Updated concept of sarcopenia based on muscle–bone relationship

Yakabe, Mitsutaka; Hosoi, Tomohiro; Akishita, Masahiro; Ogawa, Sumito

doi:10.1007/s00774-019-01048-2

Cited by 24 publications

(32 citation statements)

References 47 publications

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“…The pathophysiology of sarcopenia seems to involve degenera-tion of neurogenic, musculogenic, synaptogenic and vasculogenic systems, mitochondrial dysfunction, metabolic factors and inflammatory mechanisms. All these mechanisms have impacts on sarcopenia, but it is still difficult to establish a causal relationship between these mechanisms and their impacts on the muscle (11)(12)(13).…”

Section: Pathophysiological Mechanismsmentioning

confidence: 99%

“…Unfortunately, one can say that, there is not adequate data for muscle quality assessment although it is a very important parameter. However, recent studies suggest that early assessment of muscle quality will be of crucial importance to prevent sarcopenia in the future (13).…”

Section: Diagnostic Criteriamentioning

confidence: 99%

“…The strongest evidences in the treatment of sarcopenia are probably associated with the positive effects of resistance exercises on muscle strength, muscle mass and physical performance (13). An individual's general physical activity level is also important (28).…”

Section: Treatment Optionsmentioning

confidence: 99%

“…Positive results have been reported on supplementation with leucine and its metabolite β-hydroxy β-methylbutyrate (HMB) due to their contribution to protein synthesis (13,31). HMB has been shown to improve muscle mass and to preserve muscle strength and function in older people with sarcopenia or frailty (17,18,32).…”

Section: Treatment Optionsmentioning

confidence: 99%

“…Some oral anti-diabetic drugs are also reported to be helpful in preventing sarcopenia. Interventions to prevent sarcopenia, treatment of the primarily responsible disease, suppression of inflammation, and treatment of metabolic syndromes constitute the basic components of a successful treatment (13,14,34,35).…”

Section: Treatment Optionsmentioning

confidence: 99%

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Sarcopenia: Again and Updated

Kutsal¹

2020

tjgeri

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Sarcopenia is defined as, skeletal muscle dysfunction associated with age, chronic diseases, cancer, nutrition problems and physical inactivity. The pathophysiology of sarcopenia seems to involve degeneration of neurogenic, musculogenic, synaptogenic and vasculogenic systems, mitochondrial dysfunction, metabolic factors and inflammatory mechanisms. Early detection of sarcopenia in older adults and patients is important to prevent morbidity, functional decline and death and the diagnosis requires assessment of muscle mass, muscle strength and physical performance. The strongest evidences in the treatment of sarcopenia are probably associated with the positive effects of resistance exercises on muscle strength, muscle mass and physical performance. Also protein intake needs to be increased. Positive results have been reported on supplementation with leucine, βhydroxy β-methylbutyrate, Omega 3 and Vitamin D. Antioxidant intake naturally from food is recommended. There are promising studies related to angiotensin receptor blockers, oral anti-diabetic drugs. Interventions to prevent sarcopenia, treatment of the primarily responsible disease, suppression of inflammation, and treatment of metabolic syndromes constitute the basic components of a successful treatment.

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Section: Pathophysiological Mechanismsmentioning

confidence: 99%

Section: Diagnostic Criteriamentioning

confidence: 99%

Section: Treatment Optionsmentioning

confidence: 99%

Section: Treatment Optionsmentioning

confidence: 99%

Section: Treatment Optionsmentioning

confidence: 99%

See 3 more Smart Citations

Sarcopenia: Again and Updated

Kutsal¹

2020

tjgeri

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Osteopenia is associated with wasting in pancreatic adenocarcinoma and predicts survival after surgery

et al. 2021

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Pancreatic ductal adenocarcinoma (PDAC) is among the deadliest of all common malignancies. Treatment is difficult and often complicated by the presence of cachexia. The clinical portrait of cachexia contributes to the poor prognosis experienced by PDAC patients and worsens therapeutic outcomes. We propose that low bone mineral density is a component of cachexia, which we explore herein through a retrospective review of all patients at our facility that underwent surgery for PDAC between 2011 and 2018 and compared to sex-, age-and comorbidity-matched control individuals. Data were abstracted from the medical record and pre-operative computed tomography scans. Muscle mass and quality were measured at the L3 level and bone mineral density was measured as the radiation attenuation of the lumbar vertebral bodies. Patients with PDAC displayed typical signs of cachexia such as weight loss and radiologically appreciable deterioration of skeletal muscle. Critically, PDAC patients had significantly lower bone mineral density than controls, with 61.2% of PDAC patients categorized as osteopenic compared to 36.8% of controls. PDAC patients classified as osteopenic had significantly reduced survival (1.01 years) compared to patients without osteopenia (2.77 years). The presence of osteopenia was the strongest clinical predictor of 1-and 2-year disease-specific mortality, increasing the risk of death by 107% and 80%, respectively. Osteopenia serves as a test of 2-year mortality with sensitivity of 76% and specificity of 58%. These data therefore identify impaired bone mineral density as a key component of cachexia and predictor of postoperative survival in patients with PDAC. The mechanisms that lead to bone wasting in tumor-bearing hosts deserve further study.

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Global epidemiological features and impact of osteosarcopenia: A comprehensive meta‐analysis and systematic review

Chen,

Xu,

Gong

et al. 2023

J cachexia sarcopenia muscle

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Osteosarcopenia is defined as the concurrent occurrence of osteopenia/osteoporosis and sarcopenia. The aim of the current study was to perform a systematic review with meta‐analysis to determine the global prevalence, risk factors and clinical outcomes of osteosarcopenia. This review was registered in PROSPERO (CRD42022351229). PubMed, Cochrane, Medline and Embase were searched from inception to February 2023 to retrieve eligible observational population‐based studies. Pooled osteosarcopenia prevalence was calculated with 95% confidence interval (CI), and subgroup analyses were performed. The risk factor of osteosarcopenia and its association with clinical outcomes were expressed as odds ratio (OR) and hazard ratio (HR), respectively. Heterogeneity was estimated using the I2 test. Study quality was assessed using validated instruments matched to study designs. The search identified 55 158 studies, and 66 studies (64 404 participants, mean age from 46.6 to 93 years) were analysed in the final analysis, including 48 cross‐sectional studies, 17 cohort studies and 1 case–control study. Overall, the pooled prevalence of osteosarcopenia was 18.5% (95% CI: 16.7–20.3, I2 = 98.7%), including 15.3% (95% CI: 13.2–17.4, I2 = 97.6%) in men and 19.4% (95% CI: 16.9–21.9, I2 = 98.5%) in women. The prevalence of osteosarcopenia diagnosed using sarcopenia plus osteopenia/osteoporosis was 20.7% (95% CI: 17.1–24.4, I2 = 98.55%), and the prevalence of using sarcopenia plus osteoporosis was 16.1% (95% CI: 13.3–18.9, I2 = 98.0%). The global osteosarcopenia prevalence varied in different regions with 22.9% in Oceania, 21.6% in Asia, 20.8% in South America, 15.7% in North America and 10.9% in Europe. A statistically significant difference was found in the subgroups of the study population between the hospital (24.7%) and community (12.9%) (P = 0.001). Frailty (OR = 4.72, 95% CI: 2.71–8.23, I2 = 61.1%), malnutrition (OR = 2.35, 95% CI: 1.62–3.40, I2 = 50.0%), female sex (OR = 5.07, 95% CI: 2.96–8.69, I2 = 73.0%) and higher age (OR = 1.10, 95% CI: 1.06–1.15, I2==86.0%) were significantly associated with a higher risk for osteosarcopenia. Meta‐analysis of cohort studies showed that osteosarcopenia significantly increased the risk of fall (HR = 1.54, 95% CI: 1.20–1.97; I2 = 1.0%, three studies), fracture (HR = 2.13, 95% CI: 1.61–2.81; I2 = 67.8%, seven studies) and mortality (HR = 1.75, 95% CI: 1.34–2.28; I2 = 0.0%, five studies). Despite the heterogeneity arising from varied definitions and criteria, our findings highlight a significant global prevalence of osteosarcopenia and its negative impact on clinical health. Standardizing diagnostic criteria for osteosarcopenia would be advantageous in the future, and early detection and management should be emphasized in this patient population.

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Updated concept of sarcopenia based on muscle–bone relationship

Cited by 24 publications

References 47 publications

Sarcopenia: Again and Updated

Sarcopenia: Again and Updated

Osteopenia is associated with wasting in pancreatic adenocarcinoma and predicts survival after surgery

Global epidemiological features and impact of osteosarcopenia: A comprehensive meta‐analysis and systematic review

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