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      Selecting Appropriate Sarcopenia Screening Methods for Asian Populations

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          Abstract

          We aimed to determine the most appropriate sarcopenia screening method for Asian populations. We retrospectively studied the physiological differences between the sexes in healthy individuals and prospectively compared using skeletal muscle mass versus handgrip strength (HS) to screen for sarcopenia in a community-based population. Skeletal muscle mass was determined using dual-energy X-ray absorptiometry. Of 5881 healthy individuals recruited, 101 were from urban populations and 349 from a community-based population. The sexes were comparable in total lean muscle mass declines after peaking around 20 years of age. An age-dependent decline in total fat mass was found only among men;a persistent increase in total fat mass was observed only among women. The prevalence of low skeletal muscle mass significantly increased with age in both sexes only when applying the weight-adjusted skeletal muscle index (wSMI); it was significant only among men when applying the height-adjusted skeletal muscle index (hSMI). Using HS resulted in a much higher prevalence of sarcopenia in both sexes. A significant age-dependent increase in fat mass in women showed that the most appropriate adjustment method is wSMI for women and hSMI for men. Nevertheless, a primary HS survey is recommended for both sexes in Asian populations.

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          Recent Advances in Sarcopenia Research in Asia: 2016 Update From the Asian Working Group for Sarcopenia

          Liang-Kung Chen, Wei-Ju Lee, Li-Ning Peng … (2016)
          Sarcopenia was recently classified a geriatric syndrome and is a major challenge to healthy aging. Affected patients tend to have worse clinical outcomes and higher mortality than those without sarcopenia. Although there is general agreement on the principal diagnostic characteristics, initial thresholds for muscle mass, strength, and physical performance were based on data from populations of predominantly Europid ancestry and may not apply worldwide. The Asian Working Group for Sarcopenia (AWGS) issued regional consensus guidelines in 2014, and many more research studies from Asia have since been published; this review summarizes recent progress. The prevalence of sarcopenia estimated by the AWGS criteria ranges between 4.1% and 11.5% of the general older population; however, prevalence rates were higher in Asian studies that used European Working Group on Sarcopenia in Older People cut-offs. Risk factors include age, sex, heart disease, hyperlipidemia, daily alcohol consumption, and low protein or vitamin intake; physical activity is protective. Adjusting skeletal muscle mass by weight rather than height is better in showing the effect of older age in sarcopenia and identifying sarcopenic obesity; however, some Asian studies found no significant skeletal muscle loss, and muscle strength might be a better indicator. Although AWGS 2014 diagnostic cut-offs were generally well accepted, some may require further revision in light of conflicting evidence from some studies. The importance of sarcopenia in diverse therapeutic areas is increasingly evident, with strong research interest in sarcopenic obesity and the setting of malignancy. Pharmacologic interventions have been unsatisfactory, and the core management strategies remain physical exercise and nutritional supplementation; however, further research is required to determine the most beneficial approaches.
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            Changes in body composition and weight during the menopause transition

            Gail A. Greendale, Barbara Sternfeld, MeiHua Huang … (2019)
            BACKGROUND. The relation between the menopause transition (MT) and changes in body composition or weight remains uncertain. We hypothesized that, independent of chronological aging, the MT would have a detrimental influence on body composition. METHODS. Participants were from the longitudinal Study of Women’s Health Across the Nation (SWAN) cohort. We assessed body composition by dual energy x-ray absorptiometry. Multivariable mixed effects regressions fitted piece-wise linear models to repeated measures of outcomes as a function of time before or after the final menstrual period (FMP). Covariates were age at FMP, race, study site, and hormone therapy. RESULTS. Fat and lean mass increased prior to the MT. At the start of the MT, rate of fat gain doubled, and lean mass declined; gains and losses continued until 2 years after the FMP. After that, the trajectories of fat and lean mass decelerated to zero slope. Weight climbed linearly during premenopause without acceleration at the MT. Its trajectory became flat after the MT. CONCLUSION. Accelerated gains in fat mass and losses of lean mass are MT-related phenomena. The rate of increase in the sum of fat mass and lean mass does not differ between premenopause and the MT; thus, there is no discernable change in rate of weight gain at the start of the MT. FUNDING. NIH, Department of Health and Human Services (DHHS), through the National Institute on Aging, National Institute of Nursing Research, and NIH Office of Research on Women’s Health (U01NR004061, U01AG012505, U01AG012535, U01AG012531, U01AG012539, U01AG012546, U01AG012553, U01AG012554, and U01AG012495). Body composition changed unfavorably during the 2 years prior to and after the final menstrual period in women, with the rate of fat gain doubling and lean mass declining.
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              The Official Positions of the International Society for Clinical Densitometry: acquisition of dual-energy X-ray absorptiometry body composition and considerations regarding analysis and repeatability of measures.

              Thomas Hangartner, Sarah Warner, Pierre Braillon … (2024)
              In preparation for the International Society for Clinical Densitometry Position Development Conference of 2013 in Tampa, Florida, Task Force 2 was created as 1 of 3 task forces in the area of body composition assessment by dual-energy X-ray absorptiometry (DXA). The assignment was to review the literature, summarize the relevant findings, and formulate positions covering (1) accuracy and precision assessment, (2) acquisition of DXA body composition measures in patients, and (3) considerations regarding analysis and repeatability of measures. There were 6 primary questions proposed to the task force by the International Society for Clinical Densitometry board and expert panel. Based on a series of systematic reviews, 14 new positions were developed, which are intended to augment and define good clinical practice in quantitative assessment of body composition by DXA.
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Clin Med
                Journal ID (iso-abbrev): J Clin Med
                Journal ID (publisher-id): jcm
                Title: Journal of Clinical Medicine
                Publisher: MDPI
                ISSN (Electronic): 2077-0383
                Publication date (Electronic): 22 July 2020
                Publication date Collection: August 2020
                Volume: 9
                Issue: 8
                Electronic Location Identifier: 2333
                Affiliations
                [1 ]Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Keelung and Chang Gung University, Taoyuan 33001, Taiwan; yuching1221@ 123456gmail.com
                [2 ]Keelung Osteoporosis Prevention and Treatment Center, Keelung 200131, Taiwan; fangping@ 123456cgmh.org.tw
                [3 ]Department of Radiology, Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan; 106263@ 123456w.tmu.edu.tw
                [4 ]Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Keelung and Chang Gung University, Taoyuan 33001, Taiwan
                [5 ]Department of Family Medicine, Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan; greening1990@ 123456gmail.com
                [6 ]Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 10001, Taiwan
                [7 ]Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, Institute for Radiological Research, Chang Gung University, Taoyuan 33001, Taiwan; alex2143@ 123456ms33.hinet.net
                [8 ]Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 10001, Taiwan
                [9 ]Medical Innovation Development Center, Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan
                Author notes
                [* ]Correspondence: wingchan@ 123456tmu.edu.tw ; Tel.: +886-6(2)29307930 (ext. 1300); Fax: +886-6(2)29316809
                [†]

                Co-first authors contributed equally.

                Author information
                https://orcid.org/0000-0002-2318-8507
                Article
                Publisher ID: jcm-09-02333
                DOI: 10.3390/jcm9082333
                PMC ID: 7464734
                PubMed ID: 32707874
                SO-VID: 284d9ee5-4d51-41cf-a2a4-953f687d453b
                Copyright © © 2020 by the authors.
                License:

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                Date received : 28 June 2020
                Date accepted : 17 July 2020
                Categories
                Subject: Article

                Keywords: asian,body composition,dual-energy x-ray absorptiometry (dxa),handgrip strength,sarcopenia,adjusted skeletal muscle index
                Data availability:
                Keywords: asian, body composition, dual-energy x-ray absorptiometry (dxa), handgrip strength, sarcopenia, adjusted skeletal muscle index

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