified: a) "Western", b) "Prudent", c) "Soups", and d) "Traditional". The middle and higher tertiles of the "Prudent" pattern were associated with lower odds of DS (OR 0.71, p = 0.04; and OR 0.61, p = 0.008), respectively. The second tertile of the "Soups" pattern was associated with lower odds of low ASMM (OR 0.68, p = 0031) and inflammation (OR 0.58, p = 0.022). The highest tertile of the "Traditional" pattern was associated with low ASMM (OR 1.55, p = 0.008) and lower odds of inflammation (OR 0.69, p = 0.044). No association was found between the "Western" dietary pattern and GS. CONCLUSIONS: Three of four major dietary patterns were associated with GS in older Mexican adults. Further studies are needed to address strategies to improve diet quality in this age group and its association with health and functional outcomes.
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Inquéritos Nutricionais , Humanos , Masculino , Feminino , Idoso , Pessoa de Meia-Idade , México/epidemiologia , Dieta , Fragilidade/epidemiologia , Idoso de 80 Anos ou mais , Inflamação/epidemiologia , Depressão/epidemiologia , Síndrome , Comportamento Alimentar , Padrões DietéticosRESUMO
This study aimed to evaluate the prognostic value of thigh muscle assessed by CT images to predict overall mortality in patients with colorectal cancer (CRC). This was a multicenter cohort study including adults (≥ 18 years old) newly diagnosed with CRC, who performed a diagnostic computed tomography (CT) exam including thigh regions. CT images were analyzed to evaluate skeletal muscle (SM in cm2), skeletal muscle index (SMI in cm2/m2), and skeletal muscle density (SMD in HU). Muscle abnormalities (low SM, SMI, and SMD) were defined as the values below the median by sex. Kaplan-Meyer curves and hazard ratios (HRs) for low SM, SMI and SMD were evaluated for overall mortality, stratified by sex. A total of 257 patients were included in the final analysis. Patients' mean age was 62.6 ± 12.1 years, and 50.2% (n = 129) were females. In males, low thigh SMI was associated with shorter survival (log-rank P = .02). Furthermore, this low thigh SMI (cm2/m2) was independently associated with higher mortality rates (HR adjusted 2.08, 95% CI 1.03-4.18). Our additional findings demonstrated that low SMD was independently associated with overall mortality among early-stage patients (I-III) (HR adjusted 2.78, 95% CI 1.26-6.15).
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Neoplasias Colorretais , Músculo Esquelético , Coxa da Perna , Tomografia Computadorizada por Raios X , Humanos , Masculino , Feminino , Neoplasias Colorretais/mortalidade , Neoplasias Colorretais/diagnóstico por imagem , Neoplasias Colorretais/patologia , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X/métodos , Músculo Esquelético/diagnóstico por imagem , Músculo Esquelético/patologia , Coxa da Perna/diagnóstico por imagem , Idoso , Prognóstico , Estimativa de Kaplan-MeierRESUMO
OBJECTIVES: Given the innovative nature of the method, our study aimed to assess the prognostic significance of body mass index (BMI)-adjusted calf circumference (CC) in older patients who are hospitalized. METHODS: This was a unique analysis as part of other cohorts comprising general hospitalized patients aged 60 years or older of both sexes. Only patients with excess weight (BMI ≥ 25 kg/m2) were included. CC was adjusted by reducing 3, 7, or 12 cm for BMI (in kg/m2) within 25-29.9, 30-39.9, and ≥40 kg/m2, respectively. CC was considered low if ≤ 34 cm for males and ≤ 33 cm for females. Clinical outcomes included prolonged length of hospital stay (LOS) and mortality. RESULTS: A total of 222 patients were included. After BMI adjustments, 72.1% of the patients were reclassified from a normal CC category to a low CC category. The frequency of low CC increased from 33.8% to 81.9% following BMI adjustments. Among those reclassified to the low CC, 11 died, compared to only 2 patients in the group that maintained a normal CC classification. BMI-adjusted CC was inversely associated with mortality (HR adjusted 0.84, 95% CI 0.73 to 0.95), but not with prolonged LOS. CONCLUSIONS: Our novel study highlights the prognostic value of BMI-adjusted CC. As an anthropometric marker of muscle mass, it proved to be a predictor of mortality in older patients with high BMI. This adjustment is further important because it may help to better detect low muscle mass in these patients where such conditions might be masked.
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Índice de Massa Corporal , Hospitalização , Perna (Membro) , Tempo de Internação , Humanos , Masculino , Feminino , Idoso , Tempo de Internação/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Sobrepeso/mortalidade , Prognóstico , Mortalidade Hospitalar , Músculo EsqueléticoRESUMO
OBJECTIVE: To examine the relationship between the age-adjusted Charlson comorbidity index (A-CCI) with body composition and overall survival in patients newly diagnosed with colorectal cancer (CRC). RESEARCH METHODS AND PROCEDURES: In this cohort study, patients (≥ 18 years old) with CRC were followed for 36 months. Computed tomography images of the third lumbar were analyzed to determine body composition, including skeletal muscle area (SMA), skeletal muscle index (SMI), skeletal muscle radiodensity (SMD), visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT). Phenotypes based on comorbidity burden assessed by A-CCI and body composition parameters were established. RESULTS: A total of 436 participants were included, 50% male, with a mean age of 61 ± 13.2 years. Approximately half of the patients (50.4%) had no comorbidity, and the A-CCI median score was 4 (interquartile range: 3-6). A higher A-CCI score was a risk factor for 36-month mortality (HR = 3.59, 95% CI = 2.17-5.95). Low SMA and low SMD were associated with a higher A-CCI. All abnormal phenotypes (high A-CCI and low SMA; high A-CCI and low SMD; high A-CCI and high VAT) were independently associated with higher 36-month mortality hazard (adjusted HR 5.12, 95% CI 2.73-9.57; adjusted HR 4.58, 95% CI 2.37-8.85; and adjusted HR 2.36, 95% CI 1.07-5.22, respectively). CONCLUSION: The coexistence of comorbidity burden and abnormal body composition phenotypes, such as alterations in muscle or fat compartments, may pose an additional risk of mortality in patients newly diagnosed with CRC. Early assessment and management of these phenotypes could be crucial in optimizing outcomes in such patients.
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Composição Corporal , Neoplasias Colorretais , Comorbidade , Humanos , Masculino , Neoplasias Colorretais/mortalidade , Neoplasias Colorretais/patologia , Pessoa de Meia-Idade , Feminino , Idoso , Estudos de Coortes , Fatores de Risco , Tomografia Computadorizada por Raios X/métodos , Fatores EtáriosRESUMO
BACKGROUND & AIMS: Functional muscle quality, as assessed through the muscle quality index (MQI), represents a contemporary method to measure the capacity to generate force. Despite its potential, the prognostic significance of MQI remains uncertain in various clinical conditions, particularly among patients following acute myocardial infarction (AMI). In light of this, our study sought to evaluate the prognostic relevance of MQI concerning major adverse cardiovascular events (MACE) in patients following AMI. METHODS AND RESULTS: This is a secondary analysis of a prospective cohort study that included subjects aged ≥20 years from a Cardiovascular Unit Hospital. Functional muscle quality was estimated using MQI, defined as the ratio of handgrip strength (HGS) to muscle mass (MM) derived from bioelectrical impedance analysis. The outcomes included prolonged length of hospital stay, new adverse cardiovascular events (AMI, stroke and hospital readmission for unstable angina), and cardiovascular mortality. A composite score comprising all adverse events over the 1-year follow-up was calculated and defined as MACE. This study included 163 patients, with a median age of 61 years (IQ: 54-69 years), and the majority consisted of males (76.1%). Individual components of the functional muscle quality (HGS and MM) were not associated with any of the adverse outcomes. Only MQI was associated mortality over the 1-year follow-up. For each increase in MQI, the hazard of mortality decreases: adjusted HR: 0.08 (95% CI 0.01-0.84). CONCLUSION: Functional muscle quality assessed by the MQI may be a valuable clinical predictor of 1-year cardiovascular mortality in patients hospitalized post-AMI.
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Força da Mão , Tempo de Internação , Músculo Esquelético , Infarto do Miocárdio , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Estudos Prospectivos , Infarto do Miocárdio/mortalidade , Infarto do Miocárdio/fisiopatologia , Infarto do Miocárdio/diagnóstico , Idoso , Fatores de Tempo , Medição de Risco , Prognóstico , Fatores de Risco , Músculo Esquelético/fisiopatologia , Readmissão do Paciente , Valor Preditivo dos Testes , Impedância Elétrica , Acidente Vascular Cerebral/mortalidade , Acidente Vascular Cerebral/fisiopatologia , Acidente Vascular Cerebral/diagnóstico , Angina Instável/mortalidade , Angina Instável/fisiopatologia , Angina Instável/diagnósticoRESUMO
INTRODUCTION: Aging is accompanied by changes in body composition, such as an increase in fat mass (FM), a decrease in skeletal muscle mass index (SMMI) and muscle strength, combined with a chronic inflammatory process (CI). OBJECTIVE: Determine the relationship between age and excess body fat with markers of chronic inflammation, skeletal muscle mass and strength. METHODS: A cross-sectional alitical study was carried out in a convenience sample of adults 45 to 59 years old (n = 100) and older adults 60 to 74 years old (n = 133). All participants had their body composition measured with an impedance meter. They were subsequently divided into two groups: (i) with excess fat (WEF), (ii) without excess fat (NEF), in order to relate excess fat and age with inflammation, muscle mass and strength. RESULTS: NEF adults and older adults had similar values of SMMI (9.1 ± 1.5 vs. 8.8 ± 1.3, p > 0.05) and strength (28 ± 8 vs. 27 ± 8.6, p > 0.05). Likewise, WEF adults showed significantly lower values than NEF adults in the SMMI (7.9 ± 0.8 vs. 9.1 ± 1.5, p < 0.05) and strength (28 ± 8 vs. 22 ± 5, p < 0.001). Also, WEF older adults presented significantly lower values in the SMMI (15.9 ± 1.8 vs. 22.8 ± 5.1, p < 0.05) and strength (17.9 ± 4.8 vs. 27 ± 8.6, p < 0.001). CONCLUSIONS: Our findings suggest that excess fat mass is a risk factor that has a significantly greater influence than aging per se on the index of skeletal muscle mass and strength.
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Tecido Adiposo , Envelhecimento , Inflamação , Força Muscular , Músculo Esquelético , Humanos , Pessoa de Meia-Idade , Masculino , Feminino , Força Muscular/fisiologia , Músculo Esquelético/fisiopatologia , Inflamação/fisiopatologia , Estudos Transversais , Idoso , Envelhecimento/fisiologia , México , Composição Corporal/fisiologia , Biomarcadores/sangue , Vida IndependenteRESUMO
AIM: This study aimed to investigate the associations between upper- and lower-limb muscle strength, mass, and quality and health-related quality of life (HRQoL) among community-dwelling older adults. METHODS: A cross-sectional study was conducted with 428 Brazilian community-dwelling older adults aged 60 to 80 years. Upper- and lower-limb muscle strength were evaluated through the handgrip strength (HGS) test and the 30-s chair stand test, respectively. Muscle mass was assessed by dual-energy X-ray absorptiometry (DXA) and bioelectrical impedance analysis (BIA). Muscle quality was evaluated using the muscle quality index (MQI). HRQoL was assessed using the World Health Organization Quality of Life Brief Version questionnaire. RESULTS: Lower-limb, but not upper-limb, muscle strength and quality were independently associated with HRQoL, particularly within the domains of physical capacity, environment, and overall HRQoL for both males and females (P < 0.05). DXA- and BIA-derived analyses provided similar results in relation to muscle mass and muscle quality. CONCLUSIONS: Lower-limb, but not upper-limb, muscle strength and quality were independently associated with HRQoL among community-dwelling older adults. Moreover, the results obtained from both BIA and DXA were similar, highlighting that BIA can serve as a viable surrogate method for estimating body composition in resource-limited clinical settings. Geriatr Gerontol Int 2024; 24: 683-692.
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Vida Independente , Extremidade Inferior , Força Muscular , Qualidade de Vida , Extremidade Superior , Humanos , Idoso , Masculino , Feminino , Estudos Transversais , Força Muscular/fisiologia , Idoso de 80 Anos ou mais , Extremidade Superior/fisiologia , Brasil , Extremidade Inferior/fisiologia , Pessoa de Meia-Idade , Absorciometria de Fóton , Força da Mão/fisiologia , Impedância Elétrica , Avaliação Geriátrica/métodos , Inquéritos e QuestionáriosRESUMO
SUMMARY: This study aims to investigate body typologies based on a combination of basic anthropo-morphological characteristics and body composition measured by multichannel bioimpedance in a sample from the adult population of Lebanon. A total of 302 subjects (173 males and 129 females) without acute or chronic health disorders were included in the study. Body composition was measured by the multichannel bioelectrical impedance (BIA) method, using the i30 device (MEDIANA, Korea). The research used 10 variables, including three basic anthropo-morphological variables, three for assessing fat, three for assessing the muscle component, and one index variable. K-means cluster analysis was used to define five specific clusters (5D) of body types based on sex. In light of the results, the study established five distinct clusters representing five different body typologies among Lebanese adults, categorized by sex: Male sample, Group 1 - Obese Endomorph (15.61 %), Group 2 - Balanced Mesomorph (16.76 %), Group 3 - Short Endomorph (30.06 %), Group 4 - Short Mesomorph (34.10 %), and Group 5 - Pathological Obese Endomorph (3.47 %); Female sample, Group 1- Obese Endomorph (2.33 %), Group 2 - Short Endo/Mesomorph (28.68 %), Group 3 - Short Ectomorph (32.56 %), Group 4 - Endomorph (22.48 %), and Group 5 - Balanced Mesomorph (13.95 %). Furthermore, the results indicated that the primary factor contributing to the distinctions among the identified clusters in terms of sex is fat tissue. This leads to the conclusion that eating habits cause the given differences, rather than the level of physical activity, regardless of sex.
Este estudio ttuvo como objetivo investigar tipologías corporales basadas en una combinación de características antropomorfológicas básicas y composición corporal, medidas por bioimpedancia multicanal, en una muestra de la población adulta del Líbano. Se incluyeron en el estudio un total de 302 sujetos (173 hombres y 129 mujeres) sin trastornos de salud agudos o crónicos. La composición corporal se midió mediante el método de impedancia bioeléctrica multicanal (BIA), utilizando el dispositivo i30 (MEDIANA, Corea). La investigación utilizó 10 variables, incluidas tres variables antropomorfológicas básicas, tres para evaluar la grasa, tres para evaluar el componente muscular y una variable índice. Se utilizó el análisis de conglomerados de K-medias para definir cinco conglomerados específicos (5D) de tipos de cuerpo según el sexo. En base a los resultados, el estudio estableció cinco grupos distintos que representan cinco tipologías corporales diferentes entre los adultos libaneses, categorizados por sexo: muestra masculina, grupo 1: endomorfo obeso (15,61 %), grupo 2: mesomorfo equilibrado (16,76 %), grupo 3 - Endomorfo Corto (30,06 %), Grupo 4 - Mesomorfo Corto (34,10 %), y Grupo 5 - Endomorfo Obeso Patológico (3,47 %); Muestra femenina, Grupo 1: Endomorfo obeso (2,33 %), Grupo 2: Endo/mesomorfo corto (28,68 %), Grupo 3: Ectomorfo corto (32,56 %), Grupo 4: Endomorfo (22,48 %) y Grupo 5: Mesomorfo equilibrado (13,95 %). Además, los resultados indicaron que el factor principal que contribuye a las distinciones entre los grupos identificados en términos de sexo es el tejido adiposo. Esto lleva a la conclusión de que las diferencias dadas son causadas por los hábitos alimentarios, más que por el nivel de actividad física, independientemente del sexo.
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Humanos , Masculino , Feminino , Somatotipos , Composição Corporal , Antropometria , Tecido Adiposo , Análise de Variância , Impedância Elétrica , LíbanoRESUMO
OBJECTIVES: Muscle loss is one of the phenotypic criteria of malnutrition, is highly prevalent in patients with cirrhosis, and is associated with adverse outcomes. Mid-arm muscle circumference (MAMC) estimates the skeletal muscle mass and is especially helpful in cases of fluid overload. This study aimed to propose MAMC cutoff points for patients with cirrhosis and demonstrate its association with 1-year mortality. METHODS: This is an analysis of cohort databases from five reference centers in Brazil that included inpatients and outpatients with cirrhosis aged ≥18 y. The nutritional variables obtained were the MAMC (n = 1075) and the subjective global assessment (n = 629). We established the MAMC cutoff points stratified by sex based on the subjective global assessment as a reference standard for malnutrition diagnosis, considering the sensitivity, specificity, and Youden index. An adjusted Cox regression model was used to test the association of MAMC cutoff points and 1-year mortality. RESULTS: We included 1075 patients with cirrhosis, with a mean age of 54.8 ± 11.3 y; 70.4% (n = 757) male. Most patients had alcoholic cirrhosis (47.1%, n = 506) and were classified as Child-Pugh B (44.7%, n = 480). The MAMC cutoff points for moderate and severe depletion were ≤21.5 cm and ≤24.2 cm; ≤20.9 cm and ≤22.9 cm for women and men, respectively. According to these cutoff points, 13.8% (n = 148) and 35.1% (n = 377) of the patients had moderate or severe MAMC depletion, respectively. The 1-year mortality rate was 17.3% (n = 186). In the multivariate analysis adjusted for sex, age, MELD-Na, and Child-Pugh scores, a severe depletion in MAMC was an independent increased risk factor for 1-year mortality (HR: 1.71, 95% CI: 1.24-2.35, P < 0.001). Each increase of 1 cm in MAMC values was associated with an 11% reduction in 1-year mortality risk (HR: 0.89, 95% CI: 0.85-0.94, P < 0.001). CONCLUSIONS: Low MAMC classified according to the new cutoff points predicts mortality risk in patients with cirrhosis and could be used in clinical practice.
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Braço , Cirrose Hepática , Desnutrição , Músculo Esquelético , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Desnutrição/diagnóstico , Desnutrição/mortalidade , Cirrose Hepática/mortalidade , Cirrose Hepática/complicações , Brasil/epidemiologia , Adulto , Idoso , Estado Nutricional , Avaliação Nutricional , Modelos de Riscos Proporcionais , Estudos de Coortes , Sarcopenia/mortalidade , Sarcopenia/diagnósticoRESUMO
To assess the correlation between vitamin D status and body composition variables in adult women of childbearing age, a cross-sectional study was conducted involving women aged 20-49 years. The participants were categorized based on their vitamin D status and further divided according to body mass index (BMI). Anthropometric and biochemical data were collected to compute body composition indices, specifically body fat and muscle mass. The sample included 124 women, with 63.70% exhibiting vitamin D inadequacy. Women with inadequate vitamin D status demonstrated a higher waist-to-height ratio (WHtR) and body adiposity index (BAI), along with a lower BMI-adjusted muscle mass index (SMI BMI), compared to those with adequate levels of vitamin D (p = 0.021; p = 0.019; and p = 0.039, respectively). A positive correlation was observed between circulating concentrations of 25(OH)D and SMI BMI, while a negative correlation existed between circulating concentrations of 25(OH)D and waist circumference (WC), WHtR, conicity index (CI), fat mass index (FMI), body fat percentage (% BF), and fat-to-muscle ratio (FMR). These findings suggest that inadequate vitamin D status may impact muscle tissue and contribute to higher body adiposity, including visceral adiposity. It is recommended that these variables be incorporated into clinical practice, with a particular emphasis on WHtR and SMI BMI, to mitigate potential metabolic consequences associated with vitamin D inadequacy.
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Tecido Adiposo , Adiposidade , Composição Corporal , Índice de Massa Corporal , Músculo Esquelético , Deficiência de Vitamina D , Vitamina D , Humanos , Feminino , Adulto , Estudos Transversais , Pessoa de Meia-Idade , Vitamina D/sangue , Vitamina D/análogos & derivados , Adulto Jovem , Deficiência de Vitamina D/sangue , Tecido Adiposo/metabolismo , Músculo Esquelético/metabolismo , Circunferência da Cintura , Estado NutricionalRESUMO
This research aimed to explore the changes produced in body mass index (BMI), fat mass percentage (FMP), muscle mass percentage (MMP), and visceral fat percentage (VFP) in 60-year-old or over overweight or obese people after a multicomponent exercise program. This quasi-experimental study involved 70 overweight or obese older people between 60 and 86 years old (M = 73.15; SD = 5.94) who were randomly assigned to a control group (CG, n = 35) and an experimental group (EG, n = 35). At the beginning and at the end of the intervention program, anthropometric and body composition data were collected. The results showed an increase in BMI after the intervention in the CG (p = 0.010) and a decrease in the EG (p < 0.001). The results regarding the FMP indicate a significant decrease in the EG (p < 0.001) after the intervention, as occurs with the VFP (p = 0.003). The MMP increased in the EG (p < 0.001) after the intervention program. Regarding gender, statistically significant differences were found in the MMP after the intervention (p = 0.025), with higher percentages in men in the EG. VFP decreased in both men (p = 0.005) and women (p = 0.019) in the EG. From the results obtained, we can say that a 6-month multicomponent program produces a decrease in BMI, FMP, and VFP and an increase in MMP in its participants. This type of intervention seems to produce a greater increase in muscle mass in men than in women and a decrease in VFP in both genders.
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BACKGROUND: Elevated levels of reactive oxygen species may contribute to the gradual decline in muscle strength over time. Although caffeine and its metabolites have antioxidant properties that can mitigate oxidative stress, the association of caffeine and its metabolites with muscle strength remains unknown. AIM: To investigate whether caffeine metabolites in urine are associated with muscle strength in young and older adults. METHODS: A cross-sectional study was conducted with 1145 individuals aged over 20 years (n = 801 < 60 years and n = 344 ≥ 60 years) from the National Health and Nutrition Examination Survey (NHANES) 2011-2012. Muscle strength was assessed using a handgrip dynamometer, and combined grip strength was determined by summing the highest value from each hand. Caffeine and its metabolites in urine were quantified using ultra-high-performance liquid chromatography-electrospray ionization-tandem mass spectrometry (1-methyluric acid, 3-methyluric acid, 7-methyluric acid, 1,3-dimethyluric acid, 1,7-dimethyluric acid, 3,7-dimethyluric acid, 1,3,7-trimethyluric acid, 1-methylxanthine, 3-methylxanthine, 7-methylxanthine, 1,3-dimethylxanthine, 1,7-dimethylxanthine, 3,7-dimethylxanthine, 1,3,7-trimethylxanthine, 5-acetylamino-6-amino-3-methyluracil). Linear regression analyses were performed to determine the association of caffeine and its metabolites with muscle strength in young and older adults, adjusting for confounders. RESULTS: Positive associations between muscle strength and levels of 7-methyluric acid (ß = 0.029; p = 0.021), 1,3-dimethyluric acid (ß = 0.008; p = 0.004), 3,7-dimethyluric acid (ß = 0.645; p = 0.012), 3-methylxanthine (ß = 0.020; p = 0.002), 7-methylxanthine (ß = 0.020; p = 0.006), 1,3-dimethylxanthine (theophylline) (ß = 0.030; p = 0.004) and 3,7-dimethylxanthine (theobromine) (ß = 0.035; p = 0.029) were observed in older adults. In contrast, no such associations were noted in young adults. CONCLUSION: Our study indicates a positive association between certain caffeine metabolites in urine and muscle strength in older adults, but not in younger individuals. These findings indicate that specific caffeine metabolites may contribute to an antioxidant role especially in older adults.
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Cafeína , Força da Mão , Inquéritos Nutricionais , Humanos , Cafeína/urina , Estudos Transversais , Masculino , Feminino , Pessoa de Meia-Idade , Adulto , Força da Mão/fisiologia , Idoso , Adulto Jovem , Força Muscular/fisiologia , Ácido Úrico/urinaRESUMO
The aim of this study was to evaluate the mediation role of muscle quantity in the relationship between physical fitness and cardiometabolic risk factors (CMRF) in adolescents. This cross-sectional study conducted with 120 adolescents of both sexes, aged between 10 and 17 years. Body mass, height, fat mass (FM), lean mass, blood pressure, high-density lipoprotein, low-density lipoprotein, triglycerides, glucose, insulin, cardiorespiratory fitness (CRF) and 1 repetition maximum strength (1-RM) with evaluation of the leg press 45° (RM-leg), bench press (RM-bench) and arm curl (RM-arm). Body mass index z-score, appendicular skeletal muscle mass, appendicular skeletal muscle mass index, lean mass index (LMI), muscle-to-fat ratio (MFR), age at peak height velocity, and CMRF z-score were calculated. The direct relation between FM and CMRF was mediated by the LMI (26%) and inverse relation between CRF and CMRF was mediated by the LMI (26%). For girls, the direct relation between FM and CMRF was mediated by the LMI (32%); the inverse relation between CRF, RM-leg, RM-arm and CMRF was mediated by the LMI (32%, 33%, and 32%, respective). For boys, the indirect effect was not significant, indicating that LMI is not a mediator in the relation between FM, CRF, 1-RM with CMRF. The direct relation between RM-leg and CMRF was mediated by the MRF (16%). This finding evidenced the importance of promoting a healthy lifestyle to improve physical fitness levels and the quantity of muscle mass in adolescents.
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Adiposidade , Fatores de Risco Cardiometabólico , Aptidão Cardiorrespiratória , Músculo Esquelético , Humanos , Adolescente , Masculino , Feminino , Aptidão Cardiorrespiratória/fisiologia , Adiposidade/fisiologia , Criança , Estudos Transversais , Músculo Esquelético/fisiologia , Músculo Esquelético/metabolismo , Aptidão Física/fisiologia , Força Muscular/fisiologia , Índice de Massa CorporalRESUMO
Objective: To analyze the amount of muscle and the presence of sarcopenia in postmenopausal women using different methods, verifying the agreement between them as to skeletal muscle mass (SMM). Methods: This cross-sectional observational study was conducted with postmenopausal women aged ≥ 50 years. SMM was obtained from a predictive equation, Bioelectrical Impedance (BIA), and Dual Energy X-Ray Absorptiometry (DXA). The skeletal muscle mass index (SMI) and the appendicular skeletal muscle mass index (ASMI) were calculated. The cut-off point of SMI was determined for the population itself. The agreement between the SMI obtained using the different methods was verified. Sarcopenia was diagnosed according to the criteria proposed by the European Working Group on Sarcopenia in Older People 2 (EWGSOP2). The significance level adopted for all tests was 5.0%. Results: A total of 112 women were evaluated, with an average age of 66.1 ± 5.65 years. Among them, 51.8% were sufficiently active and 43.8% were overweight and obese. The SMI cut-offs were 6.46 kg/m2 for the predictive equation and 7.66 kg/m2 for BIA, with high sensitivity and specificity. There was an excellent agreement in the identification of SMM by the predictive equation (0.89 [0.824-0.917], p < 0.001) and BIA (0.92 [0.883-0.945], p < 0.001), in reference to DXA. The prevalence of sarcopenia was 0.9%, 1.8%, and 2.7% according to BIA, DXA, and the predictive equation, respectively. Conclusion: The predictive equation showed the expected agreement in estimating skeletal muscle mass in postmenopausal women, offering a viable and accurate alternative.
Assuntos
Absorciometria de Fóton , Músculo Esquelético , Pós-Menopausa , Sarcopenia , Humanos , Feminino , Sarcopenia/epidemiologia , Sarcopenia/diagnóstico por imagem , Sarcopenia/diagnóstico , Estudos Transversais , Pós-Menopausa/fisiologia , Idoso , Músculo Esquelético/diagnóstico por imagem , Músculo Esquelético/anatomia & histologia , Pessoa de Meia-Idade , Impedância Elétrica , AntropometriaRESUMO
SUMMARY: The identification of children and adolescents who are at risk of sarcopenic obesity development often requires specialized equipment and expensive test procedures. Therefore, the establishment of cheaper and faster methods would be greatly useful, especially if they could be applied in the field. The study's objective was to establish if identification of female adolescents who suffer the risk of developing sarcopenic obesity can be obtained through the standing-long-jump test application. To achieve the research objectives, various anthropometric and body composition measurements were performed and lower limb explosive strength was assessed using the standing long jump fitness test. The research was conducted on a sample of 535 female respondents randomly selected from 9 elementary schools in the Skopje region of the Republic of North Macedonia. The respondents were divided into quintiles according to BMI z-scores, and the arithmetic means and SD about muscle-to-fat ratio were calculated for each quintile. The cutoff was determined based on the mean and standard deviation of the muscle-to-fat ratio for the 3rd quintile of BMI and the percentage of respondents with sarcopenic obesity was examined. The optimal cut-off value of the long jump fitness test results for predicting sarcopenic obesity in an adolescent girl showed that the area under the ROC curve was 0.781 (95 % CI 0.743-0.815). The standing-long-jump test values, on grounds of odds ratio (OR 95 % CI) about the girls at risk of sarcopenic obesity development, which was identified on muscle-to-fat ratio base, were 8.76 (4.39 - 17.54, p 0.001). It can be used to predict sarcopenic obesity presence in female adolescents, which can be vital in case of health intervention.
La identificación de niños y adolescentes que corren riesgo de desarrollar obesidad sarcopénica a menudo requiere equipos especializados y procedimientos de pruebas costosos. Por lo tanto, el establecimiento de métodos más baratos y rápidos sería de gran utilidad, especialmente si pudieran aplicarse en el campo. El objetivo del estudio fue establecer si la identificación de mujeres adolescentes que sufren riesgo de desarrollar obesidad sarcopénica se puede obtener mediante la aplicación de la prueba de salto de longitud de pie. Para lograr los objetivos de la investigación, se realizaron diversas mediciones antropométricas y de composición corporal y se evaluó la fuerza explosiva de los miembros inferiores mediante la prueba de aptitud de salto de longitud de pie. La investigación se realizó con una muestra de 535 mujeres encuestadas seleccionadas al azar de 9 escuelas primarias de la región de Skopje, en la República de Macedonia del Norte. Los encuestados se dividieron en quintiles según las puntuaciones z del IMC, y se calcularon las medias aritméticas y la DE sobre la relación músculo-grasa para cada quintil. El límite se determinó en función de la media y la desviación estándar de la relación músculo-grasa para el tercer quintil del IMC y se examinó el porcentaje de encuestados con obesidad sarcopénica. El valor de corte óptimo de los resultados de la prueba de condición física de salto de longitud para predecir la obesidad sarcopénica en una adolescente mostró que el área bajo la curva ROC fue 0,781 (IC del 95 %: 0,743-0,815). Los valores de la prueba de salto de longitud de pie, sobre la base del odds ratio (OR IC del 95 %) sobre las niñas en riesgo de desarrollar obesidad sarcopénica, que se identificó sobre la base del ratio músculo-grasa, fueron 8,76 (4,39 - 17,54, p. 0,001). Puede utilizarse para predecir la presencia de obesidad sarcopénica en adolescentes, lo que puede ser vital en caso de intervención sanitaria.
Assuntos
Humanos , Feminino , Criança , Adolescente , Teste de Esforço , Sarcopenia/diagnóstico , Obesidade/diagnóstico , Composição Corporal , Antropometria , Tecido Adiposo , Inquéritos e Questionários , Análise de Regressão , Impedância Elétrica , Medição de Risco , Músculo Esquelético , Posição OrtostáticaRESUMO
BACKGROUND: Adiposity can influence the estimation of muscle mass using calf circumference (CC) and underestimate the frequency of low CC. An adjustment for CC using body mass index (BMI) was proposed to reduce this effect. We aimed to compare the low CC frequency in hospitalized patients when considering raw and BMI-adjusted values and explore data by sex, age, and race (white and non-white). METHODS: Secondary analysis from two cohort studies conducted with adult hospitalized patients using BMI and CC data collected in the first 72 h after hospital admission. We classified low CC by two approaches: (1) raw CC; (2) BMI-adjusted CC for patients with BMI ≥ 25. Cutoff values for low CC were ≤34 cm (men) and ≤33 cm (women). RESULTS: Among 1272 patients (54.1 ± 15.3 years old; 51.7% women; 82.1% White race), low CC frequency was 30.6% and low BMI-adjusted CC was 68.9%. For all elevated BMI categories, the low CC frequency was higher when considering BMI-adjusted values (P < 0.001). Low CC was more frequent (P < 0.001) in older adults (38.7% by raw; 79.1% by BMI-adjusted value) than in younger adults (27.6% by raw; 65.2% by BMI-adjusted value) and it was not associated with race. Low CC by raw values was more frequent in men than in women (35.0% versus 26.4%; P = 0.001), but did not differ between sexes when classified by BMI-adjusted values (70.7% versus 67.1%; P = 0.184). CONCLUSION: Low CC BMI adjusted was 2.2 times more frequent in comparison with raw CC values, and it was identified in >60% of patients with BMI ≥ 25.
Assuntos
Índice de Massa Corporal , Hospitalização , Perna (Membro) , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Adulto , Idoso , Prevalência , Estudos de Coortes , Músculo Esquelético , Adiposidade , Composição CorporalRESUMO
BACKGROUND: There is neither a gold standard definition nor a universal consensus to diagnose sarcopenia in patients with chronic hepatitis C. Thus, we aimed to compare the prevalence of sarcopenia and the agreement and discrepancies between European Working Group on Sarcopenia in Older People (EWGSOP1), EWGSOP2, and Foundation for the National Institutes of Health Biomarkers Consortium Sarcopenia Project (FNIH) definitions in chronic hepatitis C. METHODS: Dual-energy x-ray absorptiometry was used to assess muscle mass by quantifying appendicular lean mass (ALM) adjusted for squared height (ALM/ht2) or for body mass index (ALMBMI). Muscle function was evaluated by handgrip strength. Subjective Global Assessment was used to assess the nutrition status. RESULTS: This cross-sectional study included 103 outpatients (mean age, 50.6 ± 11.3 years; 33.0% with compensated cirrhosis). Sarcopenia prevalence was 8.7%, 9.7%, and 9.7%, according to EWGSOP1, EWGSOP2, and FNIH definitions, respectively. There was neither a sex- nor a liver disease severity-specific difference in the prevalence of sarcopenia between the criteria applied. Sixteen (15.5%) patients fulfilled at least one of these criteria, and 3 out of 16 (18.8%) simultaneously had sarcopenia by consensus of the three criteria. Sarcopenic obesity was identified in 9 out of 16 (56.3%) patients, and 6 out of 9 (66.7%) of these only met FNIH consensus. CONCLUSIONS: In patients without cirrhosis or with compensated cirrhosis, and with chronic hepatitis C, the agreement between EWGSOP1 and EWGSOP2 classifications was substantial for sarcopenia diagnosis. Concerning EWGSOP and FNIH criteria, a fair agreement and limited overlap were found in these patients.
Assuntos
Absorciometria de Fóton , Índice de Massa Corporal , Força da Mão , Hepatite C Crônica , Sarcopenia , Humanos , Sarcopenia/diagnóstico , Sarcopenia/epidemiologia , Feminino , Masculino , Estudos Transversais , Hepatite C Crônica/complicações , Pessoa de Meia-Idade , Prevalência , Adulto , Estado Nutricional , Músculo Esquelético/fisiopatologia , Composição Corporal , Idoso , Avaliação NutricionalRESUMO
Although it is well established that fibromyalgia (FM) syndrome is characterized by chronic diffuse musculoskeletal hyperalgesia, very little is known about the effect of this pathology on muscle tissue plasticity. Therefore, the present study aimed to characterize the putative alterations in skeletal muscle mass in female rats subjected to a FM model by inducing chronic diffuse hyperalgesia (CDH) through double injections of acidic saline (pH 4.0) into the left gastrocnemius muscle at 5-day intervals. To determine protein turnover, the total proteolysis, proteolytic system activities and protein synthesis were evaluated in oxidative soleus muscles of pH 7.2 (control) and pH 4.0 groups at 7 days after CDH induction. All animals underwent behavioural analyses of mechanical hyperalgesia, strength and motor performance. Our results demonstrated that, in addition to hyperalgesia, rats injected with acidic saline exhibited skeletal muscle loss, as evidenced by a decrease in the soleus fibre cross-sectional area. This muscle loss was associated with increased proteasomal proteolysis and expression of the atrophy-related gene (muscle RING-finger protein-1), as well as reduced protein synthesis and decreased protein kinase B/S6 pathway activity. Although the plasma corticosterone concentration did not differ between the control and pH 4.0 groups, the removal of the adrenal glands attenuated hyperalgesia, but it did not prevent the increase in muscle protein loss in acidic saline-injected animals. The data suggests that the stress-related hypothalamic-pituitary-adrenal axis is involved in the development of hyperalgesia, but is not responsible for muscle atrophy observed in the FM model induced by intramuscular administration of acidic saline. Although the mechanisms involved in the attenuation of hyperalgesia in rats injected with acidic saline and subjected to adrenalectomy still need to be elucidated, the results found in this study suggest that glucocorticoids may not represent an effective therapeutic approach to alleviate FM symptoms.