ObjectiveTo explore the value of sarcopenia index (SI) in the diagnosis of malnutrition in colorectal cancer patients.MethodsA retrospective study was carried out to study on 126 colorectal cancer patients who underwent chemotherapy in West China Hospital of Sichuan University between January 2015 and June 2019. SI and body mass index (BMI) were used for malnutrition diagnosis, and the detection rate of malnutrition was compared.ResultsThe detection rate of malnutrition diagnosed by SI (92.1%) was higher than that by BMI (38.1%) with a statistical difference (P<0.001). Subgroup analysis showed: the detection rate of malnutrition diagnosed by SI vs. BMI in male patients was 97.0% vs. 28.4%, with a statistical difference (P<0.001), and that in female patients was 86.4% vs. 49.2%, with a statistical difference (P<0.001); the detection rate of malnutrition diagnosed by SI vs. BMI in elderly patients (≥65 years) was 92.6% vs. 27.8%, with a statistical difference (P<0.001), and that in young and middle-aged patients (<65 years) was 91.7% vs. 45.8%, with a statistical difference (P<0.001).ConclusionUsing SI to diagnose malnutrition for colorectal cancer patients is worth popularizing for it can discover hidden malnutrition patients.
ObjectiveTo conduct a Mendelian randomization (MR) analysis to elucidate the potential causal relationship between sarcopenia (SA) and knee osteoarthritis (KOA). MethodsThree SA-related traits were selected as exposure factors from the summary data of the genome-wide association studies database (IEU GWAS). KOA and hospital-diagnosed osteoarthritis of the knee (osteoarthritis of the knee hospital diagnosed) were chosen as outcome factors. The inverse variance-weighted (IVW) method was employed as the primary analytical approach to evaluate the causal relationship between SA and KOA. Heterogeneity tests, sensitivity analyses, and pleiotropy analyses were conducted to validate the reliability of the results. ResultsThe MR results indicated a substantial causal relationship between genetically predicted appendicular muscle mass (OR=1.079, 95%CI 1.015 to 1.147, P=0.015 5), walking speed (OR=0.157, 95%CI 0.101 to 0.248, P<0.001). No significant causal relationship was found between grip strength and KOA (OR=1.318, 95%CI 0.933 to 1.859, P=0.116 6), and the sensitivity analysis results did not exhibit horizontal pleiotropy. ConclusionSA may have a causal relationship with KOA, and appendicular muscle mass and walking speed may be risk factors for the occurrence and development of KOA.
Senile sarcopenia has become a prominent problem affecting the normal life and self-care ability of the elderly. More attention to the research on senile sarcopenia is conducive to its prevention and treatment. This article states information details about the epidemiology, influencing factors and mechanism, clinical manifestations and diagnostic criteria, evaluation methods and rehabilitation therapy, so as to provide reference for research on elderly sarcopenia.
Objective
To evaluate the efficiency and security of physical exercise with low intensity against malnutrition and sarcopenia in patients with cirrhosis.
Methods
Between December 2014 and October 2015, 37 patients with cirrhosis were divided into two groups according to their willings, with 19 in the exercise group and 18 in the control group. Endurance of the exercise for 3 months were recorded. Mid-arm circumference, " up and go” time, width of portal vein and Child-Pugh score were compared before and after the research between the two groups.
Results
Three months later, the mid-arm circumference and the " up and go” time of the exercise group [(33.99±2.15) cm, (9.17±0.35) s] were better than those before the exercise [(32.09±2.58) cm, (9.77±0.46) s] and those in the control group [(31.93±2.04) cm, (9.76±0.30) s], and the differences above were all statistically significant (P<0.05). The change of the width of portal vein was positively correlated with pre-exercise body mass index in overweight patients (r=0.93, P=0.007).
Conclusions
Physical exercise with low intensity is safe and effective against malnutrition and sarcopenia in patients with cirrhosis. Overweitht patiens or malnutrition at the early stage may benefit more.
Sarcopenia, a skeletal muscle degenerative condition, is inextricably linked to the physiological processes of aging. Sarcopenia is characterized by a reduction in muscle mass, a decline in muscle strength, and/or deterioration of physical function. Comprehensive interventions are essential for the management of sarcopenia. The team from the National Clinical Research Center for Geriatrics has authored the "Comprehensive intervention for sarcopenia among older adults: an evidence-based clinical practice guideline" which discuss the specific contents of exercise, nutrition, and drug interventions for sarcopenia. This article provides a comprehensive interpretation of the guideline to facilitate their dissemination, promotion, and application.
Elderly patients with chronic kidney disease not only suffer from senescence-related muscle strength decline, but also exist muscle attenuation caused by chronic kidney disease. Sarcopenia of this group are more obvious, and falls, incapacity, weakness and death caused by sarcopenia are more prominent. At present, clinicians’ understanding of sarcopenia is still in the aspects of concept popularization and basic research, and there is a lack of practical diagnosis and treatment process and clinical prevention and treatment practice. Starting from the evolution of the definition of sarcopenia, this paper elaborates on the characteristics of sarcopenia in elderly patients with chronic kidney disease, as well as the exercise rehabilitation of sarcopenia in elderly patients with chronic kidney disease, in order to improve the attention and understanding of renal colleagues on sarcopenia in elderly people with chronic kidney disease.
Sarcopenia, a skeletal muscle degenerative condition, is inextricably linked to the physiological processes of aging. Sarcopenia is characterized by a reduction in muscle mass, a decline in muscle strength, and/or deterioration of physical function. Comprehensive interventions are essential for the management of sarcopenia. This patient version of guideline has been developed by adapting the " Comprehensive intervention for sarcopenia among older adults: an evidence-based clinical practice guideline." This patient version of guideline is designed to enhance health education and promote the widespread adoption of comprehensive intervention strategies for sarcopenia.
ObjectiveTo evaluate the quality differences in recommendations generated by large language models (LLM) and clinical practitioners for sarcopenia-related questions. MethodsA sarcopenia knowledge base was constructed based on the latest domestic and international research and consensus guidelines. Using the Python environment, a locally deployed and sarcopenia-focused hybrid vertical LLM (referred to as LC) was implemented via LangChain-LLM. Eight fixed questions covering etiology, diagnosis, and prevention were selected, along with eight virtual patient cases. The evaluation team assessed the quality of answers generated by LC and written by clinical practitioners. Quantitative analysis was performed on the precision, recall, and F1 scores (harmonic mean of precision and recall) of treatment recommendations. ResultsThe responses were generally perceived as "possibly written by humans or AI", with a stronger inclination toward being AI-generated, although the accuracy of such judgments was low. Regarding answer quality attributes, LC's responses were superior to those of clinical practitioners in guideline consistency (P<0.01), exhibited similar acceptability (P>0.05), showed better practicality (P<0.05), and had a lower proportion of "1–2 errors" (P<0.05). Quantitative analysis of treatment recommendations indicated that LC and GPT-4.0 outperformed clinical practitioners in recall and F1 scores (P<0.05), with minimal differences between LC and GPT-4.0. ConclusionThe locally deployed sarcopenia-focused hybrid vertical LLM demonstrates high accuracy and applicability in addressing sarcopenia-related issues, outperforming clinical practitioners and exhibiting strong clinical decision-support capabilities.
ObjectiveTo systematically review the correlation between sarcopenia and cognitive dysfunction. MethodsCNKI, WanFang Data, PubMed, EMbase and Web of Science databases were electronically searched to collect studies on the correlation between sarcopenia and cognitive dysfunction from inception to June 15, 2022. Two reviewers independently screened the literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed by using RevMan 5.3 and Stata 14.0 software. ResultsA total of 13 studies involving 19 262 subjects were included. Meta-analysis showed that the cognitive dysfunction was significantly associated with sarcopenia (OR=1.82, 95%CI 1.58 to 2.11, P<0.01). The results of subgroup analysis showed that the cognitive dysfunction was significantly associated with sarcopenia in Asia and Europe. However, the incidence of cognitive dysfunction in the Americas was not significantly associated with sarcopenia. ConclusionCurrent evidence shows that there is a significant correlation between sarcopenia and cognitive dysfunction, but there may be differences in different regions. Due to the limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.
ObjectiveTo explore the changes of serum irisin in maintenance hemodialysis (MHD) patients with sarcopenia.MethodsFrom January to June 2019, 56 MHD patients from Shanxi Provincial People’s Hospital were selected. Judging by the results of body composition analyzer, the MHD patients were divided into the sarcopenia group (n=31) and the non-sarcopenia group (n=25). The serum irisin level was detected by enzyme-linked immunosorbent assay. The muscle cross-sectional area at the third lumbar level was measured by CT. SPSS 21.0 software was used for inter-group comparison, correlation analysis, and regression analysis.ResultsThe serum irisin concentration in the sarcopenia group was lower than that in the non-sarcopenia group [medium (lower quartile, upper quartile): 175.46 (126.00, 220.52) vs. 459.10 (233.83, 616.91) pg/mL; Z=?4.195, P<0.001]. The results of Spearman correlation analysis showed that serum irisin level was positively correlated with lean tissue index (rs=0.265, P=0.048), however negatively correlated with serum creatinine level (rs=?0.311, P=0.020). The results of logistic regression analysis showed that serum irisin level [odds ratio (OR)=0.957, 95% confidence interval (CI) (0.925, 0.990), P=0.012], walking speed [OR=0.000, 95%CI (0.000, 0.050), P=0.031], and grip strength [OR=0.658, 95%CI (0.434, 0.997), P=0.048] were protective factors of sarcopenia in MHD patients.ConclusionsThe level of circulating irisin in MHD patients with sarcopenia is lower than that in MHD patients without sarcopenia. Irisin is a protective factor of sarcopenia in MHD patients.
