Sarcopenia y albúmina sanguínea: revisión sistemática con metaanálisis

Fhon, Jack Roberto Silva; Huayta, Violeta Magdalena Rojas; Aparco, Juan Pablo; Céspedes-Panduro, Bernardo; Rodrigues, Rosalina Aparecida Partezani

doi:10.7705/biomedica.5765

Cited by 29 publications

(16 citation statements)

References 38 publications

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“…We also found that ALB had a weaker correlation with muscle mass but a stronger correlation with muscle strength or physical performance than GNRI. However, ALB was not an independent indicator of sarcopenia risk after adjusting for confounders, which was contradictory to the finding in a previous meta-analysis that low ALB levels were significantly associated with the presence of sarcopenia in elderly adults [56].…”

Section: Discussioncontrasting

confidence: 99%

Associations of geriatric nutrition risk index and other nutritional risk-related indexes with sarcopenia presence and their value in sarcopenia diagnosis

Qiao

Xia

et al. 2022

BMC Geriatr

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Objective Standard modalities recommended for sarcopenia diagnosis may be unavailable in primary care settings. We aimed to comprehensively evaluate and compare associations of some better popularized nutritional risk-related indexes with sarcopenia presence and their value in sarcopenia diagnosis in community-dwelling middle-aged and elderly adults, including geriatric nutrition risk index (GNRI), albumin (ALB), calf circumference (CC), mid-arm circumference (MAC), triceps skinfold thickness (TST) and body mass index (BMI). Methods Based on the West China Health and Aging Trend study, the current study included participants aged 50 or older who were recruited in 2018. Sarcopenia-related assessment and diagnosis were in line with Asian Working Group for Sarcopenia 2019. For each single index, we assessed its association with sarcopenia presence by univariate and multivariate logistic regression analysis; we also computed diagnostic measures including the area under the receiver operating characteristic curve (AUC) and sensitivity, specificity, accuracy at the optimal cut-off value determined according to Youden’s index. Results A total of 3829 subjects were included, consisting of 516 and 3313 subjects in the sarcopenia and non-sarcopenia groups, respectively. Regarding the risk for sarcopenia presence, the fully adjusted odds ratios of GNRI, ALB, CC, MAC, TST and BMI per standard deviation decrease were 2.95 (95% CI 2.51–3.47, P < 0.001), 1.01 (95% CI 0.90–1.15, P = 0.816), 4.56 (95% CI 3.82–5.44, P < 0.001), 4.24 (95% CI 3.56–5.05, P < 0.001), 1.67 (95% CI 1.92–1.45, P < 0.001) and 4.09 (95% CI 3.41–4.91, P < 0.001), respectively. Regarding the value in sarcopenia diagnosis in the entire study population, their AUCs could be ordered as MAC (0.85, 95% CI 0.83–0.86) > GNRI (0.80, 95% CI 0.78–0.82), CC (0.83, 95% CI 0.81–0.85), BMI (0.81, 95% CI 0.79–0.83) > TST (0.72, 95% CI 0.70–0.74) > ALB (0.62, 95% CI 0.60–0.65). At the relevant optimal cut-off values, the sensitivity was the highest for CC (0.83, 95% CI 0.80–0.87) and MAC (0.80, 95% CI 0.77–0.84), while GNRI showed the highest specificity (0.79, 95% CI 0.78–0.81) and accuracy (0.78, 95% 0.76–0.79). Conclusion Overall diagnostic performance was the best for MAC, followed by GNRI, CC, BMI, and the worst for TST, ALB in distinguishing sarcopenia from non-sarcopenia in middle-aged and elderly adults in community-based settings. CC or MAC might do better in reducing missed diagnosis, while GNRI was superior in reducing misdiagnosis.

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Section: Discussioncontrasting

confidence: 99%

Associations of geriatric nutrition risk index and other nutritional risk-related indexes with sarcopenia presence and their value in sarcopenia diagnosis

Qiao

Xia

et al. 2022

BMC Geriatr

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“…Regardless of the criteria used, mean albumin values in our study are very low in both MN subjects (<3.0 g/dL) and non-MN (<3.5 g/dL). Although some authors have also reported values similar to ours [ 68 , 69 ], our results are lower than the majority of the values published in previous articles [ 65 , 66 , 68 ]. Serum albumin concentration has been widely used as an indicator of nutritional status (cut-off point for MN: <3.5 g/dL serum albumin) [ 66 ].…”

Section: Discussioncontrasting

confidence: 79%

“…So, those criteria could differentiate MN from non-malnourished patients according to muscle mass (independently from CRP). Several studies have documented that reduced albumin levels in older people are associated with loss of muscle mass [ 65 , 66 ], poor physical performance [ 67 ], increased disability [ 66 ], and decreased muscle strength [ 66 , 67 ]. Subjects with sarcopenia also have lower serum albumin values than non-sarcopenic subjects [ 65 ].…”

Section: Discussionmentioning

confidence: 99%

“…Serum albumin concentration has been widely used as an indicator of nutritional status (cut-off point for MN: <3.5 g/dL serum albumin) [ 66 ]. However, several authors have questioned both (1) the usefulness of albumin as an indicator of malnutrition in the elderly population since this protein is also affected by inflammatory and infectious processes and various diseases and alterations in hydration status [ 65 , 66 , 69 , 70 ] and (2) the value of 3.5 g/dl as a cut-off point for MN [ 69 ]. Some authors conclude that albumin is only a useful indicator of MN in cases of clinical stability [ 66 ].…”

Section: Discussionmentioning

confidence: 99%

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Prevalence of Malnutrition in a Group of Institutionalized Psychogeriatric Patients Using Different Diagnostic Criteria

de Mateo Silleras,

Barrera Ortega,

Carreño Enciso

et al. 2024

Nutrients

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Malnutrition (MN) is a highly prevalent condition in the elderly. It is associated with functional impairment, disability, frailty, and sarcopenia. The aim was to analyze the capacity of GLIM and ESPEN criteria to diagnose MN in a sample of institutionalized psychogeriatric patients. Clinical and anthropometric data were collected in a cross-sectional study. Patients’ frailty, dependence, functional capacity, MNA, hand-grip strength (HS), and sarcopenia were evaluated. Body composition (BC) was estimated by conventional bioimpedance analysis. MN diagnosis was established using the ESPEN and the GLIM criteria based on fat-free mass index (GLIM-FFMI), appendicular skeletal muscle mass index (GLIM-ASMMI), skeletal muscle mass index (GLIM-SMMI), and HS (mGLIM). Ninety-two patients (57.6% men; mean age: 79.4 years) were studied. Depending on the diagnosis criteria, MN prevalence was between 25% (ESPEN) and 41.3% (GLIM-SMMI). Agreement between ESPEN and all GLIM criteria was poor, but it was excellent between all GLIM criteria (kappa > 0.8). Phenotypic criteria carried more weight in the diagnosis of MN than etiological ones. Depending on the parameter used, the prevalence of reduced muscle mass was notably different. Differences in BMI, BC, inflammation, and albumin are detected by the GLIM-FFMI criteria in the MN and non-MN subjects. Also, this criterion is the only one that identified differences in phase angle (PhA) between these groups. In the elderly, PhA can be very useful to monitor nutritional status.

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“…ALB is an indicator of protein metabolic balance in a non-acutely infected individual; however, a half-life of 18 to 21 days does not reflect drastic changes in nutritional status. In a meta-analysis, a significant association was found between low ALB levels and sarcopenia in adults 60 years of age and older (34). PA has a shorter half-life than ALB (16), so its role as a possible biomarker for sarcopenia was evaluated.…”

Section: The Predictive Value Of Indicators For Sarcopeniamentioning

confidence: 99%

High Serum AST/ALT Ratio and Low Serum INS*PA Product Are Risk Factors and Can Diagnose Sarcopenia in Middle-Aged and Older Adults

Ding

Yin

et al. 2022

Front. Endocrinol.

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BackgroundSarcopenia is an age-related clinical condition and associated with an increased risk of adverse outcomes. However, to date, there is no global standard for the diagnosis of sarcopenia, and fewer serum biomarkers have been suggested for the diagnosis of sarcopenia. It is, thus, important that sarcopenia-related serological diagnostic markers be explored. The present study was based on the Asian Working Group on Sarcopenia 2019 (AWGS 2019) criteria to assess whether aspartate aminotransferase/alanine aminotransferase (AST/ALT) ratio and fasting insulin*prealbumin (INS*PA) product are diagnostic markers associated with sarcopenia in various ethnic groups in western China.MethodsThis cross-sectional study included 4,099 adults (1,471 men and 2,628 women) from the West China Health and Aging Trend (WCHAT) study. The value of serum biomarkers was based on laboratory data. The accompanying metabolic disorders and the associated parameters were evaluated. Logistic regression analysis was used to explore the association between markers and sarcopenia. Receiver operating characteristic curve (ROC) analysis was used to evaluate the diagnostic efficacy of the test in differentiating sarcopenia.ResultsBinary regression analysis showed that high serum AST/ALT (OR = 2.247) and adrenal cortisol (PTC, OR = 1.511), low serum INS*PA (OR = 2.970), free triiodothyronine (FT3, OR = 1.313), 25-OH-VitD (VitD, in male participants, OR = 1.817), and diastolic blood pressure (DBP, in female subjects, OR = 1.250) were independent risk factors for sarcopenia (P < 0.05). AST/ALT and INS*PA were not affected by metabolic factors and had better diagnostic efficacy for sarcopenia. The AUC of the INS*PA was the highest (0.705, 0.706, and 0.701, respectively, P < 0.05), followed by that of the AST/ALT (0.680, 0.675, and 0.695, respectively, P < 0.05). The AUC of the AST/ALT/(INS*PA)*10,000 used to diagnose sarcopenia was 0.727.ConclusionAmong middle-aged and older adults of multiple ethnicities in western China, we found that higher AST/ALT and lower INS*PA levels are associated with an increased prevalence of sarcopenia. Since these serum biomarkers are inexpensive and can be obtained easily from biochemical routine, regular follow-up of AST/ALT and INS*PA may be an effective strategy in sarcopenia screening and management.

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Sarcopenia y albúmina sanguínea: revisión sistemática con metaanálisis

Cited by 29 publications

References 38 publications

Associations of geriatric nutrition risk index and other nutritional risk-related indexes with sarcopenia presence and their value in sarcopenia diagnosis

Associations of geriatric nutrition risk index and other nutritional risk-related indexes with sarcopenia presence and their value in sarcopenia diagnosis

Prevalence of Malnutrition in a Group of Institutionalized Psychogeriatric Patients Using Different Diagnostic Criteria

High Serum AST/ALT Ratio and Low Serum INS*PA Product Are Risk Factors and Can Diagnose Sarcopenia in Middle-Aged and Older Adults

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