BackgroundIt has been reported that 4,4′‐diamino‐diphenyl sulfone (DDS), the longtime treatment of choice for leprosy, prolongs the lifespan and increases mobility in animal models by reducing the levels of reactive oxygen species and inhibiting muscle pyruvate kinase activity. This study aimed to investigate whether sarcopenic status in leprosy survivors was influenced by recent history of DDS medication.MethodsForty‐one elderly female leprosy survivors were recruited. The DDS group was defined as survivors who had been taking the drug for the past year or more. Body composition measured by dual energy X‐ray absorptiometry, limb muscle strength, short physical performance battery, and International Physical Activity Questionnaire in Korean were compared.ResultsThe DDS group tended to have higher skeletal muscle mass index (24.4 ± 2.7 vs. 22.6 ± 2.2%, P = 0.066) and regional skeletal muscle mass index in non‐dominant leg (8.9 ± 1.0 vs. 7.9 ± 0.9%, P = 0.018) than those of the control group although they had significantly worse leprosy disability than the control group (P = 0.027). The DDS group had greater strength than the control group in non‐dominant shoulder abductor, elbow flexor, hip flexor, and knee extensor (P = 0.005, P = 0.029, P = 0.021, and P = 0.002, respectively). Weekly walking amount was significantly longer (P = 0.020) in the DDS group than the control group. The total lifetime DDS exposure significantly correlated with skeletal muscle mass of the lower extremity in non‐dominant leg (r = 0.379, P = 0.015).ConclusionsDDS‐taking leprosy survivors had larger skeletal muscle mass and greater muscle strength over non‐taking survivors. There was a dose–response relationship between total lifetime DDS exposure and skeletal muscle mass of lower extremity. These findings might suggest potential anti‐sarcopenic effects of DDS.

Objective To investigate the association of trunk fat and muscle composition, lumbar disc space narrowing, and low back pain in middle-aged farmers.Methods Fat and muscle areas were identified using standard Hounsfield unit ranges for adipose tissue and skeletal muscle with computed tomography images at the mid-L4 vertebral level. Trunk fat mass, muscle mass, and fat/muscle mass ratio were calculated. Low back pain was assessed using the Oswestry Disability Index (ODI). The L4/5-disc space and low back pain were also assessed.Results Male had a higher total trunk, back, psoas, and abdominal muscle mass, and visceral fat; female had a higher subcutaneous fat mass and fat/muscle ratio. Pearson correlation coefficients with ODI for waist circumference, total fat mass, visceral fat mass, and fat/muscle ratio were all significant in female; only the fat/ muscle ratio was significant in male. Pearson correlation coefficients with L4/5-disc space narrowing grades for visceral fat mass, total, back, and psoas muscle mass, and fat/muscle ratio, were all significant in female; total and back muscle mass, and fat/muscle ratio in male.Conclusion There were significant relationships between: fat indicators with low back pain; trunk muscle mass with lumbar disc degeneration; and fat/muscle ratio with both lumbar disc degeneration and low back pain. The fat/muscle ratio may be a useful index for low back pain.

Objective To investigate the relationship between voluntary peak cough flow (PCF), oropharyngeal dysphagia, and pneumonia in patients who were evaluated with videofluoroscopic swallowing study (VFSS).Methods Patients who underwent both VFSS and PCF measurement on the same day were enrolled retrospectively (n=821). Pneumonia (n=138) and control (n=683) groups were assigned based on presence of pneumonia within 1 month from the date of VFSS assessment. In addition, sex, age (<65 and ≥65 years), preceding conditions, modified Barthel Index (MBI), Mini-Mental State Examination (MMSE), PCF value (<160, ≥160 and <270, and ≥270 L/min), and presence of aspiration/penetration on VFSS were reviewed.Results Pneumonia group was more likely to be male (n=108; 78.3%), ≥65 years (n=121; 87.7%), with neurodegenerative (n=25; 18.1%) or other miscellaneous diseases (n=50; 36.2%), and in poor functional level with lower value of MBI (39.1±26.59). However, MMSE was not significantly different in comparison to that of the control group. The pneumonia group was also more likely to have dysphagia (82.6%) and lower value of PCF (<160 L/min, 70.3%). In multivariable logistic regression analysis, male sex (odd ratio [OR]=6.62; 95% confidence interval [CI], 2.70–16.26), other miscellaneous diseases as preceding conditions (OR=2.52; 95% CI, 1.14–5.58), dysphagia (OR=3.82; 95% CI, 1.42–10.23), and PCF <160 L/min (OR=14.34; 95% CI, 1.84–111.60) were factors significantly related with pneumonia.Conclusion Impaired swallowing and coughing function showed an independent association with the development of pneumonia. Patients with PCF <160 L/min require more attention with lung care and should be encouraged with voluntary coughing strategy to prevent possible pulmonary complications.

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