Associations of Impaired Renal Function With Declines in Muscle Strength and Muscle Function in Older Men: Findings From the CHAMP Study

2019 ◽  
Vol 74 (11) ◽  
pp. 1812-1820 ◽  
Author(s):  
Tadashi Toyama ◽  
Oliver van den Broek-Best ◽  
Toshiaki Ohkuma ◽  
David Handelsman ◽  
Louise M Waite ◽  
...  

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.

2011 ◽  
Vol 164 (5) ◽  
pp. 811-817 ◽  
Author(s):  
Tung Wai Auyeung ◽  
Jenny Shun Wah Lee ◽  
Timothy Kwok ◽  
Jason Leung ◽  
Claes Ohlsson ◽  
...  

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.


2019 ◽  
Vol 75 (1) ◽  
pp. 175-180 ◽  
Author(s):  
Richard D Semba ◽  
Marta Gonzalez-Freire ◽  
Toshiko Tanaka ◽  
Angelique Biancotto ◽  
Pingbo Zhang ◽  
...  

Abstract Background Growth and differentiation factor 15 (GDF-15) has been associated with obesity, muscle wasting, and cachexia. The receptor for GDF-15 was recently identified in the brainstem and regulates food intake and metabolism. The relationship of plasma GDF-15 with the age-associated decline of muscle mass and strength, gait speed, and physical performance in adults has not been well characterized. Methods Plasma GDF-15, grip strength, 6-m gait speed, 400-m walking test time, lower extremity physical performance score, appendicular lean mass, and fat mass were measured in 194 healthy adult participants, aged 22–93 years, of the Baltimore Longitudinal Study of Aging. Results Plasma GDF-15 concentrations increased with age (p &lt; .001) and were higher in whites compared with blacks and Asians (p = .04). Adults with higher plasma GDF-15 had slower 6-m gait speed, longer 400-m walking time, and lower physical performance score in multivariable analyses adjusting for age and race. Plasma GDF-15 was not associated with grip strength, appendicular lean mass, or fat mass. Conclusions Elevated plasma GDF-15 is associated with slower gait speed, higher 400-m walking time, and lower physical performance in very healthy community-dwelling adults. The relationship between plasma GDF-15 and sarcopenia-related outcomes may be stronger in the population not selected to be healthy, and this hypothesis should be tested in a representative population.


2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Sophia X. Sui ◽  
Kara L. Holloway-Kew ◽  
Natalie K. Hyde ◽  
Lana J. Williams ◽  
Sarah Leach ◽  
...  

2019 ◽  
Vol 75 (5) ◽  
pp. 939-945 ◽  
Author(s):  
David Scott ◽  
Markus J Seibel ◽  
Robert Cumming ◽  
Vasi Naganathan ◽  
Fiona Blyth ◽  
...  

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 [&lt;−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 &lt; .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.


2014 ◽  
Vol 95 (4) ◽  
pp. 308-316 ◽  
Author(s):  
Harnish P. Patel ◽  
Nasser Al-Shanti ◽  
Lucy C. Davies ◽  
Sheila J. Barton ◽  
Miranda D. Grounds ◽  
...  

2014 ◽  
Vol 43 (suppl 1) ◽  
pp. i28-i28
Author(s):  
H. P. Patel ◽  
N. Al-Shanti ◽  
L. C. Davies ◽  
S. J. Barton ◽  
M. D. Grounds ◽  
...  

Gerontology ◽  
2021 ◽  
pp. 1-6
Author(s):  
Ahmed Al Saedi ◽  
Steven Phu ◽  
Sara Vogrin ◽  
Piumali Gunawardene ◽  
Gustavo Duque

<b><i>Background:</i></b> Circulating osteoprogenitor (COP) cells are a surrogate of the bone marrow mesenchymal stem cells with high levels observed in osteoporosis and the initial stages of fracture healing. Conversely, a low percentage of COP cells (%COP) is strongly associated with frailty and disability. However, it is unknown whether %COP is associated with sarcopenia, a musculoskeletal disease closely related to frailty. <b><i>Objectives:</i></b> This study sought to determine the associations between %COP and sarcopenia defined using the Sarcopenia Definitions and Outcomes Consortium (SDOC) criteria. <b><i>Methods:</i></b> Data from a random sample of 73 community-dwelling older persons enrolled in the Nepean Osteoporosis and Frailty study (median age 74 years; 60% female) were analyzed. %COP was quantified by flow cytometry using selective gating of CD45/osteocalcin (OCN) + cells. Sarcopenia was defined using handgrip strength and gait speed with cut points as per the SDOC criteria. Linear regression was used for analysis. <b><i>Results:</i></b> Sarcopenia was identified in 19% of participants, all of whom were frail. After adjusting for age, sex, and interleukin 6, sarcopenic participants had 36% lower %COP (95% confidence interval [CI] −56%, −6%, <i>p =</i> 0.024). Both grip strength and gait speed showed associations with %COP (<i>p =</i> 0.065 and 0.002, respectively); however, after adjusting for age and frailty, only gait speed remained associated with %COP (0.1 m/s increase in gait velocity was associated with a 5% increase in %COP cells (95% CI 0%, 10%, <i>p =</i> 0.052). <b><i>Conclusions:</i></b> High levels of %COP are associated with better muscle function. Future longitudinal studies are required to elucidate the clinical utility of %COP as a potential biomarker or disease stratifier for sarcopenia.


Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Michael J LaMonte ◽  
David M Buchner ◽  
Cora E Lewis ◽  
Eileen Rillamas-Sun ◽  
John Bellettiere ◽  
...  

Background: While some studies report muscle strength is associated with mortality, independent of aerobic physical activity (PA), in older people, there are less data in women and lack of studies adjusting the association for objective measures of PA and physical performance. We prospectively examined this association in 5,061 multiethnic (White, 48.2%; Black, 34.0%; Hispanic, 17.9%) women ages 63-99 (mean 78.3) with complete information for analysis in the Objective Physical Activity and Cardiovascular Health Study. Methods: Quartile categories of dominant hand grip strength (<14, 14-18, 18.1-22.5, >22.5 kg) and EPESE categories of time to complete five consecutive unassisted chair stands (>16.6, 16.6-13.7, 13.6-11.2, <11.2 sec) were the muscle strength exposure measures. Primary covariables included age, race-ethnicity, current smoking, BMI, and number of comorbidities. Accelerometer measured moderate-to-vigorous PA (MVPA) and total sedentary time, and gait speed during a self-paced 8 meter walk test were further assessed as confounding factors. Cox regression was used to estimate hazard ratios (HR) and 95% confidence intervals (CI). Results: There were 306 (5.5%) all-cause deaths during a mean 3.3 year follow-up. Adjusting for primary covariables, significant inverse trends in mortality were observed across categories of grip strength, HR (95% CI) = 1.00 (ref), 0.70 (0.53, 0.93), 0.77 (0.56, 1.05), 0.59 (0.41, 0.87), trend p = .007, and chair stands, 1.00, 0.82 (0.62, 1.09), 0.76 (0.55, 1.04), 0.53 (0.36, 0.77), trend p <.001. Further adjustment for MVPA attenuated these associations which remained statistically significant, 1.00, 0.72, 0.81, 0.66, trend p = .032, and 1.00, 0.91, 0.88, 0.65, trend p = .033, respectively. Similarly, adding sedentary time or gait speed to the primary covariables did not eliminate significance of the inverse mortality trends with either muscle strength measure. Adjusting for primary covariables, each 1-standard deviation (6.2 sec) faster chair stand time was associated with 12% lower mortality risk (p = .004), which was attenuated to 8% risk reduction (p = .04) when further controlling for MVPA. Adjusting for primary covariables and MVPA, each 1-standard deviation (6.8 kg) increment in grip strength was associated with 13% lower mortality risk (p = .04), and this inverse association was generally consistent across subgroups defined by age (interaction p = .78), race-ethnicity (p = .19), and BMI (p = .88). Controlling for gait speed opposed to MVPA resulted in consistent findings. Conclusions: Higher muscular strength is associated with lower mortality in older women, independent of device-measured MVPA and sedentary time, and measured gait speed, an indicator of aerobic fitness. If results are confirmed, in addition to guideline recommendations regarding aerobic PA, promoting skeletal muscle strength is an important component of aging well.


2015 ◽  
pp. 1-7
Author(s):  
K. STOEVER ◽  
A. HEBER ◽  
S. EICHBERG ◽  
W. ZIJLSTRA ◽  
K. BRIXIUS

Background: At present, it is unclear whether older, obese persons with or without sarcopenia respond differently to training. Furthermore, there are no differentiated recommendations for resistance training for this special target group. Objectives: The objectives are to investigate the changes in the physical parameters of older, obese men caused by training and to reappraise the modalities of resistance training for older persons. Design: Pre-test-post-test design. Participants: The participants were 33 physically inactive and obese older men (≥ 65 years, BMI ≥ 30 kg/m2), with-out severe diseases. Subjects were divided into two groups: NSAR (no or presarcopenia, n= 15) or SAR (sarcopenia, n= 18). Intervention: The intervention consisted of progressive resistance training, twice a week for 16 weeks with finally 80-85% of maximum strength and three sets with 8-12 repetitions. The training contained six exercises for the major muscle groups. Measurements: Sarcopenia was assessed using the Short Physical Performance Battery (SPPB), hand-grip strength, skeletal muscle mass index (SMI), and gait speed over a 6-meter walkway. Furthermore, the maximum dynamic strength (1 RM) was assessed. Results: At baseline, the NSAR group had significantly better values in SMI, SPPB score, hand-grip strength, and 1 RM. After training, the results in both groups displayed an increase in 1 RM at the lower limbs (NSAR 18%, SAR 38%) and the upper limbs (NSAR 12%, SAR 14%). Also, the SPPB score (NSAR 11%, SAR 15%) and the 6-m-gait speed (NSAR 5%, SAR 10%) increased. The SAR group was able to increase their right hand-grip strength by 12%, whereas the NSAR group maintained their initial high strength values. SMI did not change in both groups. Conclusions: Both groups show improvements after resistance training with slightly more benefits for men with sarcopenia. Results of this study can be used to define specific training regimens for N(SAR) subjects.


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