Sarcopenia Related to Human Immunodeficiency Virus: Protective Effects of Exercise

Deminice, Rafael; Oliveira, Vitor H F; Webel, Allison R.; Erlandson, Kristine M.

doi:10.1249/jes.0000000000000282

Cited by 8 publications

(7 citation statements)

References 54 publications

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“…A recent meta-analysis carried out by our study group showed that sarcopenia is highly prevalent (24.1%) in PLWH, who were 6.1 times more likely to develop sarcopenia than people without HIV 21 . In addition to aging, sarcopenia among PLWH is caused by different factors linked to HIV management, such as mitochondrial dysfunction, persistent inflammation, and formation of reactive oxygen species 20 , in a phenomenon called “premature” or “accelerated” aging 32 . Some behavioral and lifestyle factors also play a role, where PLWH present a high prevalence of physical inactivity, smoking, and food insecurity 20 , 33 , 34 .…”

Section: Discussionmentioning

confidence: 99%

“…In addition to aging, sarcopenia among PLWH is caused by different factors linked to HIV management, such as mitochondrial dysfunction, persistent inflammation, and formation of reactive oxygen species 20 , in a phenomenon called “premature” or “accelerated” aging 32 . Some behavioral and lifestyle factors also play a role, where PLWH present a high prevalence of physical inactivity, smoking, and food insecurity 20 , 33 , 34 . Although under investigated, we believe that sarcopenia is an emerging health-related condition affecting PLWH, which will face the burden of aging-related sarcopenia and HIV management in the years to come.…”

Section: Discussionmentioning

confidence: 99%

“…Sarcopenia, a musculoskeletal disease characterized by progressive loss of skeletal muscle mass and function 19 , is highly associated with hospitalization and mortality rates in the general population. Sarcopenia has been recently demonstrated to be high prevalent among PLWH 20 , 21 . However, the relationship between statin therapy, skeletal muscle outcomes, and physical function is still unclear, especially among PLWH 22 – 24 .…”

Section: Introductionmentioning

confidence: 99%

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Statin protects men but not women with HIV against loss of muscle mass, strength, and physical function: a pilot study

Cárdenas

Oliveira

Borsari

et al. 2023

Sci Rep

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Statins are cholesterol-lowering drugs commonly used among people with HIV, associated with an increased risk of myopathies. Considering that cardiovascular disease, statin therapy, and sarcopenia are independently prevalent in people with HIV, clarity on the potential benefits or harms of statin therapy on muscle health is useful to provide insight into ways to maximize skeletal muscle health and minimize CVD risk in this population. We aimed to study the effects of statin therapy on strength, muscle mass, and physical function parameters in people with HIV. This was a pilot cross-sectional study. People with HIV on continuous statin therapy (n = 52) were paired 1:1 according to age (people with HIV 53.9 ± 8.2 and people with HIV on statins 53.9 ± 8.4 years), sex, body mass index (Body mass index, people with HIV 28.6 ± 5.3 and people with HIV on statins 28.8 ± 6.3 kg/m2), and race with people with HIV not using statin (n = 52). Participants were evaluated for muscle strength (i.e. handgrip strength), lean and fat body mass (using bioelectric impedance analysis), and physical function (i.e. Short Physical Performance Battery—SPPB). Isokinetic strength and appendicular lean mass (using dual-energy X-ray absorptiometry), more accurate strength and body composition measures, were determined in 38% of the participants. Overall, statin usage does not exacerbated loss of muscle strength (32.2 ± 11.5 vs. 30.3 ± 9.6 kg, p > 0.05) muscle mass (7.6 ± 1.8 vs. 7.7 ± 1.1 kg/m2, p > 0.05), and impaired physical performance (10.1 ± 1.8 vs. 9.7 ± 2.1 points, p > 0.05) of PLWH. When analyzed by sex, men living with HIV on statins usage presented higher appendicular muscle mass (28.4 ± 3.1 vs. 26.2 ± 4.9 kg, p < 0.05) handgrip strength (42.1 ± 8.8 vs. 37.1 ± 8.3 kg, p < 0.05) and physical function through SPPB score (10.9 ± 1.3 vs. 9.5 ± 2.1, p < 0.05) than men living with HIV not on statins treatment. The same protection was not observed in women. This data was demonstrated when muscle mass and strength were determined clinically (i.e. handgrip strength and electrical impedance) and when more precise laboratory measurements of muscle mass and strength were conducted (i.e. isokinetic strength and DXA scans). Statin does not exacerbate muscle wasting, strength loss, or muscle dysfunction among people with HIV. Indeed, statins may protect men, but not woman with HIV against HIV and antiretroviral therapy-induced loss of muscle mass and strength.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Statin protects men but not women with HIV against loss of muscle mass, strength, and physical function: a pilot study

Cárdenas

Oliveira

Borsari

et al. 2023

Sci Rep

Self Cite

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“…Therefore, not unexpectedly, participants with sarcopenia in these two categories in our study had the most correlation with parameters associated with worse physical health‐related QOL. In other words, these two definitions were able to identify individuals with the highest risk of poor health outcomes, and evidence‐based interventions for sarcopenia to prevent future disability are urgently required for these individuals [ 41 ].…”

Section: Discussionmentioning

confidence: 99%

Sarcopenia in people living with HIV in Hong Kong: which definition correlates with health outcomes?

Luk

et al. 2022

J Int AIDS Soc.

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Introduction Sarcopenia is an important clinical syndrome in older people living with HIV (PLWH). With a change to the Asia sarcopenia definition in 2019, we aimed to determine whether health outcomes were associated with different definitions of sarcopenia among Asian PLWH. Methods We performed a prospective cross‐sectional study enrolling PLWH aged ≥35 years from January 2018 to November 2021. We defined sarcopenia by the Asia Working Group of Sarcopenia (AWGS) criteria in 2014 and 2019. AWGS‐2014 included low muscle mass plus weak handgrip strength and/or slow gait speed. AWGS‐2019 included low muscle mass plus low muscle strength or physical performance, while the presence of all defines severe sarcopenia. We measured appendicular skeletal muscle mass using dual‐energy X‐ray absorptiometry, handgrip strength, usual gait speed, five‐time chair stand test and Short Physical Performance Battery. Correlations between each sarcopenia definition and health‐related quality of life (using EQ‐5D‐5L and SF‐36) and functional disability were determined. Results One hundred and fifty Asian PLWH were enrolled, 132 (88%) were male, mean age was 60±10 years, duration of HIV diagnosis was 13 (IQR 8–18) years and current CD4 count was 574 (IQR 362–762) cells/mm3, 67 (45%) had multimorbidity, 64 (43%) had polypharmacy. Prevalence of sarcopenia by AWGS‐2014, AWGS‐2019 and severe sarcopenia was 17.3%, 27.3% and 18.0%, respectively. Age, education and polypharmacy were associated with sarcopenia. Sarcopenia (AWGS‐2014) and severe sarcopenia were associated with mobility, physical functioning and physical component score (SF‐36). All three criteria were associated with impaired instrumental activities of daily living (IADL). After age and sex adjustment, sarcopenia (AWGS‐2014) (adjusted odds ratio/aOR 5.4, 95% confidence interval/CI 2.0–15.1) and severe sarcopenia (aOR 5.1, 95% CI 1.9–14.0) were associated with mobility and physical component score (SF‐36) (β coefficients –5.3342, p = 0.022 and –5.412, p = 0.019). Sarcopenia (AWGS 2014) (aOR 5.2, 95% CI 1.7–16.2), sarcopenia (AWGS‐2019) (aOR 4.5, 95% CI 1.5–13.1) and severe sarcopenia (aOR 3.5, 95% CI 1.1–10.9) were associated with impaired IADL in fully adjusted models. Conclusions In a sample of Asian PLWH, 17.3%, 27.3% and 18.0% had sarcopenia as defined by AWGS‐2014, AWGS‐2019 and severe sarcopenia, respectively. Sarcopenia by AWGS‐2014 and severe sarcopenia correlated with parameters of poor health outcomes, while sarcopenia by AWGS‐2019 correlated with functional disability.

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“…22) In fact, it has been suggested that inflammation measured by circulating levels of IL-6 is the only known cross-sectional and longitudinal predictor of multimorbidity and one of the strongest predictors of incident mobility loss and disability in activities of daily living. 23) It is of interest to note that some authors have argued recently that similar mechanisms are active in patients with human immunodeficiency virus 24) or COVID-19 25) because both exhibit a sarcopenic phenotype.…”

Section: The Principal Clinical Manifestations Of Sarcopeniamentioning

confidence: 99%

Rehabilitation of Older Adults with Sarcopenia: From Cell to Functioning

Frontera

2022

PRM

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Sarcopenia Related to Human Immunodeficiency Virus: Protective Effects of Exercise

Abstract: Sarcopenia is increasingly common among people with HIV, and combined exercise at higher intensity is a strategy to prevent its development.

Cited by 8 publications

References 54 publications

Statin protects men but not women with HIV against loss of muscle mass, strength, and physical function: a pilot study

Statin protects men but not women with HIV against loss of muscle mass, strength, and physical function: a pilot study

Sarcopenia in people living with HIV in Hong Kong: which definition correlates with health outcomes?

Rehabilitation of Older Adults with Sarcopenia: From Cell to Functioning

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