Objective This study aims to investigate the joint associations of sarcopenia and social isolation with mortality risk.Methods Using data from the Chinese Longitudinal Healthy Longevity Survey(CLHLS)and the UK Biobank...Objective This study aims to investigate the joint associations of sarcopenia and social isolation with mortality risk.Methods Using data from the Chinese Longitudinal Healthy Longevity Survey(CLHLS)and the UK Biobank,sarcopenia was diagnosed according to European and Asian Working Groups for Sarcopenia criteria.Social isolation was assessed using standardized questionnaires,including questions on solitude,frequency of social activities,contact with others,and marital status(for the CLHLS only).Results During the follow-up period,8,249 deaths occurred in the CLHLS and 26,670 deaths in the UK Biobank groups.While no significant interaction was observed between sarcopenia and social isolation in predicting all-cause mortality in the CLHLS cohort,the association between social isolation and mortality was stronger among individuals with sarcopenia in the UK Biobank(P-interaction=0.03,relative risk due to interaction:0.23,95%confidence interval[CI]:0.06–0.41).Further joint analyses showed that participants with sarcopenia and high levels of social isolation had the highest mortality risk(hazard ration[HR]:1.99;95%CI:[1.74–2.28]in the CLHLS and 1.69[1.55–1.85]in the UK Biobank)compared to those without either condition.Conclusion The combination of social isolation and sarcopenia synergistically increases the risk of mortality in middle-aged and older adults across diverse populations.展开更多
Background:Previous studies have highlighted the frequent occurrence of sarcopenia in patients with pancreatic diseases,including chronic pancreatitis.We aimed to clarify the prevalence of skeletal muscle(SM)loss and ...Background:Previous studies have highlighted the frequent occurrence of sarcopenia in patients with pancreatic diseases,including chronic pancreatitis.We aimed to clarify the prevalence of skeletal muscle(SM)loss and sarcopenia,and their associations with clinical characteristics,bone mineral density,and pancreatic imaging findings in patients with autoimmune pancreatitis(AIP).Methods:This study included 114 patients with AIP treated at Tohoku University Hospital.The SM index was assessed using a bioelectrical impedance analysis device,grip strength was measured using a hand dynamometer,and bone mineral density was evaluated using dual-energy X-ray absorptiometry.Univari-ate and multivariate logistic regression analyses were used to analyze factors associated with SM loss and sarcopenia.Results:Among 114 patients,57(50.0%)had SM loss,31(27.2%)had reduced grip strength,and 27(23.7%)had both.Patients with SM loss were older and had a lower body mass index,weaker grip strength,higher Controlling Nutritional Status scores,and lower serum lipase and albumin levels compared to those without SM loss.Computed tomography scans revealed a higher prevalence of pancreatic parenchy-mal atrophy in patients with SM loss.Similar differences were observed between patients with sarcopenia and those without.Osteopathy was observed in 35.6%of patients with SM loss and 38.1%of those with sarcopenia,whereas only 4.1%of patients without SM loss had osteopathy.Low BMI(<21.0 kg/m^(2))was also found to be an independent risk factor for SM loss in multivariate analysis.Age>72 years,low BMI(<20.0 kg/m^(2)),and low serum lipase levels(<13 U/L)were independent risk factors for sarcopenia in multivariate analysis.Conclusions:SM loss and sarcopenia are prevalent in patients with AIP and are associated with aging,poor nutritional status,low serum lipase levels,and pancreatic parenchymal atrophy.In addition to the high risk of osteopathy,careful attention should be paid to maintain muscle health in AIP patients.展开更多
Irisin is a chief myokine released during physical activity and has garnered attention for its potential therapeutic effects on different metabolic and cardiovascular disorders.This review explores the intricate conne...Irisin is a chief myokine released during physical activity and has garnered attention for its potential therapeutic effects on different metabolic and cardiovascular disorders.This review explores the intricate connections between irisin,physical activity,sarcopenia,type 2 diabetes mellitus(T2DM),and cardiovascular complications.Experimental data suggests that through irisin release,physical activity positively influences muscle health,metabolic regulation,and cardiovascular function.In individuals with sarcopenia,characterized by progressive muscle mass and function loss,irisin plays a pivotal role in maintaining muscle integrity and function.Additionally,irisin’s beneficial effects on insulin sensitivity and glucose metabolism suggest its involvement in the pathophysiology of T2DM.The review will examine how irisin may modulate the development of cardiovascular complications,particularly in the context of diabetes and aging.Additionally,it will explore its potential as a therapeutic target for managing sarcopenia,T2DM,and cardiovascular complications,underscoring the importance of physical activity in mitigating these interconnected health challenges.Further research is needed to elucidate the precise mechanisms by which irisin mediates these effects and assess its clinical applicability in preventing and treating metabolic and cardiovascular disorders.展开更多
Introduction:Diet intervention,especially supplementation with high-quality protein,is considered to be a critical strategy in sarcopenia.However,different sources and types of protein have different health impacts.Ob...Introduction:Diet intervention,especially supplementation with high-quality protein,is considered to be a critical strategy in sarcopenia.However,different sources and types of protein have different health impacts.Objectives:The aim of this study is to explore the differences in the ameliorative effects and mechanisms of different sources and types of proteins on sarcopenia,providing an optimal path for the prevention and treatment of sarcopenia.Methods:A sarcopenia model was established by intraperitoneal injection of dexamethasone(5 mg/kg).Sixty male C57BL/6 mice(8 months old)were randomly divided into the normal control,sarcopenia,goat whey protein,goat milk casein,bovine whey protein,and bovine milk casein groups.Animals were treated for 8 consecutive weeks.Organism-level and molecular phenotypes,16S rRNA gene sequencing,and untargeted metabolomics profiling based on GC-TOF/MS were employed to investigate the correlation between host metabolism,microbial metabolism,autophagy and inflammation and their influence on sarcopenia in C57BL/6 male mice.Results:All 4 proteins increased muscle mass,and goat whey protein improved muscle strength in sarcopenic mice.Goat and bovine milk proteins promoted muscle regeneration by increasing MyoD1 and MyoG expression,and the former had a more distinct effect in inducing autophagy and decreasing inflammation than the latter.In addition,goat whey protein and casein could modulate hostmicrobial arginine co-metabolism.Notably,goat milk proteins responded well to sarcopenia comorbidities,including sarcopenic obesity,osteosarcopenia,and osteoarthritis.Conclusion:The study confirmed that goat milk proteins were more effective than bovine milk proteins for the control of sarcopenia.Moreover,we found that whey protein and casein could modulate host-microbial arginine co-metabolism,which shows their potential as precision nutritional supplements for the management of sarcopenia.Our study provides theoretical support for the prevention and control of sarcopenia.展开更多
BACKGROUND The prevalence of sarcopenia progressively increases with as liver function deteriorates.Muscle wasting has been shown to independently predict adverse outcomes in liver cirrhosis patients.AIM To screen eff...BACKGROUND The prevalence of sarcopenia progressively increases with as liver function deteriorates.Muscle wasting has been shown to independently predict adverse outcomes in liver cirrhosis patients.AIM To screen effective biomarkers for sarcopenia in liver cirrhosis.METHODS Untargeted metabolomics were performed on serum from 62 liver cirrhosis patients,including 41 with sarcopenia and 21 without sarcopenia.Candidate metabolite biomarkers were screened based on three machine-learning algorithms.The diagnostic or predictive value of potential biomarkers was evaluated by drawing receiver operating characteristic curves.RESULTS A total of 60 differential metabolites between cirrhotic sarcopenia and the nonsarcopenia group were identied.Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis revealed differential metabolites primarily involved in glycerophospholipid metabolism,alpha-linolenic acid metabolism,retrograde endocannabinoid signaling,and choline metabolism in cancer.Finally,four potential biomarkers were screened through machine learning algorithms,namely N-Acetylcarnosine,2-Stearylcitrate,CerP(d18:1/12:0),and 3-Methyl-alpha-ionylacetate.Among these,N-Acetylcarnosine can provide better diagnostic accuracy.CONCLUSION This study unveiled different plasma metabolic profiles of liver cirrhosis patients with and without sarcopenia.These valuable biomarkers have the potential to improve the prognosis of liver patients with cirrhosis by early detection or prediction of sarcopenia.展开更多
We commend Worland et al for their work associating rifaximin-αuse with imp-roved muscle mass in individuals with liver cirrhosis.This observation adds momentum to the evolving gut-liver-muscle axis hypothesis.Howeve...We commend Worland et al for their work associating rifaximin-αuse with imp-roved muscle mass in individuals with liver cirrhosis.This observation adds momentum to the evolving gut-liver-muscle axis hypothesis.However,the retro-spective design and lack of functional outcomes invite caution in interpretation.Mechanistically,rifaximin may exert benefit beyond ammonia reduction through modulation of systemic inflammation,tumor necrosis factor alpha suppression,and restoration of myocyte integrity.Additionally,concerns about long-term anti-microbial resistance must be acknowledged.Overall,this study represents a valuable first step,but its implications require validation in future,prospective,mechanistically informed clinical trials.展开更多
Esophageal cancer is a highly aggressive malignancy often diagnosed at an advanced stage,with poor prognosis and high recurrence rates despite curative treatment.Accurate prognostic tools are urgently needed to guide ...Esophageal cancer is a highly aggressive malignancy often diagnosed at an advanced stage,with poor prognosis and high recurrence rates despite curative treatment.Accurate prognostic tools are urgently needed to guide personalized management strategies.Recent research has demonstrated significant potential of integrating quantitative imaging biomarkers,specifically radiomics and sarcopenia,with machine learning(ML)techniques to enhance outcome prediction.This review systematically summarizes six recent studies(2022-2024)exploring integrated ML models combining sarcopenia and radiomics biomarkers with clinical parameters to predict survival in patients with esophageal and gastroesophageal cancers.Sample sizes ranged from 83 to 243 patients,with studies utilizing various imaging modalities(positron emission tomography/computed tomography and computed tomography)and model analysis approaches,including Cox regression,random forest,and light gradient boosting machine.These models incorporated features such as skeletal muscle indices,tumor texture,and shape descriptors.Models that combined clinical data,radiomics,and sarcopenia outperformed those using single modalities.These findings support the utility of multimodal imaging biomarkers in developing robust,individualized prognostic models.However,the retrospective nature of most studies highlights the need for standardization and external validation.This review underscores the potential of multimodal ML-based models in enhancing personalized risk stratification and treatment planning for esophageal cancer.展开更多
With the aging global population,the decline in muscle mass and function among the elderly has emerged as a significant concern.This systemic progressive generalized loss of muscle function and mass is referred to as ...With the aging global population,the decline in muscle mass and function among the elderly has emerged as a significant concern.This systemic progressive generalized loss of muscle function and mass is referred to as sarcopenia(SP).In recent years,a growing number of studies have investigated SP,revealing that many tumor diseases,especially in the digestive system,promote its occurrence due to the influence of the disease itself,diet,and other factors.Moreover,SP patients tend to have poorer postoperative recovery.At present,many diagnostic methods have been developed for SP,but no unified standard has been established.Furthermore,the cutoff values of many diagnostic methods for different populations are still in the exploratory stage,and additional clinical studies are required to explore these issues.This article comprehensively and systematically summarizes the diagnostic methods and criteria mentioned in previous research,focusing on the impact of SP on post-surgical patients with various malignant tumors.展开更多
The prevalence of sarcopenia tends to be high in patients with biliopancreatic disease.Sarcopenia is a risk factor of poor prognosis in patients with acute and chronic pancreatitis and biliary tract and pancreatic can...The prevalence of sarcopenia tends to be high in patients with biliopancreatic disease.Sarcopenia is a risk factor of poor prognosis in patients with acute and chronic pancreatitis and biliary tract and pancreatic cancer.Several studies have suggested that sarcopenia may be a risk factor for perioperative complications and decreased recurrence-free or overall survival in patients with biliary tract and pancreatic cancer after surgery.Sarcopenia in biliary tract and pancreatic cancer may also increase chemotherapy-induced toxicities and worsen quality of life and survival in neoadjuvant or palliative chemotherapy.Moreover,sarcopenia is a risk factor for biliary stent occlusion in patients with malignant biliary obstruction,predictors of the efficacy of endoscopic ultrasound-guided celiac plexus neurolysis(EUS-CPN)for pain relief,EUS-guided drainage,and endoscopic necrosectomy for walled-off necrosis(WON).Diagnosis of sarcopenia prior to the treatment of biliopancreatic diseases and endoscopy may predict treatment efficacy,and appropriate nutritional and exercise therapy improve therapeutic outcomes of patients with biliopancreatic diseases.展开更多
BACKGROUND The impact of psychiatric disorder,especially depression,on the prognosis of sarcopenic patients is gaining prominence.Yet,there have been very few studies focusing on this issue,let alone the related targe...BACKGROUND The impact of psychiatric disorder,especially depression,on the prognosis of sarcopenic patients is gaining prominence.Yet,there have been very few studies focusing on this issue,let alone the related targeted mental health prevention.This cohort-based nested case-control study is geared to compare risk of depression and the depression-related ambulatory care utilization for sarcopenia persons with and without receiving add-on Chinese herbal medicines(CHMs)treatment.AIM To compare risk of depression and the depression-related ambulatory care utili-zation for sarcopenia persons with and without receiving add-on CHMs treat-ment.METHODS In the beginning,we recruited those aged 20-70 years with newly diagnosed sarcopenia and free of depression between 2002 and 2010 from a nationwide insurance database.From them,we identified cases with depression onset occurring after sarcopenia until December 31,2013.To cautiously isolate the effect of CHMs,we established the matched sets of treated and untreated subjects with CHMs use by randomly frequency matching.A conditional logistic regression was executed to explore the association of CHMs to depression risk,and the frequency and costs of depression-related ambulatory care were compared using Mann-Whitney U test.RESULTS Addition of CHMs to routine care of sarcopenia notably correlated with a lower risk of depression.A remarkable effect of CHMs in reducing depression was detected when sarcopenia subjects received CHMs for more than three years,lowering depression risk by as much as 65%.As compared to CHMs users,the non-CHMs users indeed incurred higher frequency and costs of depression-related ambulatory care after depression attack(P<0.05).Notably,the costs for per depression-related ambulatory care profoundly increased with the years after depression attack.CONCLUSION Sarcopenic patients can greatly benefit from add-on CHMs treatment,underscoring the urgent need for interdisciplinary collaboration and proactive treatment planning.展开更多
BACKGROUND Esophageal cancer is a common malignancy with high mortality.Radiotherapy is an important treatment.Sarcopenia affects patients'physical function and prog-nosis.However,the relationship between sarcopen...BACKGROUND Esophageal cancer is a common malignancy with high mortality.Radiotherapy is an important treatment.Sarcopenia affects patients'physical function and prog-nosis.However,the relationship between sarcopenia diagnosed by Chun-Hou Chen method for sarcopenia measurement and index(C3SMI)criteria and eso-phageal cancer prognosis after radiotherapy is unclear.AIM To explore the correlation between sarcopenia(SA)diagnosed based on C3SMI criteria and the prognosis of patients with esophageal cancer following radiothe-rapy.METHODS A retrospective analysis was conducted on the general clinical data of 131 eso-phageal cancer patients who received radiotherapy in the Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University from March 2021 to July 2024.Based on the presence of SA,the patients were assigned into two groups-the SA group and the non-SA group.Logistic regression analysis was used for investi-gating the risk factors influencing SA in esophageal cancer patients.Additionally,the patients were followed up,with their prognosis recorded.As per their prognostic outcomes,the patients were allocated into a good prognosis group and a poor prognosis group.The data of the two groups were compared.Using logistic regression analysis,the risk factors that may influence the prognosis of these patients were analyzed.SPSS 26.0 statistical software was introduced for analyzing the study data.Comparisons were made between groups using t-tests or χ_(2) tests based on the data type.RESULTS As revealed through logistic regression analysis,age[odds ratio(OR)=2.898,P=0.038],body mass index(OR=5.983,P=0.006),prealbumin(OR=6.253,P=0.003),and Karnofsky performance status score(OR=3.854,P=0.010)were independent risk factors impacting SA for esophageal cancer patients(P<0.05).Logistic regression analysis also found that age(OR=3.823,P=0.030),differentiation degree(OR=4.802,P=0.028),American Joint Committee on Cancer clinical staging(OR=3.732,P=0.013),alpha-fetoprotein level(OR=3.508,P=0.018),thrombospondin-1 level(OR=5.749,P=0.006),carcinoembryonic antigen level(OR=3.873,P=0.030),and SA(OR=3.593,P=0.017)were independent risk factors that may influence esophageal cancer patients'prognosis(P<0.05).CONCLUSION The presence of SA has a significant relation to the poor prognosis of esophageal cancer patients,which highlights the importance of assessing and intervening in SA in clinical management so as to improve patient prognosis.展开更多
Skeletal muscles perform important metabolic functions.Muscle mass wasting in sarcopenia is an urgent problem of modern medicine,the interest in which is related to its prognostic significance.The liver has numerous d...Skeletal muscles perform important metabolic functions.Muscle mass wasting in sarcopenia is an urgent problem of modern medicine,the interest in which is related to its prognostic significance.The liver has numerous direct and indirect metabolic and immune connections with skeletal muscle and disruptions of these connections in liver disease are of clinical interest.A recent article by Liang et al emphasized potential biomarkers of sarcopenia in liver cirrhosis.Identification of biomarkers of sarcopenia in patients with cirrhosis has important diagnostic value.Common pathophysiologic mechanisms of sarcopenia and liver cirrhosis include disorders of protein and energy metabolism,disturbances in the structure of gut microbiota,inflammation and oxidative stress.展开更多
BACKGROUND Sarcopenia is a clinical syndrome presented with progressive and generalized skeletal muscle loss and function dysfunction.Usually,it is considered an agerelated process influenced by genetic,lifestyle fact...BACKGROUND Sarcopenia is a clinical syndrome presented with progressive and generalized skeletal muscle loss and function dysfunction.Usually,it is considered an agerelated process influenced by genetic,lifestyle factors,and diseases.Obstructive jaundice is one of the most common pathophysiological changes in patients needing hepatobiliary or pancreatic operations that can adversely affect the tissue and organ function throughout the human body.However,the effects of obstructive jaundice on the occurrence of sarcopenia remain unclear.AIM To investigate the incidence of sarcopenia in patients with surgical obstructive jaundice and the association of sarcopenia with postoperative outcome.METHODS This cross-sectional study was conducted from December 2019 to January 2024.Data retrieved included patient demographics,disease entities,sarcopenia-related parameters(including grip strength,6-m walking time,and limb skeletal muscle mass index),postoperative complications,and length of hospital stay.Sarcopenia was confirmed using Asian Working Group standards.Logistic regression was used to analyze the relationship between total bilirubin level and sarcopenia.The factors influencing sarcopenia in patients with surgical obstructive jaundice and association of sarcopenia with postoperative complications were also investigated.RESULTS Overall,1708 patients met the inclusion criteria,with a mean age of 60.09±13.52 years(sex:52.28%male).There were 383 patients(22.42%)with obstructive jaundice and 1325(77.58%)without jaundice.Sarcopenia,low walking speed,low grip strength,and low limb skeletal muscle index were more prevalent in patients with obstructive jaundice than nonobstructive jaundice.The odds ratio(OR)for sarcopenia in patients with obstructive jaundice was 1.689[95%confidence interval(CI):1.295-2.203,P<0.001],indicating that jaundice is a significant risk factor for sarcopenia.The occurrence of sarcopenia was higher in patients with severe obstructive jaundice than mild obstructive jaundice(39.3%vs 22.8%,P<0.05).Obstructive jaundice was positively correlated with reduced walking speed(OR=1.627,95%CI:1.185-2.234,P=0.003)and decreased grip strength(OR=1.669,95%CI:1.212-2.300,P=0.002).Age(OR=1.077,95%CI:1.040-1.114,P<0.001)and body mass index(OR=0.703,95%CI:0.630-0.784,P<0.001)were independent risk factors of sarcopenia in patients with obstructive jaundice.Patients with obstructive jaundice and sarcopenia had a higher rate of postoperative complications(46.3%vs 33.1%,P=0.032),longer postoperative hospital stays(11.33±6.75 days vs 9.19±7.32 days,P=0.016),and longer total hospital stays(17.10±7.69 days vs 15.98±8.55 days,P=0.032)than those without sarcopenia.CONCLUSION Sarcopenia is more prevalent in patients with obstructive jaundice and is positively correlated with the degree of jaundice.Sarcopenia prolongs hospital stays and is associate with postoperative complications.展开更多
The etiology,risk factors,and management of sarcopenia and metabolic dysfunction-associated steatotic liver disease(MASLD)are comparable,which prompted the investigators to search for a particular diagnostic or progno...The etiology,risk factors,and management of sarcopenia and metabolic dysfunction-associated steatotic liver disease(MASLD)are comparable,which prompted the investigators to search for a particular diagnostic or prognostic biomarker that was involved in both disorders.Peptides or proteins known as myokines,or exerkines,are produced and secreted by contracted muscles.Myokines work similarly to hormones in their actions.One common clinical hallmark of sarcopenia and MASLD is physical inactivity,which is associated with alterations in the levels of myokines.Irisin is a positive regulator of muscle size that is elevated in the biological fluids during exercise.Significantly low levels were observed in the pathological conditions associated with physical inactivity.The serum levels of irisin are significantly higher in MASLD patients,while their levels were lower in risk factors of MASLD,e.g.,diabetes mellitus,obesity,and insulin resistance.In sarcopenia with obesity(sarcopenic obesity)or with a normal build,serum irisin levels are significantly lower than in healthy subjects.Therefore,serial determination of irisin levels that showed a transition from higher to lower levels in MASLD indicated the development of sarcopenia in those patients.展开更多
BACKGROUND Sarcopenia is prevalent among patients with end-stage liver disease(ESLD)and is associated with adverse outcomes both before and after liver transplantation(LT).Accurate assessment of muscle mass is essenti...BACKGROUND Sarcopenia is prevalent among patients with end-stage liver disease(ESLD)and is associated with adverse outcomes both before and after liver transplantation(LT).Accurate assessment of muscle mass is essential for effective risk stratification and optimization of transplant outcomes.AIM To identify imaging modalities used to assess sarcopenia in ESLD patients awaiting LT,and evaluate the clinical utility of each technique in predicting waitlist mortality,length of hospital stay,and post-transplant survival.METHODS A systematic search was conducted in PubMed,MEDLINE,EMBASE,and Scopus for studies published between May 2015 and May 2025.Eligible studies included original research evaluating sarcopenia using imaging techniques in ESLD patients listed for LT.Due to heterogeneity in study design,diagnostic criteria,and outcomes,data were synthesized qualitatively.RESULTS A total of 17 studies met the inclusion criteria,encompassing modalities such as computed tomography(CT),magnetic resonance imaging,dual-energy X-ray absorptiometry,and ultrasound.CT at the third lumbar vertebra level was most frequently used,exhibiting consistent prognostic values for pre-and post-transplant outcomes.However,considerable variability in cutoff values and sarcopenia definitions was observed.Emerging evidence also supports the prognostic relevance of muscle quality indicators,including muscle attenuation and fat infiltration.CONCLUSION CT and magnetic resonance imaging are the most robust imaging methods for sarcopenia diagnosis in patients with ESLD.Standardized diagnostic criteria incorporating muscle quality metrics are essential for improving prognostic accuracy and guiding clinical decision making in LT candidates.Such integration would also support the development of unified frameworks for sarcopenia assessment in transplantation practice.展开更多
The skeletal muscle is the largest organ present in the body and is responsible for mechanical activities like maintaining posture,movement,respiratory function,and support for the health and functioning of other syst...The skeletal muscle is the largest organ present in the body and is responsible for mechanical activities like maintaining posture,movement,respiratory function,and support for the health and functioning of other systems of the body.Skeletal muscle atrophy is a condition characterized by a reduction in muscle size,strength,and activity,which leads to an increased dependency on others for movement,an increased risk of falls,and a reduced quality of life.Various conditions like osteoarthritis,osteoporosis,and fractures are directly associated with increased muscle atrophy.Additionally,numerous risk factors,like aging,malnutrition,physical inactivity,and certain disease conditions,through distinct pathways,negatively affect skeletal muscle health and lead to muscle atrophy.Among various determinants of overall muscle health,the rate of muscle protein synthesis and degradation is an important parameter that eventually alters the fate of overall muscle health.In conditions of excessive skeletal muscle atrophy,including sarcopenia,the rate of muscle protein degradation usually exceeds the rate of protein synthesis.The availability of amino acids in the systemic circulation is a crucial step in muscle protein synthesis.The current review aims to consolidate the existing evidence on amino acids,highlight their mechanisms of action,and assess their roles and effectiveness in enhancing skeletal muscle health.展开更多
OBJECTIVE:To explore the potential molecular mechanism of Qigu capsule(芪骨胶囊,QGC) in the treatment of sarcopenia through network pharmacology and to verify it experimentally.METHODS:The active compounds of QGC and ...OBJECTIVE:To explore the potential molecular mechanism of Qigu capsule(芪骨胶囊,QGC) in the treatment of sarcopenia through network pharmacology and to verify it experimentally.METHODS:The active compounds of QGC and common targets between QGC and sarcopenia were screened from databases.Then the herbs-compounds-targets network,and protein-protein interaction(PPI) network was constructed.Gene ontology(GO) and Kyoto Encyclopedia of Genes and Genomes(KEGG) pathway enrichment analysis were performed by R software.Next,we used a dexamethasone-induced sarcopenia mouse model to evaluate the anti-sarcopenic mechanism of QGC.RESULTS:A total of 57 common targets of QGC and sarcopenia were obtained.Based on the enrichment analysis of GO and KEGG,we took the phosphatidylinositol 3-kinase(PI3K)/protein kinase B(Akt) signaling pathway as a key target to explore the mechanism of QGC on sarcopenia.Animal experiments showed that QGC could increase muscle strength and inhibit muscle fiber atrophy.In the model group,the expression of muscle ring finger-1 and Atrogin-1 were increased,while myosin heavy chain was decreased,QGC treatment reversed these changes.Moreover,compared with the model group,the expressions of pPI3K,p-Akt,p-mammalian target of rapamycin and pForkhead box O3 in the QGC group were all upregulated.CONCLUSION:QGC exerts an anti-sarcopenic effect by activating PI3K/Akt signaling pathway to regulate skeletal muscle protein metabolism.展开更多
Cirrhosis represents the end stage of chronic liver disease,significantly reducing life expectancy as it progresses from a compensated to a decompensated state,leading to serious complications.Recent improvements in m...Cirrhosis represents the end stage of chronic liver disease,significantly reducing life expectancy as it progresses from a compensated to a decompensated state,leading to serious complications.Recent improvements in medical treatment have created a shift in cirrhosis management.Various causes,including hepatitis viruses,alcohol consumption,and fatty liver disease,contribute to cirrhosis and are closely linked to liver cancer.The disease develops through hepatocyte necrosis and regeneration,resulting in fibrosis and sinusoidal capillarization,leading to portal hypertension and complications such as ascites,hepatic encephalopathy,and organ dysfunction.Cirrhosis also holds an increased risk of hepatocellular carcinoma.Diagnosing cirrhosis involves assessing fibrosis scores through blood tests and measuring liver stiffness through elastography.Liver transplantation is the definitive treatment for endstage liver disease and acute liver failure.展开更多
Intensive care unit(ICU)acquired sarcopenia and myosteatosis are increasingly recognized complications of critical illness,characterized by a rapid loss of ske-letal muscle mass,quality,and function.These conditions r...Intensive care unit(ICU)acquired sarcopenia and myosteatosis are increasingly recognized complications of critical illness,characterized by a rapid loss of ske-letal muscle mass,quality,and function.These conditions result from a complex interplay of systemic inflammation,immobilization,catabolic stress,mitochon-drial dysfunction,and immune dysregulation,often culminating in impaired recovery,prolonged hospitalization,and increased long-term mortality.First identified in survivors of sepsis and prolonged mechanical ventilation,these muscle abnormalities were initially described using computed tomography-based assessments of muscle area and density.Subsequent advances in imaging,biomarker discovery,and functional testing have enabled earlier detection and risk stratification across diverse ICU populations.While nutritional optimization and early mobilization form the cornerstone of current prevention and treatment strategies,the emergence of novel approaches,including automated artificial intelligence-based screening,neuromuscular electrical stimulation,and targeted pharmacologic therapies,has broadened the clinical scope of interventions.Despite their significant prognostic implications,ICU-acquired sarcopenia and myosteatosis remain under-recognized in routine critical care practice.This mini-review aims to synthesize current knowledge regarding their pathophysiology,available diagnostic modalities,prognostic relevance,and the evolving landscape of therapeutic strategies for long-term functional recovery in critically ill patients.展开更多
Rapid population aging has led to an increased focus on age-related conditions such as sarcopenia.causing loss of muscle mass and strength^([1,2]). Sarcopenia is associated with adverse outcomes,including falls, funct...Rapid population aging has led to an increased focus on age-related conditions such as sarcopenia.causing loss of muscle mass and strength^([1,2]). Sarcopenia is associated with adverse outcomes,including falls, functional decline, frailty, and mortality, which can lower the quality of life and shorten lifespan^([1,2]).展开更多
基金supported by grants from the National Key Research and Development Program of China(No.2023YFC3606300,No.2022YFC3600300)the National Natural Science Foundation of China(No.82325043)the National Key Research and Development Program of Hubei Province(2022BCA036)。
文摘Objective This study aims to investigate the joint associations of sarcopenia and social isolation with mortality risk.Methods Using data from the Chinese Longitudinal Healthy Longevity Survey(CLHLS)and the UK Biobank,sarcopenia was diagnosed according to European and Asian Working Groups for Sarcopenia criteria.Social isolation was assessed using standardized questionnaires,including questions on solitude,frequency of social activities,contact with others,and marital status(for the CLHLS only).Results During the follow-up period,8,249 deaths occurred in the CLHLS and 26,670 deaths in the UK Biobank groups.While no significant interaction was observed between sarcopenia and social isolation in predicting all-cause mortality in the CLHLS cohort,the association between social isolation and mortality was stronger among individuals with sarcopenia in the UK Biobank(P-interaction=0.03,relative risk due to interaction:0.23,95%confidence interval[CI]:0.06–0.41).Further joint analyses showed that participants with sarcopenia and high levels of social isolation had the highest mortality risk(hazard ration[HR]:1.99;95%CI:[1.74–2.28]in the CLHLS and 1.69[1.55–1.85]in the UK Biobank)compared to those without either condition.Conclusion The combination of social isolation and sarcopenia synergistically increases the risk of mortality in middle-aged and older adults across diverse populations.
基金supported in part by the Japan Pancreas Soci-ety and the MHLW Research Program on Rare and Intractable Dis-eases(Grant Number 23FC1015,Principal investigator:Mitsuhiro Kawano).
文摘Background:Previous studies have highlighted the frequent occurrence of sarcopenia in patients with pancreatic diseases,including chronic pancreatitis.We aimed to clarify the prevalence of skeletal muscle(SM)loss and sarcopenia,and their associations with clinical characteristics,bone mineral density,and pancreatic imaging findings in patients with autoimmune pancreatitis(AIP).Methods:This study included 114 patients with AIP treated at Tohoku University Hospital.The SM index was assessed using a bioelectrical impedance analysis device,grip strength was measured using a hand dynamometer,and bone mineral density was evaluated using dual-energy X-ray absorptiometry.Univari-ate and multivariate logistic regression analyses were used to analyze factors associated with SM loss and sarcopenia.Results:Among 114 patients,57(50.0%)had SM loss,31(27.2%)had reduced grip strength,and 27(23.7%)had both.Patients with SM loss were older and had a lower body mass index,weaker grip strength,higher Controlling Nutritional Status scores,and lower serum lipase and albumin levels compared to those without SM loss.Computed tomography scans revealed a higher prevalence of pancreatic parenchy-mal atrophy in patients with SM loss.Similar differences were observed between patients with sarcopenia and those without.Osteopathy was observed in 35.6%of patients with SM loss and 38.1%of those with sarcopenia,whereas only 4.1%of patients without SM loss had osteopathy.Low BMI(<21.0 kg/m^(2))was also found to be an independent risk factor for SM loss in multivariate analysis.Age>72 years,low BMI(<20.0 kg/m^(2)),and low serum lipase levels(<13 U/L)were independent risk factors for sarcopenia in multivariate analysis.Conclusions:SM loss and sarcopenia are prevalent in patients with AIP and are associated with aging,poor nutritional status,low serum lipase levels,and pancreatic parenchymal atrophy.In addition to the high risk of osteopathy,careful attention should be paid to maintain muscle health in AIP patients.
文摘Irisin is a chief myokine released during physical activity and has garnered attention for its potential therapeutic effects on different metabolic and cardiovascular disorders.This review explores the intricate connections between irisin,physical activity,sarcopenia,type 2 diabetes mellitus(T2DM),and cardiovascular complications.Experimental data suggests that through irisin release,physical activity positively influences muscle health,metabolic regulation,and cardiovascular function.In individuals with sarcopenia,characterized by progressive muscle mass and function loss,irisin plays a pivotal role in maintaining muscle integrity and function.Additionally,irisin’s beneficial effects on insulin sensitivity and glucose metabolism suggest its involvement in the pathophysiology of T2DM.The review will examine how irisin may modulate the development of cardiovascular complications,particularly in the context of diabetes and aging.Additionally,it will explore its potential as a therapeutic target for managing sarcopenia,T2DM,and cardiovascular complications,underscoring the importance of physical activity in mitigating these interconnected health challenges.Further research is needed to elucidate the precise mechanisms by which irisin mediates these effects and assess its clinical applicability in preventing and treating metabolic and cardiovascular disorders.
基金supported by the Beijing Natural Science Foundation(7232236)the National Key R&D Program of China(2022YFF1100104)。
文摘Introduction:Diet intervention,especially supplementation with high-quality protein,is considered to be a critical strategy in sarcopenia.However,different sources and types of protein have different health impacts.Objectives:The aim of this study is to explore the differences in the ameliorative effects and mechanisms of different sources and types of proteins on sarcopenia,providing an optimal path for the prevention and treatment of sarcopenia.Methods:A sarcopenia model was established by intraperitoneal injection of dexamethasone(5 mg/kg).Sixty male C57BL/6 mice(8 months old)were randomly divided into the normal control,sarcopenia,goat whey protein,goat milk casein,bovine whey protein,and bovine milk casein groups.Animals were treated for 8 consecutive weeks.Organism-level and molecular phenotypes,16S rRNA gene sequencing,and untargeted metabolomics profiling based on GC-TOF/MS were employed to investigate the correlation between host metabolism,microbial metabolism,autophagy and inflammation and their influence on sarcopenia in C57BL/6 male mice.Results:All 4 proteins increased muscle mass,and goat whey protein improved muscle strength in sarcopenic mice.Goat and bovine milk proteins promoted muscle regeneration by increasing MyoD1 and MyoG expression,and the former had a more distinct effect in inducing autophagy and decreasing inflammation than the latter.In addition,goat whey protein and casein could modulate hostmicrobial arginine co-metabolism.Notably,goat milk proteins responded well to sarcopenia comorbidities,including sarcopenic obesity,osteosarcopenia,and osteoarthritis.Conclusion:The study confirmed that goat milk proteins were more effective than bovine milk proteins for the control of sarcopenia.Moreover,we found that whey protein and casein could modulate host-microbial arginine co-metabolism,which shows their potential as precision nutritional supplements for the management of sarcopenia.Our study provides theoretical support for the prevention and control of sarcopenia.
基金Supported by The Medical Key Science and Technology Project of Shanxi Province,No.2020xm23.
文摘BACKGROUND The prevalence of sarcopenia progressively increases with as liver function deteriorates.Muscle wasting has been shown to independently predict adverse outcomes in liver cirrhosis patients.AIM To screen effective biomarkers for sarcopenia in liver cirrhosis.METHODS Untargeted metabolomics were performed on serum from 62 liver cirrhosis patients,including 41 with sarcopenia and 21 without sarcopenia.Candidate metabolite biomarkers were screened based on three machine-learning algorithms.The diagnostic or predictive value of potential biomarkers was evaluated by drawing receiver operating characteristic curves.RESULTS A total of 60 differential metabolites between cirrhotic sarcopenia and the nonsarcopenia group were identied.Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis revealed differential metabolites primarily involved in glycerophospholipid metabolism,alpha-linolenic acid metabolism,retrograde endocannabinoid signaling,and choline metabolism in cancer.Finally,four potential biomarkers were screened through machine learning algorithms,namely N-Acetylcarnosine,2-Stearylcitrate,CerP(d18:1/12:0),and 3-Methyl-alpha-ionylacetate.Among these,N-Acetylcarnosine can provide better diagnostic accuracy.CONCLUSION This study unveiled different plasma metabolic profiles of liver cirrhosis patients with and without sarcopenia.These valuable biomarkers have the potential to improve the prognosis of liver patients with cirrhosis by early detection or prediction of sarcopenia.
文摘We commend Worland et al for their work associating rifaximin-αuse with imp-roved muscle mass in individuals with liver cirrhosis.This observation adds momentum to the evolving gut-liver-muscle axis hypothesis.However,the retro-spective design and lack of functional outcomes invite caution in interpretation.Mechanistically,rifaximin may exert benefit beyond ammonia reduction through modulation of systemic inflammation,tumor necrosis factor alpha suppression,and restoration of myocyte integrity.Additionally,concerns about long-term anti-microbial resistance must be acknowledged.Overall,this study represents a valuable first step,but its implications require validation in future,prospective,mechanistically informed clinical trials.
基金Supported by Feng Chia University/Chung Shan Medical University,No.FCU/CSMU 112-001Taiwan National Science and Technology Council,No.111-2314-B-035-001-MY3.
文摘Esophageal cancer is a highly aggressive malignancy often diagnosed at an advanced stage,with poor prognosis and high recurrence rates despite curative treatment.Accurate prognostic tools are urgently needed to guide personalized management strategies.Recent research has demonstrated significant potential of integrating quantitative imaging biomarkers,specifically radiomics and sarcopenia,with machine learning(ML)techniques to enhance outcome prediction.This review systematically summarizes six recent studies(2022-2024)exploring integrated ML models combining sarcopenia and radiomics biomarkers with clinical parameters to predict survival in patients with esophageal and gastroesophageal cancers.Sample sizes ranged from 83 to 243 patients,with studies utilizing various imaging modalities(positron emission tomography/computed tomography and computed tomography)and model analysis approaches,including Cox regression,random forest,and light gradient boosting machine.These models incorporated features such as skeletal muscle indices,tumor texture,and shape descriptors.Models that combined clinical data,radiomics,and sarcopenia outperformed those using single modalities.These findings support the utility of multimodal imaging biomarkers in developing robust,individualized prognostic models.However,the retrospective nature of most studies highlights the need for standardization and external validation.This review underscores the potential of multimodal ML-based models in enhancing personalized risk stratification and treatment planning for esophageal cancer.
文摘With the aging global population,the decline in muscle mass and function among the elderly has emerged as a significant concern.This systemic progressive generalized loss of muscle function and mass is referred to as sarcopenia(SP).In recent years,a growing number of studies have investigated SP,revealing that many tumor diseases,especially in the digestive system,promote its occurrence due to the influence of the disease itself,diet,and other factors.Moreover,SP patients tend to have poorer postoperative recovery.At present,many diagnostic methods have been developed for SP,but no unified standard has been established.Furthermore,the cutoff values of many diagnostic methods for different populations are still in the exploratory stage,and additional clinical studies are required to explore these issues.This article comprehensively and systematically summarizes the diagnostic methods and criteria mentioned in previous research,focusing on the impact of SP on post-surgical patients with various malignant tumors.
文摘The prevalence of sarcopenia tends to be high in patients with biliopancreatic disease.Sarcopenia is a risk factor of poor prognosis in patients with acute and chronic pancreatitis and biliary tract and pancreatic cancer.Several studies have suggested that sarcopenia may be a risk factor for perioperative complications and decreased recurrence-free or overall survival in patients with biliary tract and pancreatic cancer after surgery.Sarcopenia in biliary tract and pancreatic cancer may also increase chemotherapy-induced toxicities and worsen quality of life and survival in neoadjuvant or palliative chemotherapy.Moreover,sarcopenia is a risk factor for biliary stent occlusion in patients with malignant biliary obstruction,predictors of the efficacy of endoscopic ultrasound-guided celiac plexus neurolysis(EUS-CPN)for pain relief,EUS-guided drainage,and endoscopic necrosectomy for walled-off necrosis(WON).Diagnosis of sarcopenia prior to the treatment of biliopancreatic diseases and endoscopy may predict treatment efficacy,and appropriate nutritional and exercise therapy improve therapeutic outcomes of patients with biliopancreatic diseases.
文摘BACKGROUND The impact of psychiatric disorder,especially depression,on the prognosis of sarcopenic patients is gaining prominence.Yet,there have been very few studies focusing on this issue,let alone the related targeted mental health prevention.This cohort-based nested case-control study is geared to compare risk of depression and the depression-related ambulatory care utilization for sarcopenia persons with and without receiving add-on Chinese herbal medicines(CHMs)treatment.AIM To compare risk of depression and the depression-related ambulatory care utili-zation for sarcopenia persons with and without receiving add-on CHMs treat-ment.METHODS In the beginning,we recruited those aged 20-70 years with newly diagnosed sarcopenia and free of depression between 2002 and 2010 from a nationwide insurance database.From them,we identified cases with depression onset occurring after sarcopenia until December 31,2013.To cautiously isolate the effect of CHMs,we established the matched sets of treated and untreated subjects with CHMs use by randomly frequency matching.A conditional logistic regression was executed to explore the association of CHMs to depression risk,and the frequency and costs of depression-related ambulatory care were compared using Mann-Whitney U test.RESULTS Addition of CHMs to routine care of sarcopenia notably correlated with a lower risk of depression.A remarkable effect of CHMs in reducing depression was detected when sarcopenia subjects received CHMs for more than three years,lowering depression risk by as much as 65%.As compared to CHMs users,the non-CHMs users indeed incurred higher frequency and costs of depression-related ambulatory care after depression attack(P<0.05).Notably,the costs for per depression-related ambulatory care profoundly increased with the years after depression attack.CONCLUSION Sarcopenic patients can greatly benefit from add-on CHMs treatment,underscoring the urgent need for interdisciplinary collaboration and proactive treatment planning.
文摘BACKGROUND Esophageal cancer is a common malignancy with high mortality.Radiotherapy is an important treatment.Sarcopenia affects patients'physical function and prog-nosis.However,the relationship between sarcopenia diagnosed by Chun-Hou Chen method for sarcopenia measurement and index(C3SMI)criteria and eso-phageal cancer prognosis after radiotherapy is unclear.AIM To explore the correlation between sarcopenia(SA)diagnosed based on C3SMI criteria and the prognosis of patients with esophageal cancer following radiothe-rapy.METHODS A retrospective analysis was conducted on the general clinical data of 131 eso-phageal cancer patients who received radiotherapy in the Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University from March 2021 to July 2024.Based on the presence of SA,the patients were assigned into two groups-the SA group and the non-SA group.Logistic regression analysis was used for investi-gating the risk factors influencing SA in esophageal cancer patients.Additionally,the patients were followed up,with their prognosis recorded.As per their prognostic outcomes,the patients were allocated into a good prognosis group and a poor prognosis group.The data of the two groups were compared.Using logistic regression analysis,the risk factors that may influence the prognosis of these patients were analyzed.SPSS 26.0 statistical software was introduced for analyzing the study data.Comparisons were made between groups using t-tests or χ_(2) tests based on the data type.RESULTS As revealed through logistic regression analysis,age[odds ratio(OR)=2.898,P=0.038],body mass index(OR=5.983,P=0.006),prealbumin(OR=6.253,P=0.003),and Karnofsky performance status score(OR=3.854,P=0.010)were independent risk factors impacting SA for esophageal cancer patients(P<0.05).Logistic regression analysis also found that age(OR=3.823,P=0.030),differentiation degree(OR=4.802,P=0.028),American Joint Committee on Cancer clinical staging(OR=3.732,P=0.013),alpha-fetoprotein level(OR=3.508,P=0.018),thrombospondin-1 level(OR=5.749,P=0.006),carcinoembryonic antigen level(OR=3.873,P=0.030),and SA(OR=3.593,P=0.017)were independent risk factors that may influence esophageal cancer patients'prognosis(P<0.05).CONCLUSION The presence of SA has a significant relation to the poor prognosis of esophageal cancer patients,which highlights the importance of assessing and intervening in SA in clinical management so as to improve patient prognosis.
文摘Skeletal muscles perform important metabolic functions.Muscle mass wasting in sarcopenia is an urgent problem of modern medicine,the interest in which is related to its prognostic significance.The liver has numerous direct and indirect metabolic and immune connections with skeletal muscle and disruptions of these connections in liver disease are of clinical interest.A recent article by Liang et al emphasized potential biomarkers of sarcopenia in liver cirrhosis.Identification of biomarkers of sarcopenia in patients with cirrhosis has important diagnostic value.Common pathophysiologic mechanisms of sarcopenia and liver cirrhosis include disorders of protein and energy metabolism,disturbances in the structure of gut microbiota,inflammation and oxidative stress.
基金Supported by Shandong Province Biliary Pancreatic Cancer Clinical Quality Specialty Construction Fund,No.SLCZDZK-2401.
文摘BACKGROUND Sarcopenia is a clinical syndrome presented with progressive and generalized skeletal muscle loss and function dysfunction.Usually,it is considered an agerelated process influenced by genetic,lifestyle factors,and diseases.Obstructive jaundice is one of the most common pathophysiological changes in patients needing hepatobiliary or pancreatic operations that can adversely affect the tissue and organ function throughout the human body.However,the effects of obstructive jaundice on the occurrence of sarcopenia remain unclear.AIM To investigate the incidence of sarcopenia in patients with surgical obstructive jaundice and the association of sarcopenia with postoperative outcome.METHODS This cross-sectional study was conducted from December 2019 to January 2024.Data retrieved included patient demographics,disease entities,sarcopenia-related parameters(including grip strength,6-m walking time,and limb skeletal muscle mass index),postoperative complications,and length of hospital stay.Sarcopenia was confirmed using Asian Working Group standards.Logistic regression was used to analyze the relationship between total bilirubin level and sarcopenia.The factors influencing sarcopenia in patients with surgical obstructive jaundice and association of sarcopenia with postoperative complications were also investigated.RESULTS Overall,1708 patients met the inclusion criteria,with a mean age of 60.09±13.52 years(sex:52.28%male).There were 383 patients(22.42%)with obstructive jaundice and 1325(77.58%)without jaundice.Sarcopenia,low walking speed,low grip strength,and low limb skeletal muscle index were more prevalent in patients with obstructive jaundice than nonobstructive jaundice.The odds ratio(OR)for sarcopenia in patients with obstructive jaundice was 1.689[95%confidence interval(CI):1.295-2.203,P<0.001],indicating that jaundice is a significant risk factor for sarcopenia.The occurrence of sarcopenia was higher in patients with severe obstructive jaundice than mild obstructive jaundice(39.3%vs 22.8%,P<0.05).Obstructive jaundice was positively correlated with reduced walking speed(OR=1.627,95%CI:1.185-2.234,P=0.003)and decreased grip strength(OR=1.669,95%CI:1.212-2.300,P=0.002).Age(OR=1.077,95%CI:1.040-1.114,P<0.001)and body mass index(OR=0.703,95%CI:0.630-0.784,P<0.001)were independent risk factors of sarcopenia in patients with obstructive jaundice.Patients with obstructive jaundice and sarcopenia had a higher rate of postoperative complications(46.3%vs 33.1%,P=0.032),longer postoperative hospital stays(11.33±6.75 days vs 9.19±7.32 days,P=0.016),and longer total hospital stays(17.10±7.69 days vs 15.98±8.55 days,P=0.032)than those without sarcopenia.CONCLUSION Sarcopenia is more prevalent in patients with obstructive jaundice and is positively correlated with the degree of jaundice.Sarcopenia prolongs hospital stays and is associate with postoperative complications.
文摘The etiology,risk factors,and management of sarcopenia and metabolic dysfunction-associated steatotic liver disease(MASLD)are comparable,which prompted the investigators to search for a particular diagnostic or prognostic biomarker that was involved in both disorders.Peptides or proteins known as myokines,or exerkines,are produced and secreted by contracted muscles.Myokines work similarly to hormones in their actions.One common clinical hallmark of sarcopenia and MASLD is physical inactivity,which is associated with alterations in the levels of myokines.Irisin is a positive regulator of muscle size that is elevated in the biological fluids during exercise.Significantly low levels were observed in the pathological conditions associated with physical inactivity.The serum levels of irisin are significantly higher in MASLD patients,while their levels were lower in risk factors of MASLD,e.g.,diabetes mellitus,obesity,and insulin resistance.In sarcopenia with obesity(sarcopenic obesity)or with a normal build,serum irisin levels are significantly lower than in healthy subjects.Therefore,serial determination of irisin levels that showed a transition from higher to lower levels in MASLD indicated the development of sarcopenia in those patients.
文摘BACKGROUND Sarcopenia is prevalent among patients with end-stage liver disease(ESLD)and is associated with adverse outcomes both before and after liver transplantation(LT).Accurate assessment of muscle mass is essential for effective risk stratification and optimization of transplant outcomes.AIM To identify imaging modalities used to assess sarcopenia in ESLD patients awaiting LT,and evaluate the clinical utility of each technique in predicting waitlist mortality,length of hospital stay,and post-transplant survival.METHODS A systematic search was conducted in PubMed,MEDLINE,EMBASE,and Scopus for studies published between May 2015 and May 2025.Eligible studies included original research evaluating sarcopenia using imaging techniques in ESLD patients listed for LT.Due to heterogeneity in study design,diagnostic criteria,and outcomes,data were synthesized qualitatively.RESULTS A total of 17 studies met the inclusion criteria,encompassing modalities such as computed tomography(CT),magnetic resonance imaging,dual-energy X-ray absorptiometry,and ultrasound.CT at the third lumbar vertebra level was most frequently used,exhibiting consistent prognostic values for pre-and post-transplant outcomes.However,considerable variability in cutoff values and sarcopenia definitions was observed.Emerging evidence also supports the prognostic relevance of muscle quality indicators,including muscle attenuation and fat infiltration.CONCLUSION CT and magnetic resonance imaging are the most robust imaging methods for sarcopenia diagnosis in patients with ESLD.Standardized diagnostic criteria incorporating muscle quality metrics are essential for improving prognostic accuracy and guiding clinical decision making in LT candidates.Such integration would also support the development of unified frameworks for sarcopenia assessment in transplantation practice.
文摘The skeletal muscle is the largest organ present in the body and is responsible for mechanical activities like maintaining posture,movement,respiratory function,and support for the health and functioning of other systems of the body.Skeletal muscle atrophy is a condition characterized by a reduction in muscle size,strength,and activity,which leads to an increased dependency on others for movement,an increased risk of falls,and a reduced quality of life.Various conditions like osteoarthritis,osteoporosis,and fractures are directly associated with increased muscle atrophy.Additionally,numerous risk factors,like aging,malnutrition,physical inactivity,and certain disease conditions,through distinct pathways,negatively affect skeletal muscle health and lead to muscle atrophy.Among various determinants of overall muscle health,the rate of muscle protein synthesis and degradation is an important parameter that eventually alters the fate of overall muscle health.In conditions of excessive skeletal muscle atrophy,including sarcopenia,the rate of muscle protein degradation usually exceeds the rate of protein synthesis.The availability of amino acids in the systemic circulation is a crucial step in muscle protein synthesis.The current review aims to consolidate the existing evidence on amino acids,highlight their mechanisms of action,and assess their roles and effectiveness in enhancing skeletal muscle health.
基金Shanghai Clinical Research Center for Chronic Musculoskeletal Diseases (20MC1920600)Shanghai Key Clinical Specialty "Traditional Chinese Medicine Orthopaedic Traumatology"(shslczdzk03901)+3 种基金The Second Round of Construction Project of National TCM Academic School Inheritance Studio "Shi's Trauma Department"[Letter of the People's Education of Traditional Chinese Medicine (2019) No.62]Shanghai High-level Local Universities "Chronic Muscle and Bone Damage Research and Transformation" Innovation Team [No.3 of Shanghai Education Commission (2022)]Program for Shanghai High-Level Local University Innovation Team (SZY20220315)Shanghai Shenkang Hospital Development Center Clinical Three-year Action Plan (SHDC2020CR3090B)。
文摘OBJECTIVE:To explore the potential molecular mechanism of Qigu capsule(芪骨胶囊,QGC) in the treatment of sarcopenia through network pharmacology and to verify it experimentally.METHODS:The active compounds of QGC and common targets between QGC and sarcopenia were screened from databases.Then the herbs-compounds-targets network,and protein-protein interaction(PPI) network was constructed.Gene ontology(GO) and Kyoto Encyclopedia of Genes and Genomes(KEGG) pathway enrichment analysis were performed by R software.Next,we used a dexamethasone-induced sarcopenia mouse model to evaluate the anti-sarcopenic mechanism of QGC.RESULTS:A total of 57 common targets of QGC and sarcopenia were obtained.Based on the enrichment analysis of GO and KEGG,we took the phosphatidylinositol 3-kinase(PI3K)/protein kinase B(Akt) signaling pathway as a key target to explore the mechanism of QGC on sarcopenia.Animal experiments showed that QGC could increase muscle strength and inhibit muscle fiber atrophy.In the model group,the expression of muscle ring finger-1 and Atrogin-1 were increased,while myosin heavy chain was decreased,QGC treatment reversed these changes.Moreover,compared with the model group,the expressions of pPI3K,p-Akt,p-mammalian target of rapamycin and pForkhead box O3 in the QGC group were all upregulated.CONCLUSION:QGC exerts an anti-sarcopenic effect by activating PI3K/Akt signaling pathway to regulate skeletal muscle protein metabolism.
文摘Cirrhosis represents the end stage of chronic liver disease,significantly reducing life expectancy as it progresses from a compensated to a decompensated state,leading to serious complications.Recent improvements in medical treatment have created a shift in cirrhosis management.Various causes,including hepatitis viruses,alcohol consumption,and fatty liver disease,contribute to cirrhosis and are closely linked to liver cancer.The disease develops through hepatocyte necrosis and regeneration,resulting in fibrosis and sinusoidal capillarization,leading to portal hypertension and complications such as ascites,hepatic encephalopathy,and organ dysfunction.Cirrhosis also holds an increased risk of hepatocellular carcinoma.Diagnosing cirrhosis involves assessing fibrosis scores through blood tests and measuring liver stiffness through elastography.Liver transplantation is the definitive treatment for endstage liver disease and acute liver failure.
文摘Intensive care unit(ICU)acquired sarcopenia and myosteatosis are increasingly recognized complications of critical illness,characterized by a rapid loss of ske-letal muscle mass,quality,and function.These conditions result from a complex interplay of systemic inflammation,immobilization,catabolic stress,mitochon-drial dysfunction,and immune dysregulation,often culminating in impaired recovery,prolonged hospitalization,and increased long-term mortality.First identified in survivors of sepsis and prolonged mechanical ventilation,these muscle abnormalities were initially described using computed tomography-based assessments of muscle area and density.Subsequent advances in imaging,biomarker discovery,and functional testing have enabled earlier detection and risk stratification across diverse ICU populations.While nutritional optimization and early mobilization form the cornerstone of current prevention and treatment strategies,the emergence of novel approaches,including automated artificial intelligence-based screening,neuromuscular electrical stimulation,and targeted pharmacologic therapies,has broadened the clinical scope of interventions.Despite their significant prognostic implications,ICU-acquired sarcopenia and myosteatosis remain under-recognized in routine critical care practice.This mini-review aims to synthesize current knowledge regarding their pathophysiology,available diagnostic modalities,prognostic relevance,and the evolving landscape of therapeutic strategies for long-term functional recovery in critically ill patients.
基金supported by the Ministry of Education Chunhui Program Collaborative Scientific Research Projects(Grant No.:HZKY20220286)Henan Province Foreign Experts Introduction Program(Grant No.:HNGD2022021)+1 种基金Natural Science Foundation of Henan Province(Grant No.:23230042151)the Foundation of the National Key Program of Research and Development of China(Grant No.:2016YFC0900803)。
文摘Rapid population aging has led to an increased focus on age-related conditions such as sarcopenia.causing loss of muscle mass and strength^([1,2]). Sarcopenia is associated with adverse outcomes,including falls, functional decline, frailty, and mortality, which can lower the quality of life and shorten lifespan^([1,2]).
