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      Association between metabolic syndrome and limb muscle quantity and quality in older adults: a pilot ultrasound study

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          Limited imaging studies have investigated whether limb muscle quantity and quality change after metabolic syndrome (MetS) development. This pilot study examined MetS influence on limb muscle characteristics in older adults.


          Participants were recruited from annual health examinations; their right biceps brachii, triceps brachii, rectus femoris, and gastrocnemius muscles were measured by ultrasound. Anthropometric parameters, blood biochemistry, and physical performance (handgrip strength and gait speed) were also examined.


          Overall, 129 participants were enrolled, including 26 with MetS. Although handgrip strength was lower in MetS patients, there were no significant between-group differences considering thickness and mean echogenicity of the four muscles. Handgrip strength was positively correlated with the thickness of biceps brachii, triceps brachii, and rectus femoris but was negatively associated with their echogenicity. On multivariate analysis, triceps muscle echogenicity was trivially associated (odds ratio, 0.93; 95% confidence interval, 0.86–0.99) with MetS, possibly due to multicollinearity with grip strength.


          No significant difference was recognized in limb muscle thickness and echogenicity in the geriatric population with MetS compared with healthy controls by ultrasound imaging. However, the finding might be caused by the small sample size of our participants. Future large-scale studies should explore the influence of separated risk factors of MetS on limb muscle echotexture and examine whether manifestation differs in different age populations.

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          Most cited references 26

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          Health Outcomes of Sarcopenia: A Systematic Review and Meta-Analysis

          Objective The purpose of this study was to perform a systematic review to assess the short-, middle- and long-term consequences of sarcopenia. Methods Prospective studies assessing the consequences of sarcopenia were searched across different electronic databases (MEDLINE, EMBASE, EBM Reviews, Cochrane Database of Systematic Reviews, EBM Reviews ACP Journal Club, EBM Reviews DARE and AMED). Only studies that used the definition of the European Working Group on Sarcopenia in Older People to diagnose sarcopenia were included. Study selection and data extraction were performed by two independent reviewers. For outcomes reported by three or more studies, a meta-analysis was performed. The study results are expressed as odds ratios (OR) with 95% CI. Results Of the 772 references identified through the database search, 17 were included in this systematic review. The number of participants in the included studies ranged from 99 to 6658, and the duration of follow-up varied from 3 months to 9.8 years. Eleven out of 12 studies assessed the impact of sarcopenia on mortality. The results showed a higher rate of mortality among sarcopenic subjects (pooled OR of 3.596 (95% CI 2.96–4.37)). The effect was higher in people aged 79 years or older compared with younger subjects (p = 0.02). Sarcopenia is also associated with functional decline (pooled OR of 6 studies 3.03 (95% CI 1.80–5.12)), a higher rate of falls (2/2 studies found a significant association) and a higher incidence of hospitalizations (1/1 study). The impact of sarcopenia on the incidence of fractures and the length of hospital stay was less clear (only 1/2 studies showed an association for both outcomes). Conclusion Sarcopenia is associated with several harmful outcomes, making this geriatric syndrome a real public health burden.
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            Sarcopenic Obesity: Prevalence and Association With Metabolic Syndrome in the Korean Longitudinal Study on Health and Aging (KLoSHA)

            OBJECTIVE We investigated the prevalence of sarcopenic obesity (SO) and its relationship with metabolic syndrome in a community-based elderly cohort in Korea. RESEARCH DESIGN AND METHODS In this study, 287 men and 278 women aged 65 or older were recruited. Sarcopenia was defined as the appendicular skeletal muscle mass (ASM) divided by height squared (Ht2) (kg/m2) or by weight (Wt) (%) of <1 SD below the sex-specific mean for young adults. Obesity was defined as a visceral fat area ≥100 cm2. RESULTS The prevalence of SO was 16.7% in men and 5.7% in women with sarcopenia defined by ASM/Ht2; however, it was 35.1% in men and 48.1% in women by ASM/Wt. Using ASM/Wt, the homeostasis model assessment of insulin resistance of subjects with SO was higher and they were at higher risk for metabolic syndrome (odds ratio [OR] 8.28 [95% CI 4.45–15.40]) than the obese (5.51 [2.81–10.80]) or sarcopenic group (2.64 [1.08–6.44]). CONCLUSIONS SO defined by ASM/Wt was more closely associated with metabolic syndrome than either sarcopenia or obesity alone.
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              Reliability of rehabilitative ultrasound imaging of the transversus abdominis and lumbar multifidus muscles.

              To evaluate the intraexaminer and interexaminer reliability of rehabilitative ultrasound imaging (RUSI) in obtaining thickness measurements of the transversus abdominis (TrA) and lumbar multifidus muscles at rest and during contractions. Single-group repeated-measures reliability study. University and orthopedic physical therapy clinic. A volunteer sample of adults (N=30) with current nonspecific low back pain (LBP) was examined by 2 clinicians with minimal RUSI experience. Not applicable. Thickness measurements of the TrA and lumbar multifidus muscles at rest and during contractions were obtained by using RUSI during 2 sessions 1 to 3 days apart. Percent thickness change was calculated as thickness(contracted)-thickness(rest)/thickness(rest). Intraclass correlation coefficients (ICC) were used to estimate reliability. By using the mean of 2 measures, intraexaminer reliability point estimates (ICC(3,2)) ranged from 0.96 to 0.99 for same-day comparisons and from 0.87 to 0.98 for between-day comparisons. Interexaminer reliability estimates (ICC(2,2)) ranged from 0.88 to 0.94 for within-day comparisons and from 0.80 to 0.92 for between-day comparisons. Reliability estimates comparing measurements by the 2 examiners of the same image (ICC(2,2)) ranged from 0.96 to 0.98. Reliability estimates were lower for percent thickness change measures than the corresponding single thickness measures for all conditions. RUSI thickness measurements of the TrA and lumbar multifidus muscles in patients with LBP, when based on the mean of 2 measures, are highly reliable when taken by a single examiner and adequately reliable when taken by different examiners.

                Author and article information

                Diabetes Metab Syndr Obes
                Diabetes Metab Syndr Obes
                Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy
                11 September 2019
                : 12
                : 1821-1830
                [1 ]Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch , Taipei, Taiwan
                [2 ]Department of Physical Medicine and Rehabilitation, National Taiwan University College of Medicine , Taipei, Taiwan
                [3 ]Department of Family Medicine, National Taiwan University Hospital, Bei-Hu Branch , Taipei, Taiwan
                [4 ]Department of Family Medicine, National Taiwan University College of Medicine , Taipei, Taiwan
                [5 ]Health Science and Wellness Center, National Taiwan University , Taipei, Taiwan
                Author notes
                Correspondence: Der-Sheng HanDepartment of Physical Medicine and Rehabilitation, National Taiwan University Hospital , BeiHu Branch, No. 87, Nei-Jiang Road, Wan-Hwa District, Taipei108, TaiwanTel +886 223 717 101 5001Email dshan1121@yahoo.com.tw
                © 2019 Chang et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                Page count
                Figures: 4, Tables: 3, References: 34, Pages: 10
                Original Research

                Endocrinology & Diabetes

                metabolic syndrome, sarcopenia, sonography, nutrition, obesity


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