103 * LEAN MASS, MUSCLE STRENGTH AND GENE EXPRESSION IN COMMUNITY DWELLING OLDER MEN

Abstract Background Advanced kidney disease is associated with reduced muscle strength and physical performance. However, associations between early stages of renal impairment and physical outcomes are unclear. Methods The Concord Health and Ageing in Men Project is a prospective study of 1,705 community-dwelling men aged 70 years and older. Participants with estimated glomerular filtration rate (eGFR) more than 30 mL/min/1.73 m2 were included and further divided into four eGFR categories. Physical parameters including grip strength, gait speed, appendicular lean mass (ALM, a sum of skeletal mass of arms and legs), ALM adjusted for body mass index (ALMBMI), and muscle function (measured using grip strength divided by arm lean mass) were assessed at both baseline and 5-year follow-up. Associations between kidney function and changes in physical parameters were analyzed using linear and logistic regression models. Results Our study included 789 men with a median age of 75 years and median eGFR of 72 mL/min/1.73 m2 at baseline. Over 5 years, grip strength, gait speed, ALMBMI, and muscle function all declined in the whole cohort, compared with baseline. The multivariable analyses showed that poorer renal function was associated with more rapid declines in grip strength, gait speed, and muscle function in participants with mild-to-moderate renal impairment (GFR category stage G3, eGFR < 60 mL/min/1.73 m2) (p = .01, p < .01, p = .02, respectively) but less so in those with eGFR more than 60 mL/min/1.73 m2, whereas eGFR category did not have a significant impact on declines in ALMBMI. These results remained unchanged with or without adjustment for age. Conclusions In community-dwelling older men, mild-to-moderate renal impairment at baseline was associated with declines in grip strength, gait speed, and muscle function over time despite preservation of muscle mass.

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Associations Between Lean Mass, Muscle Strength and Power, and Skeletal Size, Density and Strength in Older Men

Journal of Bone and Mineral Research ◽

10.1002/jbmr.3458 ◽

2018 ◽

Vol 33 (9) ◽

pp. 1612-1621 ◽

Cited By ~ 8

Author(s):

Didier Chalhoub ◽

Robert Boudreau ◽

Susan Greenspan ◽

Anne B Newman ◽

Joseph Zmuda ◽

...

Keyword(s):

Muscle Strength ◽

Lean Mass ◽

Older Men ◽

Skeletal Size

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Testosterone but not estradiol level is positively related to muscle strength and physical performance independent of muscle mass: a cross-sectional study in 1489 older men

Acta Endocrinologica ◽

10.1530/eje-10-0952 ◽

2011 ◽

Vol 164 (5) ◽

pp. 811-817 ◽

Cited By ~ 55

Author(s):

Tung Wai Auyeung ◽

Jenny Shun Wah Lee ◽

Timothy Kwok ◽

Jason Leung ◽

Claes Ohlsson ◽

...

Keyword(s):

Muscle Strength ◽

Grip Strength ◽

Muscle Mass ◽

Physical Performance ◽

Older Men ◽

Community Dwelling ◽

Sex Hormone ◽

Sex Hormone Binding Globulin ◽

Cross Sectional ◽

Skeletal Mass

ObjectiveTo examine the relationship between different measures of testosterone and estradiol (E2), muscle mass, muscle strength, and physical performance; and to test whether the association of sex hormone level with muscle strength and physical performance was independent of muscle mass.Design and methodsA cross-sectional survey on 1489 community-dwelling men older than 64 years of age. Serum levels of testosterone and E2were measured by mass spectrometry, and sex hormone-binding globulin (SHBG) levels were measured by immunoradioassay. Muscle mass was examined by dual-energy X-ray absorptiometry and physical performance was assessed by hand-grip strength, gait speed, step length and chair-stand test.ResultsAppendicular skeletal mass (ASM) was positively associated with total testosterone (TT;P<0.001), free testosterone (FT;P<0.001), and total E2(P<0.001) but not with free E2(P=0.102). After adjustment for age, serum SHBG and relative ASM, both TT and FT were significantly associated with grip strength, narrow-walk speed and the composite neuromuscular score. Higher total E2, but not free E2was associated with lower grip strength (P<0.05) after adjustment for age, FT, SHBG and relative ASM.ConclusionsTestosterone level was related to both muscle mass, strength and physical performance. Total E2level, though related to muscle mass positively, affected muscle strength adversely in older men.

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Muscle Mass Assessed by the D3-Creatine Dilution Method and Incident Self-reported Disability and Mortality in a Prospective Observational Study of Community-Dwelling Older Men

The Journals of Gerontology Series A ◽

10.1093/gerona/glaa111 ◽

2020 ◽

Vol 76 (1) ◽

pp. 123-130 ◽

Cited By ~ 4

Author(s):

Peggy M Cawthon ◽

Terri Blackwell ◽

Steven R Cummings ◽

Eric S Orwoll ◽

Kate A Duchowny ◽

...

Keyword(s):

Risk Factor ◽

Muscle Mass ◽

Lean Mass ◽

Negative Binomial ◽

Older Men ◽

Community Dwelling ◽

Dilution Method ◽

Relative Risks ◽

Clinical Center ◽

Adl Disability

Abstract Background Whether low muscle mass is a risk factor for disability and mortality is unclear. Associations between approximations of muscle mass (including lean mass from dual-energy x-ray absorptiometry [DXA]), and these outcomes are inconsistent. Methods Muscle mass measured by deuterated creatine (D3Cr) dilution and appendicular lean mass (ALM, by DXA) were assessed at the Year 14 Visit (2014–2016) of the prospective Osteoporotic Fractures in Men study (N = 1,425, age 77–101 years). Disability in activities of daily living (ADLs), instrumental ADLs, and mobility tasks was self-reported at the Year 14 visit and 2.2 years later; deaths were centrally adjudicated over 3.3 years. Relative risks and 95% confidence intervals (CI) were estimated per standard deviation decrement with negative binomial, logistic regression, or proportional hazards models. Results In age- and clinical center-adjusted models, the relative risks per decrement in D3Cr muscle mass/wgt was 1.9 (95% CI: 1.2, 3.1) for incident self-reported ADL disability; 1.5 (95% CI: 1.3, 1.9) for instrumental ADL disability; and 1.8 (95% CI: 1.5, 2.2) for mobility disability. In age-, clinical center-, and weight-adjusted models, the relative risks per decrement in D3Cr muscle mass was 1.8 (95% CI: 1.5, 2.2) for all-cause mortality. In contrast, lower DXA ALM was not associated with any outcome. Associations of D3Cr muscle mass with these outcomes were slightly attenuated after adjustment for confounding factors and the potentially mediating effects of strength and physical performance. Conclusions Low muscle mass as measured by D3Cr dilution is a novel risk factor for clinically meaningful outcomes in older men.

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Muscle strength and gait speed rather than lean mass are better indicators for poor cognitive function in older men

Scientific Reports ◽

10.1038/s41598-020-67251-8 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Sophia X. Sui ◽

Kara L. Holloway-Kew ◽

Natalie K. Hyde ◽

Lana J. Williams ◽

Sarah Leach ◽

...

Keyword(s):

Cognitive Function ◽

Muscle Strength ◽

Lean Mass ◽

Gait Speed ◽

Older Men ◽

Poor Cognitive Function

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Associations of Body Composition Trajectories with Bone Mineral Density, Muscle Function, Falls, and Fractures in Older Men: The Concord Health and Ageing in Men Project

The Journals of Gerontology Series A ◽

10.1093/gerona/glz184 ◽

2019 ◽

Vol 75 (5) ◽

pp. 939-945 ◽

Cited By ~ 4

Author(s):

David Scott ◽

Markus J Seibel ◽

Robert Cumming ◽

Vasi Naganathan ◽

Fiona Blyth ◽

...

Keyword(s):

Bone Mineral Density ◽

Weight Loss ◽

Body Composition ◽

Fracture Risk ◽

Bone Mineral ◽

Lean Mass ◽

Gait Speed ◽

Older Men ◽

Community Dwelling ◽

Mineral Density

Abstract Background Weight loss increases fracture risk in older adults. We aimed to determine associations of 2-year body composition trajectories with subsequent falls and fractures in older men. Methods We measured appendicular lean mass (ALM) and total fat mass (FM) by dual-energy X-ray absorptiometry at baseline and Year 2 in 1,326 community-dwelling men aged ≥70 and older. Body composition trajectories were determined from residuals of a linear regression of change in ALM on change in FM (higher values indicate maintenance of ALM over FM), and a categorical variable for change in ALM and FM (did not lose [≥−5% change] versus lost [<−5% change]). Bone mineral density (BMD), hand grip strength, and gait speed were assessed at Years 2 and 5. After Year 2, incident fractures (confirmed by radiographical reports) and falls were recorded for 6.8 years. Results Compared with men who did not lose ALM or FM, men who did not lose ALM but lost FM, and men who lost both ALM and FM, had reduced falls (−24% and −34%, respectively; both p < .05). Men who lost ALM but did not lose FM had increased falls (incidence rate ratio = 1.73; 95% CI 1.37–2.18). ALM/FM change residuals were associated with improved lumbar spine BMD (B = 0.007; 95% CI 0.002–0.012 g/cm2 per SD increase) and gait speed (0.015; 0.001–0.029 m/s), and reduced hip fractures (hazard ratio = 0.68; 95% CI 0.47–0.99). Conclusions Fracture risk may be increased in older men who lose higher ALM relative to FM. Weight loss interventions for obese older men should target maintenance of lean mass.

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Decline in Muscle Strength and Performance Predicts Fracture Risk in Elderly Women and Men

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgaa414 ◽

2020 ◽

Vol 105 (9) ◽

pp. e3363-e3373

Author(s):

Dima Alajlouni ◽

Dana Bliuc ◽

Thach Tran ◽

John A Eisman ◽

Tuan V Nguyen ◽

...

Keyword(s):

Muscle Strength ◽

Fracture Risk ◽

Physical Performance ◽

Lean Mass ◽

Ordinary Least Squares ◽

Community Dwelling ◽

Mineral Density ◽

Sit To Stand ◽

Rate Of Decline ◽

And Performance

Abstract Context Muscle strength and performance are associated with fractures. However, the contribution of their rate of decline is unclear. Objective To assess the independent contribution of the rate of decline in muscle strength and performance to fracture risk. Design, Setting, and Participants Community-dwelling women (n = 811) and men (n = 440) aged 60 years or older from the prospective Dubbo Osteoporosis Epidemiology Study followed from 2000 to 2018 for incident fracture. Clinical data, appendicular lean mass/height2 (ht)2, bone mineral density, quadricep strength/ht (QS), timed get-up-and-go (TGUG), 5 times repeated sit-to-stand (5xSTS), and gait speed (GS) measured biennially. Rates of decline in muscle parameters were calculated using ordinary least squares regression and fracture risk was assessed using Cox’s models. Main Outcome Incident low-trauma fracture ascertained by x-ray report. Results Apart from lean mass in women, all muscle parameters declined over time. Greater rates of decline in physical performance were associated with increased fracture risk in women (Hazard ratios [HRs] ranging from 2.1 (95% CI: 1.5–2.9) for GS to 2.7 (95% CI: 1.9–3.6) for 5xSTS, while in men only the decline in GS was associated with fracture risk (HR: 3.4 [95% CI: 1.8–6.3]). Baseline performance and strength were also associated with increased fracture risk in men (HRs ranging from 1.8 (95% CI: 1.1–3.0) for QS to 2.5 (95% CI: 1.5–4.1) for TGUG, but not in women. Conclusion Rate of decline in physical performance in both genders, and baseline strength and performance in men, contributed independently to fracture risk. Sit-to-stand and GS were the tests most consistently associated with fractures. Further studies are required to determine whether muscle strength and/or performance improve the predictive accuracy of fracture prediction models.

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Intracellular Water Content in Lean Mass is Associated with Muscle Strength, Functional Capacity, and Frailty in Community-Dwelling Elderly Individuals. A Cross-Sectional Study

Nutrients ◽

10.3390/nu11030661 ◽

2019 ◽

Vol 11 (3) ◽

pp. 661 ◽

Cited By ~ 6

Author(s):

Mateu Serra-Prat ◽

Isabel Lorenzo ◽

Elisabet Palomera ◽

Juan Yébenes ◽

Lluís Campins ◽

...

Keyword(s):

Muscle Strength ◽

Elderly People ◽

Functional Capacity ◽

Lean Mass ◽

Functional Performance ◽

Cross Sectional Study ◽

Community Dwelling ◽

Intracellular Water ◽

Sectional Study ◽

Cross Sectional

High intracellular water (ICW) content has been associated with better functional performance and a lower frailty risk in elderly people. However, it is not clear if the protective effect of high ICW is due to greater muscle mass or better muscle quality and cell hydration. We aimed to assess the relationship between ICW content in lean mass (LM) and muscle strength, functional performance, frailty, and other clinical characteristics in elderly people. In an observational cross-sectional study of community-dwelling subjects aged ≥75 years, ICW and LM were estimated by bioelectrical impedance, and the ICW/LM ratio (mL/kg) calculated. Muscle strength was measured as hand grip, frailty status was assessed according to Fried criteria, and functional status was assessed by Barthel score. For 324 recruited subjects (mean age 80 years), mean (SD) ICW/LM ratio was 408 (29.3) mL/kg. The ICW/LM ratio was negatively correlated with age (rs = −0.249; p < 0.001). A higher ICW/LM ratio was associated with greater muscle strength, better functional capacity, and a lower frailty risk, even when adjusted by age, sex, nº of co-morbidities, and LM. ICW content in LM (including the muscle) may influence muscle strength, functional capacity and frailty. However, further studies are needed to confirm this hypothesis.

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