Cirrhosis is frequently associated with sarcopenia,with reported rates of over 80%in patients with decompensated alcohol-related liver disease.Sarcopenia nega-tively impacts the prognosis of cirrhotic patients and aff...Cirrhosis is frequently associated with sarcopenia,with reported rates of over 80%in patients with decompensated alcohol-related liver disease.Sarcopenia nega-tively impacts the prognosis of cirrhotic patients and affects the response to treatment of patients with hepatocellular carcinoma(HCC).For these reasons,identifying an easy-to-perform method to assess sarcopenia in is a key element in the optimization of care in this patient population.Assessment of muscle mass by computed tomography is considered the standard of care for the diagnosis of sarcopenia,but exposure to radiation and high costs limit its application in this setting,especially for repeated assessments.We believe that ultrasound,a cheap and harmless technique also used for HCC screening in cirrhotic patients,could have an expanding role in the diagnosis and follow-up of sarcopenia in these patients.展开更多
BACKGROUND The prevalence of sarcopenia in patients undergoing liver transplantation(LT)remains to be determined partly because of different diagnostic criteria.Sarcopenia has recently been recognized as a new prognos...BACKGROUND The prevalence of sarcopenia in patients undergoing liver transplantation(LT)remains to be determined partly because of different diagnostic criteria.Sarcopenia has recently been recognized as a new prognostic factor for predicting outcomes in LT candidates.AIM To estimate the prevalence of sarcopenia and evaluate its clinical effect on LT candidates.METHODS This systematic search was conducted in PubMed,Web of Science,Embase,and Cochrane Library for original English-language articles that investigated the prevalence and influence of sarcopenia in patients undergoing LT from database inception to November 30,2022.Cohort studies of the definition of sarcopenia that estimate sarcopenia prevalence and evaluate its effect on clinical outcomes and the risk of mortality were included.RESULTS Twenty-five studies involving 7760 patients undergoing LT were included.The pooled prevalence of sarcopenia in patients undergoing LT was 40.7%[95%confidence intervals(95%CI):32.1-49.6].The 1-,3-,and 5-year cumulative probab-ilities of post-LT survival in patients with preoperative sarcopenia were all lower than those without sarcopenia(P<0.05).Sarcopenia was associated with an increased risk of post-LT mortality in patients undergoing LT(adjusted hazard ratio:1.58;95%CI:1.21-2.07).Patients with preoperative sarcopenia had a longer intensive care unit stay,a high risk ratio of sepsis,and serious post-LT complications than those without sarcopenia.CONCLUSION Sarcopenia is prevalent in a substantial proportion of patients undergoing LT and is strongly and independently associated with higher a risk of mortality risk.展开更多
BACKGROUND The development and progression of gastric cancer(GC)are closely linked to the nutritional status of patients.Although immunotherapy has been demonstrated to be clinically effective,the relationships of sar...BACKGROUND The development and progression of gastric cancer(GC)are closely linked to the nutritional status of patients.Although immunotherapy has been demonstrated to be clinically effective,the relationships of sarcopenia and myosteatosis with the use of immune checkpoint inhibitors(ICIs)in patients with gastric cancer remain to be characterized.METHODS We performed a retrospective study of patients who were undergoing immuno-therapy for GC.For the evaluation of sarcopenia,the optimal cut-off value for the skeletal muscle index was established using receiver operating characteristic analysis of data obtained from pre-treatment computed tomography images at the L3 vertebral level.Myosteatosis was defined using the mean skeletal muscle density(SMD),with a threshold value of<41 Hounsfield units(HU)for patients with a body mass index(BMI)<25 kg/m^(2)and<33 HU for those with a BMI≥25 kg/m^(2).The log-rank test was used to compare progression-free survival(PFS)and overall survival(OS),and a Cox proportional hazard model was used to identify prognostic factors.Nomograms were developed to predict the PFS and OS of patients on the basis of the results of multivariate analyses.RESULTS We studied 115 patients who were undergoing ICI therapy for GC,of whom 27.4%had sarcopenia and 29.8%had myosteatosis.Patients with sarcopenia or myosteatosis had significantly shorter PFS and OS than those without these conditions.Furthermore,both sarcopenia and myosteatosis were found to be independent predictors of PFS and OS in patients with GC administering an ICI.The prediction models created for PFS and OS were associated with C-indexes of 0.758 and 0.781,respectively.CONCLUSION The presence of sarcopenia or myosteatosis is a reliable predictor of the clinical outcomes of patients with GC who are undergoing treatment with an ICI.展开更多
BACKGROUND Sarcopenia is a progressively diminishing state characterized by the reduction of muscle mass and density,which is frequently observed in malignancies of solid organs.AIM To assess how sarcopenia affects th...BACKGROUND Sarcopenia is a progressively diminishing state characterized by the reduction of muscle mass and density,which is frequently observed in malignancies of solid organs.AIM To assess how sarcopenia affects the overall survival of individuals who have been diagnosed with metastatic gastric cancer.METHODS The study retrospectively included individuals who had been diagnosed with metastatic gastric cancer between January 2008 and December 2020.Sarcopenia was identified through the calculation of the average Hounsfield units(HUAC)using computed tomography(CT)images taken at the time of diagnosis in patients.RESULTS A total of 118 patients with metastatic gastric cancer were evaluated.Sarcopenia was detected in 29 patients(24.6%).The median survival of all patients was 8(1-43)mo.The median survival of patients with sarcopenia was 2 mo,while it was 10 mo for those without sarcopenia(P<0.001).A significant relationship was found between sarcopenia and survival.CONCLUSION Sarcopenia has been observed to impact survival outcomes in various types of solid tumor cancers.Sarcopenic patients can be identified in a short time,easily and inexpensively,by HUAC measurements from CT images used for diagnosis,and survival could be promoted with nutritional support.展开更多
Sarcopenia reflects patient frailty and should be routinely assessed due to its high prevalence in cirrhotic patients awaiting liver transplants.Pre-transplant nutritional optimization should be tailored for patients ...Sarcopenia reflects patient frailty and should be routinely assessed due to its high prevalence in cirrhotic patients awaiting liver transplants.Pre-transplant nutritional optimization should be tailored for patients with a definitive diagnosis of sarcopenia,therefore improving functional status at transplant and reducing posttransplant mortality.Hepatologists and transplant surgeons should have raised awareness regarding sarcopenia and the reflected frailty that hinder posttransplant outcomes.The policymakers should also take into account when modifying the organ allocation model that sarcopenia or frailty might become a decisive factor in allocating organs for cirrhotic patients,in order to ensure post-transplant survival and quality of life.展开更多
The prevalence of metabolic-associated fatty liver disease(MAFLD)has increased substantially in recent years because of the global obesity pandemic.MAFLD,now recognized as the number one cause of chronic liver disease...The prevalence of metabolic-associated fatty liver disease(MAFLD)has increased substantially in recent years because of the global obesity pandemic.MAFLD,now recognized as the number one cause of chronic liver disease in the world,not only increases liver-related morbidity and mortality among sufferers but also worsens the complications associated with other comorbid conditions such as cardiovascular disease,type 2 diabetes mellitus,obstructive sleep apnoea,lipid disorders and sarcopenia.Understanding the interplay between MAFLD and these comorbidities is important to design optimal therapeutic strategies.Sarcopenia can be either part of the disease process that results in MAFLD(e.g.,obesity or adiposity)or a consequence of MAFLD,especially in the advanced stages such as fibrosis and cirrhosis.Sarcopenia can also worsen MAFLD by reducing exercise capacity and by the production of various muscle-related chemical factors.Therefore,it is crucial to thoroughly understand how we deal with these diseases,especially when they coexist.We explore the pathobiological interlinks between MAFLD and sarcopenia in this comprehensive clinical update review article and propose evidence-based therapeutic strategies to enhance patient care.展开更多
Objectives: In this study, bibliometric approach was used to explore the literature in the field of research related to Diabetic Myasthenia Gravis in order to identify the current research progress in Diabetic Myasthe...Objectives: In this study, bibliometric approach was used to explore the literature in the field of research related to Diabetic Myasthenia Gravis in order to identify the current research progress in Diabetic Myasthenia Gravis related research and to help the researchers to predict the future hotspots in the field of research and to provide reference for the research. Methods: Literature related to diabetic sarcopenia published from 1993 to 2023 since the inception of the repository was extracted from the Web of Science Core Collection (WoSCC) and bibliometric analyses were performed. We have analysed the published literature of the last approximately almost 30 years, as well as publication and citation analyses from different countries, institutions, journals and authors. For keywords, we performed co-occurrence, clustering, timeline view and citation burst analysis. Results: On the basis of 1564 publications, we found a continuous increase in the number of publications and citations, especially in the last six years. The United States is the most representative country, and Seoul National University (SNU) is the most representative institution. The most popular journal in the field is Diabetes Care;Fukui, Michiaki is the most prolific author, leading many studies related to diabetic sarcopenia. The most frequently cited reference was a revised European consensus on the definition and diagnosis of sarcopenia;the most cited keywords were related to physiological factors of diabetes, sarcopenia and related conditions, such as “insulin resistance”, “skeletal muscle”, “body composition”, “risk” and “prevalence”. Conclusion: With more and more studies on the relationship between diabetic sarcopenia, this study presents the current status and trend of research related to diabetic sarcopenia over the past nearly 30 years through the visualization software CiteSpace. It can help researchers identify potential collaborators and partner institutions, hotspots and research frontiers in the field of diabetic sarcopenia. However, our work is only based on the English language literature in the WoSCC database, and for future studies, we recommend that researchers explore the literature from multiple databases to enhance the scope of their research.展开更多
In recent years, sarcopenia, as a progressive muscular atrophy and weakness, has become one of the common diseases in the elderly. Although its cause is not fully understood, a growing body of research suggests that e...In recent years, sarcopenia, as a progressive muscular atrophy and weakness, has become one of the common diseases in the elderly. Although its cause is not fully understood, a growing body of research suggests that epigenetic mechanisms play an important role in the pathogenesis of sarcopenia. The purpose of this review is to summarize the current research progress in the epigenetics of sarcopenia, focusing on the role of DNA methylation, RNA methylation and non-coding RNA in the pathogenesis of sarcopenia. While exploring the epigenetic mechanism of sarcopenia, this study will also look into the application prospect of epigenetics in the treatment strategy of sarcopenia, which will provide new ideas and directions for the treatment of sarcopenia.展开更多
BACKGROUND Nonalcoholic fatty liver disease(NAFLD)includes a spectrum of conditions,progressing from mild steatosis to advanced fibrosis.Sarcopenia,characterized by decreased muscle strength and mass,shares common pat...BACKGROUND Nonalcoholic fatty liver disease(NAFLD)includes a spectrum of conditions,progressing from mild steatosis to advanced fibrosis.Sarcopenia,characterized by decreased muscle strength and mass,shares common pathophysiological traits with NAFLD.An association exists between sarcopenia and increased NAFLD prevalence.However,data on the prevalence of sarcopenia in NAFLD and its impact on the outcomes of NAFLD remain inconsistent.AIM To analyze the prevalence and outcomes of sarcopenia in patients with NAFLD.METHODS We conducted a comprehensive search for relevant studies in MEDLINE,Embase,and Scopus from their inception to June 2023.We included studies that focused on patients with NAFLD,reported the prevalence of sarcopenia as the primary outcome,and examined secondary outcomes,such as liver fibrosis and other adverse events.We also used the Newcastle-Ottawa scale for quality assessment.RESULTS Of the 29 studies included,the prevalence of sarcopenia in NAFLD varied widely(1.6%to 63.0%),with 20 studies reporting a prevalence of more than 10.0%.Substantial heterogeneity was noted in the measurement modalities for sarcopenia.Sarcopenia was associated with a higher risk of advanced fibrosis(odd ratio:1.97,95%confidence interval:1.44-2.70).Increased odds were consistently observed in fibrosis assessment through biopsy,NAFLD fibrosis score/body mass index,aspartate aminotransferase to alanine aminotransferase ratio,diabetes(BARD)score,and transient elastography,whereas the fibrosis-4 score showed no such association.Sarcopenia in NAFLD was associated with a higher risk of steatohepatitis,insulin resistance,cardiovascular risks,and mortality.CONCLUSION This systematic review highlights the critical need for standardized diagnostic criteria and measurement methods for sarcopenia in NAFLD patients.The variability in study designs and assessment methods for sarcopenia and liver fibrosis may account for the inconsistent findings.This review demonstrates the multidimensional impact of sarcopenia on NAFLD,indicating its importance beyond liver-related events to include cardiovascular risks,mortality,and metabolic complications.展开更多
Sarcopenia,or muscle loss,has been one of the hot topics in the medical field in recent years.Due to limited attention and effective treatments for sarcopenia in the past,many patients,especially the elderly,suffered ...Sarcopenia,or muscle loss,has been one of the hot topics in the medical field in recent years.Due to limited attention and effective treatments for sarcopenia in the past,many patients,especially the elderly,suffered irreversible damage to their motor function caused by sarcopenia.However,recent scientific studies have found that the occurrence and development of sarcopenia are closely related to the function and quantity of muscle satellite cells.This article briefly discusses the relationship between muscle satellite cells and sarcopenia.展开更多
BACKGROUND Skeletal muscle abnormalities,such as muscle mass depletion(sarcopenia)and fatty infiltration of the muscle(myosteatosis),are frequent complications in cirrhotic patients scheduled for transjugular intrahep...BACKGROUND Skeletal muscle abnormalities,such as muscle mass depletion(sarcopenia)and fatty infiltration of the muscle(myosteatosis),are frequent complications in cirrhotic patients scheduled for transjugular intrahepatic portosystemic shunt(TIPS).AIM To investigate the association and predictive value of sarcopenia and myosteatosis for overt hepatic encephalopathy(HE)and mortality after TIPS.METHODS The records of cirrhotic patients who underwent the TIPS procedure at our hospital between January 2020 and June 2021 were retrospectively retrieved.The transversal psoas muscle thickness(TPMT)and psoas muscle attenuation(PMA)measured from the unenhanced abdominal computed tomography(CT)at the level of the third lumbar vertebrae were used to analyze the sarcopenia and myosteatosis,respectively.The area under curve(AUC)was used to evaluate the discriminative power of TPMT,PMA,and relevant clinical parameters.Furthermore,log-rank test was performed to compare the incidence of overt HE and survival between the different groups,and the association of risk factors with overt HE and mortality was analyzed using Cox proportional hazards regression models.RESULTS A total of 108 patients were collected.Among these patients,45.4%of patients developed overt HE after TIPS treatment.Furthermore,32.4%and 28.7%of these patients were identified to have myosteatosis and sarcopenia,respectively.Myosteatosis(51.0%vs 16.9%,P<0.001)and sarcopenia(40.8 vs 18.6%,P=0.011)were found to be more frequent in patients with overt HE,when compared to patients without overt HE.The receiver operating characteristics analysis indicated that the predictive power of TPMT and PMA in overt HE(AUC=0.713 and 0.778,respectively)was higher when compared to the neutrophil lymphocyte ratio(AUC=0.636).The cumulative incidence of overt HE was the highest in patients with concomitant sarcopenia and myosteatosis,followed by patients with myosteatosis or sarcopenia,while this was the lowest in patients without sarcopenia and myosteatosis.In addition,sarcopenia and myosteatosis were independently associated with overt HE and mortality after adjusting for confounding factors in post-TIPS patients.CONCLUSION CT-based estimations for sarcopenia and myosteatosis can be used as reliable predictors for the risk of developing overt HE and mortality in cirrhotic patients after TIPS.展开更多
Liver cirrhosis is commonly associated with nutritional alterations,reported in 20% of patients with compensated disease and over 60% of patients with decompensated cirrhosis.Nutritional disturbances are associated wi...Liver cirrhosis is commonly associated with nutritional alterations,reported in 20% of patients with compensated disease and over 60% of patients with decompensated cirrhosis.Nutritional disturbances are associated with a worse prognosis and increased risk of complication.Serum levels of branched-chain amino acids(BCAAs)are decreased in patients with liver cirrhosis.The imbalance of amino acids levels has been suggested to be associated with the development of complications,such as hepatic encephalopathy and sarcopenia,and to affect the clinical presentation and prognosis of these patients.Several studies investigated the efficacy of BCAAs supplementation as a therapeutic option in liver cirrhosis,but uncertainties remain about the real efficacy,the best route of administration,and dosage.展开更多
Objective: The aim of this study was to investigate the prevalence of sarcopenia(SP) and its relationship with gut microbiota alterations in patients with hematological diseases before and after hematopoietic stem cel...Objective: The aim of this study was to investigate the prevalence of sarcopenia(SP) and its relationship with gut microbiota alterations in patients with hematological diseases before and after hematopoietic stem cell transplantation(HSCT).Methods: A total of 108 patients with various hematological disorders were selected from Peking University People’s Hospital. SP was screened and diagnosed based on the 2019 Asian Sarcopenia Diagnosis Strategy. Physical measurements and fecal samples were collected, and 16S rRNA gene sequencing was conducted. Alpha and beta diversity analyses were performed to evaluate gut microbiota composition and diversity.Results: After HSCT, significant decreases in calf circumference and body mass index(BMI) were observed,accompanied by a decline in physical function. Gut microbiota analyses revealed significant differences in the relative abundance of Enterococcus, Bacteroides, Blautia and Dorea species before and after HSCT(P<0.05). Before HSCT, sarcopenic patients had lower Dorea levels and higher Phascolarctobacterium levels than non-sarcopenia patients(P<0.01). After HSCT, no significant differences in species abundance were observed. Alpha diversity analysis showed significant differences in species diversity among the groups, with the highest diversity in the postHSCT 90-day group and the lowest in the post-HSCT 30-day group. Beta diversity analysis revealed significant differences in species composition between pre-and post-HSCT time points but not between SP groups. Linear discriminant analysis effect size(LEfSe) identified Alistipes, Rikenellaceae, Alistipes putredinis, Prevotellaceae defectiva and Blautia coccoides as biomarkers for the pre-HSCT sarcopenia group. Functional predictions showed significant differences in anaerobic, biofilm-forming and oxidative stress-tolerant functions among the groups(P<0.05).Conclusions: This study demonstrated a significant decline in physical function after HSCT and identified potential gut microbiota biomarkers and functional alterations associated with SP in patients with hematological disorders. Further research is needed to explore the underlying mechanisms and potential therapeutic targets.展开更多
Aging is characterized by the gradual deterioration of function at the molecular,cellular,tissue,and organism levels in humans.The typical diseases caused by changes in body composition,as well as functional decline i...Aging is characterized by the gradual deterioration of function at the molecular,cellular,tissue,and organism levels in humans.The typical diseases caused by changes in body composition,as well as functional decline in the human body’s organs due to aging include sarcopenia and metabolic disorders.The accumulation of dysfunctional agingβcells with age can cause decreased glucose tolerance and diabetes.Muscle decline has a multifactorial origin,involving lifestyle habits,disease triggers,and age-dependent biological changes.The reduced function ofβcells in elderly people lowers insulin sensitivity,which affects protein synthesis and interferes with muscle synthesis.The functional decrease and aggravation of disease in elderly people with less regular exercise or physical activity causes imbalances in food intake and a continuous,vicious cycle.In contrast,resistance exercise increases the function ofβcells and protein synthesis in elderly people.In this review,we discuss regular physical activities or exercises to prevent and improve health,which is sarcopenia as decreased muscle mass and metabolic disorders as diabetes in the elderly.展开更多
Although the frequency of metabolic risk factors for cirrhosis and hepatocellular carcinoma(HCC)is increasing,chronic hepatitis B(CHB)and chronic hepatitis C(CHC)remain the most relevant risk factors for advanced live...Although the frequency of metabolic risk factors for cirrhosis and hepatocellular carcinoma(HCC)is increasing,chronic hepatitis B(CHB)and chronic hepatitis C(CHC)remain the most relevant risk factors for advanced liver disease worldwide.In addition to liver damage,hepatitis B virus(HBV)and hepatitis C virus(HCV)infections are associated with a myriad of extrahepatic manifestations including mixed cryoglobulinaemia,lymphoproliferative disorders,renal disease,insulin resistance,type 2 diabetes,sicca syndrome,rheumatoid arthritislike polyarthritis,and autoantibody production.Recently,the list has grown to include sarcopenia.Loss of muscle mass or muscle function is a critical feature of malnutrition in cirrhotic patients and has been found in approximately 23.0%-60.0%of patients with advanced liver disease.Nonetheless,among published studies,there is significant heterogeneity in the aetiologies of hepatic diseases and measurement methods used to determine sarcopenia.In particular,the interaction between sarcopenia,CHB and CHC has not been completely clarified in a real-world setting.Sarcopenia can result from a complex and multifaceted virus-host-environment interplay in individuals chronically infected with HBV or HCV.Thus,in the present review,we provide an overview of the concept,prevalence,clinical relevance,and potential mechanisms of sarcopenia in patients with chronic viral hepatitis,with an emphasis on clinical outcomes,which have been associated with skeletal muscle loss in these patients.A comprehensive overview of sarcopenia in individuals chronically infected with HBV or HCV,independent of the stage of the liver disease,will reinforce the necessity of an integrated medical/nutritional/physical education approach in the daily clinical care of patients with CHB and CHC.展开更多
BACKGROUND Observational studies have suggested that depression is associated with sarcopenia.However,the causal relationship between depression and sarcopenia remains unclear.AIM To investigate the causal relationshi...BACKGROUND Observational studies have suggested that depression is associated with sarcopenia.However,the causal relationship between depression and sarcopenia remains unclear.AIM To investigate the causal relationship between depression and sarcopenia.METHODS We performed a Mendelian randomization(MR)analysis to identify the bidirectional relationship between depression and sarcopenia-related traits.Summarylevel data and independent variants used as instrumental variables came from large genome-wide association studies of depression(414055 cases and 892299 controls),of appendicular lean mass(ALM,450243 participants),and of hand grip strength(exposure:360000 participants;outcome:334925 participants).RESULTS We identified a negative association of depression with lower ALM[odds ratio(OR):0.932,95%confidence interval(95%CI):0.889-0.979,P=0.005].In the reverse MR analysis,we also observed an inverse association of hand grip strength with depression(OR:0.200,95%CI:0.108-0.370,P<0.001).Similar results were obtained in sensitivity analyses.CONCLUSION Depression was causally related to decreased muscle mass,and declined muscle strength might lead to a higher risk of depression.展开更多
Sarcopenia is a common complication of malnutrition.Patients with colorectal cancer are prone to secondary sarcopenia due to nutrient absorption,intestinal obstruction,metabolic disorders and other reasons.Nutritional...Sarcopenia is a common complication of malnutrition.Patients with colorectal cancer are prone to secondary sarcopenia due to nutrient absorption,intestinal obstruction,metabolic disorders and other reasons.Nutritional status not only participates in the body’s normal function but also has an important impact on anti-tumor treatment.More and more evidence shows that sarcopenia has a negative effect on the treatment and prognosis of colorectal cancer.This article summarizes the related research,such as the influence of sarcopenia on the treatment of colorectal cancer.To evaluate the clinical value of sarcopenia in treating colorectal cancer and provide new ideas for the comprehensive treatment of sarcopenia in patients with colorectal cancer.展开更多
Objective:To investigate the impact of sarcopenia on the prognosis of frail elderly patients with chronic kidney disease.Methods:A total of 98 elderly frail patients with chronic kidney disease were included in this s...Objective:To investigate the impact of sarcopenia on the prognosis of frail elderly patients with chronic kidney disease.Methods:A total of 98 elderly frail patients with chronic kidney disease were included in this study from June 2020 to July 2022.The patients were randomly divided into a study group of 48 cases and a control group of 50 cases.The control group only received conventional treatment for chronic kidney disease.On the basis of conventional treatment for chronic kidney disease,the study group added sarcopenia intervention treatment.The quality-of-life scores,muscle mass and muscle strength,renal function,and incidence of complications of the two groups were observed and analyzed.Results:The quality-of-life score,muscle mass and muscle strength,and renal function of the study group were significantly better than those of the control group(P<0.05);the incidence of complications in the study group was 12.5%,which was significantly lower than that of the control group 36%of the group(P<0.05).Conclusion:There is a close relationship between sarcopenia and frail elderly patients with chronic kidney disease.Sarcopenia will further aggravate the frailty symptoms and increase the risk of complications in elderly patients with chronic kidney disease.For elderly patients with chronic kidney disease,sarcopenia should be screened and intervened as early as possible to improve the prognosis and quality of life of the patients.展开更多
文摘Cirrhosis is frequently associated with sarcopenia,with reported rates of over 80%in patients with decompensated alcohol-related liver disease.Sarcopenia nega-tively impacts the prognosis of cirrhotic patients and affects the response to treatment of patients with hepatocellular carcinoma(HCC).For these reasons,identifying an easy-to-perform method to assess sarcopenia in is a key element in the optimization of care in this patient population.Assessment of muscle mass by computed tomography is considered the standard of care for the diagnosis of sarcopenia,but exposure to radiation and high costs limit its application in this setting,especially for repeated assessments.We believe that ultrasound,a cheap and harmless technique also used for HCC screening in cirrhotic patients,could have an expanding role in the diagnosis and follow-up of sarcopenia in these patients.
基金This meta-analysis was conducted based on the PRISMA checklist and was registered in PROSPERO(CRD42022379765).
文摘BACKGROUND The prevalence of sarcopenia in patients undergoing liver transplantation(LT)remains to be determined partly because of different diagnostic criteria.Sarcopenia has recently been recognized as a new prognostic factor for predicting outcomes in LT candidates.AIM To estimate the prevalence of sarcopenia and evaluate its clinical effect on LT candidates.METHODS This systematic search was conducted in PubMed,Web of Science,Embase,and Cochrane Library for original English-language articles that investigated the prevalence and influence of sarcopenia in patients undergoing LT from database inception to November 30,2022.Cohort studies of the definition of sarcopenia that estimate sarcopenia prevalence and evaluate its effect on clinical outcomes and the risk of mortality were included.RESULTS Twenty-five studies involving 7760 patients undergoing LT were included.The pooled prevalence of sarcopenia in patients undergoing LT was 40.7%[95%confidence intervals(95%CI):32.1-49.6].The 1-,3-,and 5-year cumulative probab-ilities of post-LT survival in patients with preoperative sarcopenia were all lower than those without sarcopenia(P<0.05).Sarcopenia was associated with an increased risk of post-LT mortality in patients undergoing LT(adjusted hazard ratio:1.58;95%CI:1.21-2.07).Patients with preoperative sarcopenia had a longer intensive care unit stay,a high risk ratio of sepsis,and serious post-LT complications than those without sarcopenia.CONCLUSION Sarcopenia is prevalent in a substantial proportion of patients undergoing LT and is strongly and independently associated with higher a risk of mortality risk.
基金This study was approved by the Ethics Committee of Harbin Medical University Cancer Hospital.
文摘BACKGROUND The development and progression of gastric cancer(GC)are closely linked to the nutritional status of patients.Although immunotherapy has been demonstrated to be clinically effective,the relationships of sarcopenia and myosteatosis with the use of immune checkpoint inhibitors(ICIs)in patients with gastric cancer remain to be characterized.METHODS We performed a retrospective study of patients who were undergoing immuno-therapy for GC.For the evaluation of sarcopenia,the optimal cut-off value for the skeletal muscle index was established using receiver operating characteristic analysis of data obtained from pre-treatment computed tomography images at the L3 vertebral level.Myosteatosis was defined using the mean skeletal muscle density(SMD),with a threshold value of<41 Hounsfield units(HU)for patients with a body mass index(BMI)<25 kg/m^(2)and<33 HU for those with a BMI≥25 kg/m^(2).The log-rank test was used to compare progression-free survival(PFS)and overall survival(OS),and a Cox proportional hazard model was used to identify prognostic factors.Nomograms were developed to predict the PFS and OS of patients on the basis of the results of multivariate analyses.RESULTS We studied 115 patients who were undergoing ICI therapy for GC,of whom 27.4%had sarcopenia and 29.8%had myosteatosis.Patients with sarcopenia or myosteatosis had significantly shorter PFS and OS than those without these conditions.Furthermore,both sarcopenia and myosteatosis were found to be independent predictors of PFS and OS in patients with GC administering an ICI.The prediction models created for PFS and OS were associated with C-indexes of 0.758 and 0.781,respectively.CONCLUSION The presence of sarcopenia or myosteatosis is a reliable predictor of the clinical outcomes of patients with GC who are undergoing treatment with an ICI.
文摘BACKGROUND Sarcopenia is a progressively diminishing state characterized by the reduction of muscle mass and density,which is frequently observed in malignancies of solid organs.AIM To assess how sarcopenia affects the overall survival of individuals who have been diagnosed with metastatic gastric cancer.METHODS The study retrospectively included individuals who had been diagnosed with metastatic gastric cancer between January 2008 and December 2020.Sarcopenia was identified through the calculation of the average Hounsfield units(HUAC)using computed tomography(CT)images taken at the time of diagnosis in patients.RESULTS A total of 118 patients with metastatic gastric cancer were evaluated.Sarcopenia was detected in 29 patients(24.6%).The median survival of all patients was 8(1-43)mo.The median survival of patients with sarcopenia was 2 mo,while it was 10 mo for those without sarcopenia(P<0.001).A significant relationship was found between sarcopenia and survival.CONCLUSION Sarcopenia has been observed to impact survival outcomes in various types of solid tumor cancers.Sarcopenic patients can be identified in a short time,easily and inexpensively,by HUAC measurements from CT images used for diagnosis,and survival could be promoted with nutritional support.
文摘Sarcopenia reflects patient frailty and should be routinely assessed due to its high prevalence in cirrhotic patients awaiting liver transplants.Pre-transplant nutritional optimization should be tailored for patients with a definitive diagnosis of sarcopenia,therefore improving functional status at transplant and reducing posttransplant mortality.Hepatologists and transplant surgeons should have raised awareness regarding sarcopenia and the reflected frailty that hinder posttransplant outcomes.The policymakers should also take into account when modifying the organ allocation model that sarcopenia or frailty might become a decisive factor in allocating organs for cirrhotic patients,in order to ensure post-transplant survival and quality of life.
文摘The prevalence of metabolic-associated fatty liver disease(MAFLD)has increased substantially in recent years because of the global obesity pandemic.MAFLD,now recognized as the number one cause of chronic liver disease in the world,not only increases liver-related morbidity and mortality among sufferers but also worsens the complications associated with other comorbid conditions such as cardiovascular disease,type 2 diabetes mellitus,obstructive sleep apnoea,lipid disorders and sarcopenia.Understanding the interplay between MAFLD and these comorbidities is important to design optimal therapeutic strategies.Sarcopenia can be either part of the disease process that results in MAFLD(e.g.,obesity or adiposity)or a consequence of MAFLD,especially in the advanced stages such as fibrosis and cirrhosis.Sarcopenia can also worsen MAFLD by reducing exercise capacity and by the production of various muscle-related chemical factors.Therefore,it is crucial to thoroughly understand how we deal with these diseases,especially when they coexist.We explore the pathobiological interlinks between MAFLD and sarcopenia in this comprehensive clinical update review article and propose evidence-based therapeutic strategies to enhance patient care.
文摘Objectives: In this study, bibliometric approach was used to explore the literature in the field of research related to Diabetic Myasthenia Gravis in order to identify the current research progress in Diabetic Myasthenia Gravis related research and to help the researchers to predict the future hotspots in the field of research and to provide reference for the research. Methods: Literature related to diabetic sarcopenia published from 1993 to 2023 since the inception of the repository was extracted from the Web of Science Core Collection (WoSCC) and bibliometric analyses were performed. We have analysed the published literature of the last approximately almost 30 years, as well as publication and citation analyses from different countries, institutions, journals and authors. For keywords, we performed co-occurrence, clustering, timeline view and citation burst analysis. Results: On the basis of 1564 publications, we found a continuous increase in the number of publications and citations, especially in the last six years. The United States is the most representative country, and Seoul National University (SNU) is the most representative institution. The most popular journal in the field is Diabetes Care;Fukui, Michiaki is the most prolific author, leading many studies related to diabetic sarcopenia. The most frequently cited reference was a revised European consensus on the definition and diagnosis of sarcopenia;the most cited keywords were related to physiological factors of diabetes, sarcopenia and related conditions, such as “insulin resistance”, “skeletal muscle”, “body composition”, “risk” and “prevalence”. Conclusion: With more and more studies on the relationship between diabetic sarcopenia, this study presents the current status and trend of research related to diabetic sarcopenia over the past nearly 30 years through the visualization software CiteSpace. It can help researchers identify potential collaborators and partner institutions, hotspots and research frontiers in the field of diabetic sarcopenia. However, our work is only based on the English language literature in the WoSCC database, and for future studies, we recommend that researchers explore the literature from multiple databases to enhance the scope of their research.
文摘In recent years, sarcopenia, as a progressive muscular atrophy and weakness, has become one of the common diseases in the elderly. Although its cause is not fully understood, a growing body of research suggests that epigenetic mechanisms play an important role in the pathogenesis of sarcopenia. The purpose of this review is to summarize the current research progress in the epigenetics of sarcopenia, focusing on the role of DNA methylation, RNA methylation and non-coding RNA in the pathogenesis of sarcopenia. While exploring the epigenetic mechanism of sarcopenia, this study will also look into the application prospect of epigenetics in the treatment strategy of sarcopenia, which will provide new ideas and directions for the treatment of sarcopenia.
文摘BACKGROUND Nonalcoholic fatty liver disease(NAFLD)includes a spectrum of conditions,progressing from mild steatosis to advanced fibrosis.Sarcopenia,characterized by decreased muscle strength and mass,shares common pathophysiological traits with NAFLD.An association exists between sarcopenia and increased NAFLD prevalence.However,data on the prevalence of sarcopenia in NAFLD and its impact on the outcomes of NAFLD remain inconsistent.AIM To analyze the prevalence and outcomes of sarcopenia in patients with NAFLD.METHODS We conducted a comprehensive search for relevant studies in MEDLINE,Embase,and Scopus from their inception to June 2023.We included studies that focused on patients with NAFLD,reported the prevalence of sarcopenia as the primary outcome,and examined secondary outcomes,such as liver fibrosis and other adverse events.We also used the Newcastle-Ottawa scale for quality assessment.RESULTS Of the 29 studies included,the prevalence of sarcopenia in NAFLD varied widely(1.6%to 63.0%),with 20 studies reporting a prevalence of more than 10.0%.Substantial heterogeneity was noted in the measurement modalities for sarcopenia.Sarcopenia was associated with a higher risk of advanced fibrosis(odd ratio:1.97,95%confidence interval:1.44-2.70).Increased odds were consistently observed in fibrosis assessment through biopsy,NAFLD fibrosis score/body mass index,aspartate aminotransferase to alanine aminotransferase ratio,diabetes(BARD)score,and transient elastography,whereas the fibrosis-4 score showed no such association.Sarcopenia in NAFLD was associated with a higher risk of steatohepatitis,insulin resistance,cardiovascular risks,and mortality.CONCLUSION This systematic review highlights the critical need for standardized diagnostic criteria and measurement methods for sarcopenia in NAFLD patients.The variability in study designs and assessment methods for sarcopenia and liver fibrosis may account for the inconsistent findings.This review demonstrates the multidimensional impact of sarcopenia on NAFLD,indicating its importance beyond liver-related events to include cardiovascular risks,mortality,and metabolic complications.
文摘Sarcopenia,or muscle loss,has been one of the hot topics in the medical field in recent years.Due to limited attention and effective treatments for sarcopenia in the past,many patients,especially the elderly,suffered irreversible damage to their motor function caused by sarcopenia.However,recent scientific studies have found that the occurrence and development of sarcopenia are closely related to the function and quantity of muscle satellite cells.This article briefly discusses the relationship between muscle satellite cells and sarcopenia.
基金Natural Science Foundation of Anhui Province,No.2108085MH301The Key Project of University Research Found of Anhui Province Education Department,No.2022AH040189.
文摘BACKGROUND Skeletal muscle abnormalities,such as muscle mass depletion(sarcopenia)and fatty infiltration of the muscle(myosteatosis),are frequent complications in cirrhotic patients scheduled for transjugular intrahepatic portosystemic shunt(TIPS).AIM To investigate the association and predictive value of sarcopenia and myosteatosis for overt hepatic encephalopathy(HE)and mortality after TIPS.METHODS The records of cirrhotic patients who underwent the TIPS procedure at our hospital between January 2020 and June 2021 were retrospectively retrieved.The transversal psoas muscle thickness(TPMT)and psoas muscle attenuation(PMA)measured from the unenhanced abdominal computed tomography(CT)at the level of the third lumbar vertebrae were used to analyze the sarcopenia and myosteatosis,respectively.The area under curve(AUC)was used to evaluate the discriminative power of TPMT,PMA,and relevant clinical parameters.Furthermore,log-rank test was performed to compare the incidence of overt HE and survival between the different groups,and the association of risk factors with overt HE and mortality was analyzed using Cox proportional hazards regression models.RESULTS A total of 108 patients were collected.Among these patients,45.4%of patients developed overt HE after TIPS treatment.Furthermore,32.4%and 28.7%of these patients were identified to have myosteatosis and sarcopenia,respectively.Myosteatosis(51.0%vs 16.9%,P<0.001)and sarcopenia(40.8 vs 18.6%,P=0.011)were found to be more frequent in patients with overt HE,when compared to patients without overt HE.The receiver operating characteristics analysis indicated that the predictive power of TPMT and PMA in overt HE(AUC=0.713 and 0.778,respectively)was higher when compared to the neutrophil lymphocyte ratio(AUC=0.636).The cumulative incidence of overt HE was the highest in patients with concomitant sarcopenia and myosteatosis,followed by patients with myosteatosis or sarcopenia,while this was the lowest in patients without sarcopenia and myosteatosis.In addition,sarcopenia and myosteatosis were independently associated with overt HE and mortality after adjusting for confounding factors in post-TIPS patients.CONCLUSION CT-based estimations for sarcopenia and myosteatosis can be used as reliable predictors for the risk of developing overt HE and mortality in cirrhotic patients after TIPS.
文摘Liver cirrhosis is commonly associated with nutritional alterations,reported in 20% of patients with compensated disease and over 60% of patients with decompensated cirrhosis.Nutritional disturbances are associated with a worse prognosis and increased risk of complication.Serum levels of branched-chain amino acids(BCAAs)are decreased in patients with liver cirrhosis.The imbalance of amino acids levels has been suggested to be associated with the development of complications,such as hepatic encephalopathy and sarcopenia,and to affect the clinical presentation and prognosis of these patients.Several studies investigated the efficacy of BCAAs supplementation as a therapeutic option in liver cirrhosis,but uncertainties remain about the real efficacy,the best route of administration,and dosage.
基金supported by Grant National Key R&D Program of China (No.2020YFC2005600 and No.2020YFC2005605)。
文摘Objective: The aim of this study was to investigate the prevalence of sarcopenia(SP) and its relationship with gut microbiota alterations in patients with hematological diseases before and after hematopoietic stem cell transplantation(HSCT).Methods: A total of 108 patients with various hematological disorders were selected from Peking University People’s Hospital. SP was screened and diagnosed based on the 2019 Asian Sarcopenia Diagnosis Strategy. Physical measurements and fecal samples were collected, and 16S rRNA gene sequencing was conducted. Alpha and beta diversity analyses were performed to evaluate gut microbiota composition and diversity.Results: After HSCT, significant decreases in calf circumference and body mass index(BMI) were observed,accompanied by a decline in physical function. Gut microbiota analyses revealed significant differences in the relative abundance of Enterococcus, Bacteroides, Blautia and Dorea species before and after HSCT(P<0.05). Before HSCT, sarcopenic patients had lower Dorea levels and higher Phascolarctobacterium levels than non-sarcopenia patients(P<0.01). After HSCT, no significant differences in species abundance were observed. Alpha diversity analysis showed significant differences in species diversity among the groups, with the highest diversity in the postHSCT 90-day group and the lowest in the post-HSCT 30-day group. Beta diversity analysis revealed significant differences in species composition between pre-and post-HSCT time points but not between SP groups. Linear discriminant analysis effect size(LEfSe) identified Alistipes, Rikenellaceae, Alistipes putredinis, Prevotellaceae defectiva and Blautia coccoides as biomarkers for the pre-HSCT sarcopenia group. Functional predictions showed significant differences in anaerobic, biofilm-forming and oxidative stress-tolerant functions among the groups(P<0.05).Conclusions: This study demonstrated a significant decline in physical function after HSCT and identified potential gut microbiota biomarkers and functional alterations associated with SP in patients with hematological disorders. Further research is needed to explore the underlying mechanisms and potential therapeutic targets.
文摘Aging is characterized by the gradual deterioration of function at the molecular,cellular,tissue,and organism levels in humans.The typical diseases caused by changes in body composition,as well as functional decline in the human body’s organs due to aging include sarcopenia and metabolic disorders.The accumulation of dysfunctional agingβcells with age can cause decreased glucose tolerance and diabetes.Muscle decline has a multifactorial origin,involving lifestyle habits,disease triggers,and age-dependent biological changes.The reduced function ofβcells in elderly people lowers insulin sensitivity,which affects protein synthesis and interferes with muscle synthesis.The functional decrease and aggravation of disease in elderly people with less regular exercise or physical activity causes imbalances in food intake and a continuous,vicious cycle.In contrast,resistance exercise increases the function ofβcells and protein synthesis in elderly people.In this review,we discuss regular physical activities or exercises to prevent and improve health,which is sarcopenia as decreased muscle mass and metabolic disorders as diabetes in the elderly.
文摘Although the frequency of metabolic risk factors for cirrhosis and hepatocellular carcinoma(HCC)is increasing,chronic hepatitis B(CHB)and chronic hepatitis C(CHC)remain the most relevant risk factors for advanced liver disease worldwide.In addition to liver damage,hepatitis B virus(HBV)and hepatitis C virus(HCV)infections are associated with a myriad of extrahepatic manifestations including mixed cryoglobulinaemia,lymphoproliferative disorders,renal disease,insulin resistance,type 2 diabetes,sicca syndrome,rheumatoid arthritislike polyarthritis,and autoantibody production.Recently,the list has grown to include sarcopenia.Loss of muscle mass or muscle function is a critical feature of malnutrition in cirrhotic patients and has been found in approximately 23.0%-60.0%of patients with advanced liver disease.Nonetheless,among published studies,there is significant heterogeneity in the aetiologies of hepatic diseases and measurement methods used to determine sarcopenia.In particular,the interaction between sarcopenia,CHB and CHC has not been completely clarified in a real-world setting.Sarcopenia can result from a complex and multifaceted virus-host-environment interplay in individuals chronically infected with HBV or HCV.Thus,in the present review,we provide an overview of the concept,prevalence,clinical relevance,and potential mechanisms of sarcopenia in patients with chronic viral hepatitis,with an emphasis on clinical outcomes,which have been associated with skeletal muscle loss in these patients.A comprehensive overview of sarcopenia in individuals chronically infected with HBV or HCV,independent of the stage of the liver disease,will reinforce the necessity of an integrated medical/nutritional/physical education approach in the daily clinical care of patients with CHB and CHC.
基金Zhejiang Province Traditional Chinese Medicine Science and Technology Project,No.2023ZR075.
文摘BACKGROUND Observational studies have suggested that depression is associated with sarcopenia.However,the causal relationship between depression and sarcopenia remains unclear.AIM To investigate the causal relationship between depression and sarcopenia.METHODS We performed a Mendelian randomization(MR)analysis to identify the bidirectional relationship between depression and sarcopenia-related traits.Summarylevel data and independent variants used as instrumental variables came from large genome-wide association studies of depression(414055 cases and 892299 controls),of appendicular lean mass(ALM,450243 participants),and of hand grip strength(exposure:360000 participants;outcome:334925 participants).RESULTS We identified a negative association of depression with lower ALM[odds ratio(OR):0.932,95%confidence interval(95%CI):0.889-0.979,P=0.005].In the reverse MR analysis,we also observed an inverse association of hand grip strength with depression(OR:0.200,95%CI:0.108-0.370,P<0.001).Similar results were obtained in sensitivity analyses.CONCLUSION Depression was causally related to decreased muscle mass,and declined muscle strength might lead to a higher risk of depression.
基金This work was supported by the Science Research Foundation of Yunnan Provincial Department of Education(No.2022Y862).
文摘Sarcopenia is a common complication of malnutrition.Patients with colorectal cancer are prone to secondary sarcopenia due to nutrient absorption,intestinal obstruction,metabolic disorders and other reasons.Nutritional status not only participates in the body’s normal function but also has an important impact on anti-tumor treatment.More and more evidence shows that sarcopenia has a negative effect on the treatment and prognosis of colorectal cancer.This article summarizes the related research,such as the influence of sarcopenia on the treatment of colorectal cancer.To evaluate the clinical value of sarcopenia in treating colorectal cancer and provide new ideas for the comprehensive treatment of sarcopenia in patients with colorectal cancer.
文摘Objective:To investigate the impact of sarcopenia on the prognosis of frail elderly patients with chronic kidney disease.Methods:A total of 98 elderly frail patients with chronic kidney disease were included in this study from June 2020 to July 2022.The patients were randomly divided into a study group of 48 cases and a control group of 50 cases.The control group only received conventional treatment for chronic kidney disease.On the basis of conventional treatment for chronic kidney disease,the study group added sarcopenia intervention treatment.The quality-of-life scores,muscle mass and muscle strength,renal function,and incidence of complications of the two groups were observed and analyzed.Results:The quality-of-life score,muscle mass and muscle strength,and renal function of the study group were significantly better than those of the control group(P<0.05);the incidence of complications in the study group was 12.5%,which was significantly lower than that of the control group 36%of the group(P<0.05).Conclusion:There is a close relationship between sarcopenia and frail elderly patients with chronic kidney disease.Sarcopenia will further aggravate the frailty symptoms and increase the risk of complications in elderly patients with chronic kidney disease.For elderly patients with chronic kidney disease,sarcopenia should be screened and intervened as early as possible to improve the prognosis and quality of life of the patients.
