scholarly journals Impaired Muscle Strength and Performance in Patients With Mild Autonomous Cortisol Secretion

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A85-A85
Author(s):  
Catherine D Zhang ◽  
Sumitabh Singh ◽  
Malavika Suresh ◽  
Andreas Ladefoged Ebbehøj ◽  
Nathan K LeBrasseur ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Accelerated Aging ◽  
Cortisol Secretion ◽  
Timed Up And Go ◽  
Tissue Accumulation ◽  
Hand Grip ◽  
Autonomous Cortisol Secretion ◽  
And Performance ◽  
6 Minute Walk Test ◽  
The Impact

Abstract Background: Glucocorticoid-induced myopathy is well-recognized in overt Cushing syndrome (CS), but the impact of mild cortisol secretion on muscle is unclear. Recent data suggest that patients with mild autonomous cortisol secretion (MACS) are frailer and report more weakness than patients with non-functioning adrenal adenomas. We hypothesized that MACS is associated with 1) objective measures of impaired muscle strength and performance and 2) increased tissue accumulation of advanced glycation end products (AGEs), a measure of accelerated aging. Aim: To determine the effect of MACS on muscle mass, strength, performance, and tissue accumulation of AGEs. Methods: We conducted a cross-sectional analysis as part of an ongoing cohort study in patients with MACS compared to age and sex-matched referent subjects without cortisol excess. MACS was defined as serum cortisol >1.8 mcg/dL after the 1 mg overnight dexamethasone suppression test (DST), in the absence of overt signs and symptoms of CS. We measured hand grip strength with hand grip dynamometer and evaluated functional performance on the timed up and go test, 6 minute walk test, and gait speed assessment. Tissue accumulation of AGEs was measured with point-of-care AGE reader. Appendicular lean mass was calculated and adjusted for height in participants who underwent body composition scan. Results: A total of 23 patients with MACS and 23 age and sex-matched referent subjects without cortisol excess were enrolled. The median age of diagnosis was 63 years (range, 51–81), and 26 (56%) were women. In the MACS cohort, median cortisol following 1 mg DST was 2.6 µg/dL (range, 1.9–13.0), median DHEA-S 37 µg/dL (range, 5.0- 141.0), and median ACTH 8.5 pg/mL (range, 5.0–38.0). Patients with MACS had lower hand grip strength (median 29.3 vs. 32.5 kg, p=0.052), slower gait speed (median 1.1 vs. 1.4 m/s, p=0.001), covered less distance during the 6 minute walk test (median 453 vs. 510 m, p=0.001), and took longer to complete the timed up and go test (median 10.1 vs. 8.6 s, p=0.04) than referent subjects without cortisol excess. Accumulation of AGEs was higher in patients with MACS (median 2.9 vs. 2.4, p=0.01). No significant difference was observed in appendicular lean mass (n=19 pairs, 7.8 vs. 7.5 kg/m2, p=0.57). Conclusions: MACS is associated with decreased muscle strength and performance without a significant change in muscle mass, suggesting poor muscle quality. We also observed increased tissue accumulation of AGEs in MACS patients, consistent with our hypothesis of MACS-induced accelerated aging. These findings may help explain the increased frailty observed in MACS, and suggest muscle assessment be considered in all patients with autonomous cortisol secretion. Further studies should examine the impact of muscle and functional impairments on morbidity in MACS, and its possible reversal with either a structured exercise intervention or adrenalectomy.

scholarly journals Impact of Malnutrition Status on Muscle Parameter Changes over a 5-Year Follow-Up of Community-Dwelling Older Adults from the SarcoPhAge Cohort

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 407
Author(s):  
Laetitia Lengelé ◽  
Olivier Bruyère ◽  
Charlotte Beaudart ◽  
Jean-Yves Reginster ◽  
Médéa Locquet
Keyword(s):  
Older Adults ◽  
Muscle Strength ◽  
Physical Performance ◽  
Community Dwelling ◽  
Timed Up And Go ◽  
P Values ◽  
Student’S T ◽  
The Impact ◽  
Community Dwelling Older Adults

This study aimed to assess the impact of malnutrition on the 5-year evolution of physical performance, muscle mass and muscle strength in participants from the SarcoPhAge cohort, consisting of community-dwelling older adults. The malnutrition status was assessed at baseline (T0) according to the “Global Leadership Initiatives on Malnutrition” (GLIM) criteria, and the muscle parameters were evaluated both at T0 and after five years of follow-up (T5). Lean mass, muscle strength and physical performance were assessed using dual X-ray absorptiometry, handgrip dynamometry, the short physical performance battery test and the timed up and go test, respectively. Differences in muscle outcomes according to nutritional status were tested using Student’s t-test. The association between malnutrition and the relative 5-year change in the muscle parameters was tested using multiple linear regressions adjusted for several covariates. A total of 411 participants (mean age of 72.3 ± 6.1 years, 56% women) were included. Of them, 96 individuals (23%) were diagnosed with malnutrition at baseline. Their muscle parameters were significantly lower than those of the well-nourished patients both at baseline and after five years of follow-up (all p-values < 0.05), except for muscle strength in women at T5, which was not significantly lower in the presence of malnutrition. However, the 5-year changes in muscle parameters of malnourished individuals were not significantly different than those of well-nourished individuals (all p-values > 0.05).

scholarly journals SAT-366 The Impact of Mild Autonomous Cortisol Secretion on Bone Metabolism

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Shobana Athimulam ◽  
Danae Delivanis ◽  
Sundeep Khosla ◽  
Matthew Drake ◽  
Irina Bancos
Keyword(s):  
Bone Metabolism ◽  
Cortisol Secretion ◽  
Autonomous Cortisol Secretion ◽  
The Impact

scholarly journals Impaired Cognitive Performance in Patients With Mild Autonomous Cortisol Secretion

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A84-A85
Author(s):  
Catherine D Zhang ◽  
Sumitabh Singh ◽  
Malavika Suresh ◽  
Andreas Ladefoged Ebbehøj ◽  
Nikki H Stricker ◽  
...  
Keyword(s):  
Working Memory ◽  
Executive Function ◽  
Episodic Memory ◽  
Cognitive Performance ◽  
Processing Speed ◽  
Neuropsychiatric Symptoms ◽  
Cortisol Secretion ◽  
Autonomous Cortisol Secretion ◽  
The Impact ◽  
Age And Sex

Abstract Background: Cognitive deficits in memory, language, and executive function have been described in Cushing’s syndrome, but the impact of mild cortisol secretion on cognition is unclear. Rather than overt hypercortisolism, mild autonomous cortisol secretion (MACS) is typically associated with abnormal circadian cortisol production. Aim: To characterize the effect of MACS on cognitive performance. Methods: We conducted a cross-sectional analysis as part of an ongoing cohort study in patients with MACS compared to age and sex-matched referent subjects without cortisol excess. MACS was defined as serum cortisol concentration &gt;1.8 mcg/dL after the 1 mg overnight dexamethasone suppression test (DST), in the absence of signs and symptoms of overt Cushing syndrome. We used the National Institute of Health Toolbox Cognition Battery to assess cognitive performance. A series of seven IPad-based tests were administered to evaluate five key domains: 1) executive function, 2) episodic memory, 3) working memory, 4) language, and 5) processing speed. Performance was reported using fully corrected T-scores for age, sex, education, and race with a normative mean of 50 and a standard deviation of 10. T-scores were generated for the individual components as well as three summary measures: 1) fluid cognition (includes executive function, episodic memory, working memory, and processing speed), 2) crystallized cognition (includes language), and 3) total cognition (composite of fluid and crystalized cognition). Results: A total of 23 patients with MACS and 23 age and sex-matched referent subjects without cortisol excess were enrolled. The median age of diagnosis was 63 years (range, 51–81), and 26 (56%) were women. In the MACS cohort, median cortisol following 1 mg DST was 2.6 ug/dL (range, 1.9–13.0) with median ACTH of 8.5 pg/mL (range, 5.0–38.0) and median DHEA-S of 37 mcg/dL (range, 5.0- 141.0). On cognitive assessment, patients with MACS had lower total cognition (T-scores 50 vs. 54, p=0.05) and fluid cognition (T-scores 48 vs. 53, p=0.01) composite scores compared to referent subjects without cortisol excess. In particular, patients with MACS performed worse on tests of executive function (Dimensional Change Card Sort: T-scores 55 vs. 63, p= 0.02 and Flanker Inhibitory Control and Attention: T-scores 45 vs. 52, p=0.01). There were no significant differences observed in the remaining individual domains of language, processing speed, working memory, and episodic memory, or crystallized cognition. Conclusions: MACS is associated with impaired total cognition, and in particular, executive function and fluid cognition. These findings suggest that patients with MACS are susceptible to cortisol-mediated changes in the brain. Additional studies should examine the contribution of neuropsychiatric symptoms on cognition in MACS, and possible improvement following treatment for cortisol excess.

scholarly journals The impact of an 8-week Pilates-based physical training program on functional mobility: data from a septuagenarian group

2021 ◽  
Vol 13 (1) ◽  
pp. 11-19
Author(s):  
Miguel Lima ◽  
Bruno Silva ◽  
Sílvia Rocha-Rodrigues ◽  
Pedro Bezerra
Keyword(s):  
Muscle Strength ◽  
Training Program ◽  
Cardiorespiratory Fitness ◽  
Physical Training ◽  
Community Dwelling ◽  
Functional Mobility ◽  
Elderly Subjects ◽  
Timed Up And Go ◽  
Eyes Closed ◽  
The Impact

Abstract Study aim: This study aimed to evaluate the effects of a Pilates-based training program on functional mobility and strength in community-dwelling adults over 70 years old. Material and methods: Twenty community-dwelling elderly subjects were recruited and randomly assigned to control (C = 10) or Pilates training (PT = 10) groups for 8 weeks (2 times/week). Anthropometric, strength, cardiorespiratory fitness, functional mobility, and static and dynamic balance parameters were assessed before and after the intervention. Results: The PT group had higher values of lower limb strength (p = 0.013 d = 0.56) and 6-minute walking test distance (p = 0.04; d = 0.45) than the C group. The PT group also had differences in one leg stance duration and decrease in the Timed Up and Go test. We also observed a positive correlation between muscle strength and cardiorespiratory fitness (p < 0.01, r = 0.62), cardiorespiratory fitness and one leg stance, eyes closed, right and left leg (p = 0.04, r = 0.45; p = 0.05, r = 0.45, respectively). Conclusions: Eight weeks of Pilates-based physical training induced improvements in skeletal muscle strength and functional mobility of community-dwelling septuagenarians.

scholarly journals The Impact of Mild Autonomous Cortisol Secretion on Bone Turnover Markers

2020 ◽  
Vol 105 (5) ◽  
pp. 1469-1477 ◽  
Author(s):  
Shobana Athimulam ◽  
Danae Delivanis ◽  
Melinda Thomas ◽  
William F Young ◽  
Sundeep Khosla ◽  
...  
Keyword(s):  
Bone Turnover ◽  
Bone Metabolism ◽  
Bone Turnover Markers ◽  
Cushing Syndrome ◽  
Adrenal Tumors ◽  
Cortisol Secretion ◽  
Increased Risk ◽  
Autonomous Cortisol Secretion ◽  
Turnover Markers ◽  
The Impact

Abstract Context Several studies have reported increased risk of fragility fractures in patients with mild autonomous cortisol secretion (MACS), discordant to the degree of bone density deterioration. Objective To evaluate the effect of MACS on bone metabolism in patients with adrenal adenomas. Design Cross-sectional study with prospective enrollment, 2014-2019 Setting Referral center. Patients 213 patients with adrenal adenomas: 22 Cushing syndrome (CS), 92 MACS and 99 nonfunctioning adrenal tumors (NFAT). Main Outcome Measures Osteocalcin, procollagen I intact N-terminal (PINP), C-terminal telopeptide (CTX), sclerostin. Results Patients with CS demonstrated lower markers of bone formation compared with patients with MACS and NFAT (CS vs MACS vs NFAT: mean osteocalcin 14.8 vs 20.1 vs 21.3 ng/mL [P &lt; 0.0001]; mean PINP 34.8 vs 48.7 vs 48.5 µg/L [P = 0.003]). Severity of cortisol excess was inversely associated with sclerostin (CS vs MACS vs NFAT: mean sclerostin 419 vs 538 vs 624 ng/L, [P &lt; 0.0001]). In a multivariable model of age, sex, body mass index, cortisol, and bone turnover markers, sclerostin was a significant predictor of low bone mass in patients with MACS (OR 0.63 [CI 95%, 0.40–0.98] for each 100 ng/L of sclerostin increase). After adrenalectomy, osteocalcin, CTX, and sclerostin increased by a mean difference of 6.3 ng/mL, 0.12 ng/mL, and 171 pg/mL (P = 0.02 for all), respectively. Conclusions Lower sclerostin level in patients with MACS reflects a reduction in osteocyte function or number associated with exposure to chronic cortisol excess. Increase in bone turnover markers after adrenalectomy suggests restoration of favorable bone metabolism.

scholarly journals The relationship between knee-ankle muscle strength and performance tests in young female adults with flexible pes planus

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Serkan Bakırhan ◽  
Nuray Elibol ◽  
Mehmet Özkeskin ◽  
Fatih Özden
Keyword(s):  
Muscle Strength ◽  
Young Female ◽  
Performance Tests ◽  
Flexor Muscle ◽  
Timed Up And Go ◽  
Pes Planus ◽  
Significant Difference ◽  
Ankle Muscle ◽  
And Performance ◽  
The Relationship

Abstract Background A decrease in muscular activation of the knee and ankle is one of the primary reasons for pes planus. The muscle strength of the knee and ankle in patients with pes planus may affect the performance tests which consists of daily life activities. The aim of the study was to determine the relationship between knee and ankle muscle strength with performance tests in young female adults with flexible pes planus. In addition, we also aimed to observe whether the severity of pes planus affects the ankle muscle strength and performance test scores. We carried out a cross-sectional single-center study. The muscle strength measurement of knee flexion-extension, ankle dorsal-plantar flexion, and ankle inversion-eversion movements were evaluated with the manual muscle test (MMT) device. The timed up and go test (TUG), 5-repeat sit-and-stand test (5STS), and 10-m walk test (10MWT) were used to evaluate knee and ankle performance. Results A significant difference was found only for the five-repetitive sit-and-stand test among the classified groups considering the pes planus grade (p < 0.05). There was no significant difference between groups for other parameters (p > 0.05). In correlation analysis, there was only a relationship between the timed up and go test (TUG) with left foot dorsal flexor muscle strength and between 10-m walk test (10MWT) with right foot invertor muscle strength (r1 = − 0.288, r2 = − 0.288, p < 0.05). Conclusions The results of this study reveal that the duration of 5STS was significantly lower in the second degree pes planus group. TUG test score showed low negative correlation with left foot dorsal flexor muscle strength. In addition, the scores of 10MWT exhibited poor negative correlation with right foot invertor muscle strength. Regarding other parameters, no significant correlations were found.

Coexistent Osteoarthritis and Parkinson’s Disease: Data from the Parkinson’s Foundation Outcomes Project

2020 ◽  
Vol 10 (4) ◽  
pp. 1601-1610
Author(s):  
Jaimie A. Roper ◽  
Abigail C. Schmitt ◽  
Hanzhi Gao ◽  
Ying He ◽  
Samuel Wu ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Study Data ◽  
Functional Mobility ◽  
Quality Improvement Initiative ◽  
Timed Up And Go ◽  
Mobility Performance ◽  
Risk Of Mortality ◽  
The Impact

Background: The impact of concurrent osteoarthritis on mobility and mortality in individuals with Parkinson’s disease is unknown. Objective: We sought to understand to what extent osteoarthritis severity influenced mobility across time and how osteoarthritis severity could affect mortality in individuals with Parkinson’s disease. Methods: In a retrospective observational longitudinal study, data from the Parkinson’s Foundation Quality Improvement Initiative was analyzed. We included 2,274 persons with Parkinson’s disease. The main outcomes were the effects of osteoarthritis severity on functional mobility and mortality. The Timed Up and Go test measured functional mobility performance. Mortality was measured as the osteoarthritis group effect on survival time in years. Results: More individuals with symptomatic osteoarthritis reported at least monthly falls compared to the other groups (14.5% vs. 7.2% without reported osteoarthritis and 8.4% asymptomatic/minimal osteoarthritis, p = 0.0004). The symptomatic group contained significantly more individuals with low functional mobility (TUG≥12 seconds) at baseline (51.5% vs. 29.0% and 36.1%, p < 0.0001). The odds of having low functional mobility for individuals with symptomatic osteoarthritis was 1.63 times compared to those without reported osteoarthritis (p < 0.0004); and was 1.57 times compared to those with asymptomatic/minimal osteoarthritis (p = 0.0026) after controlling pre-specified covariates. Similar results hold at the time of follow-up while changes in functional mobility were not significant across groups, suggesting that osteoarthritis likely does not accelerate the changes in functional mobility across time. Coexisting symptomatic osteoarthritis and Parkinson’s disease seem to additively increase the risk of mortality (p = 0.007). Conclusion: Our results highlight the impact and potential additive effects of symptomatic osteoarthritis in persons with Parkinson’s disease.

The Impact of Property Characteristics on Economic Performance of Russian Industrial Enterprises

2005 ◽  
pp. 53-68 ◽  
Author(s):  
R. Kapeliushnikov ◽  
N. Demina
Keyword(s):  
Detailed Analysis ◽  
Economic Performance ◽  
Ownership Concentration ◽  
Corporate Sector ◽  
Concentrated Ownership ◽  
Industrial Enterprises ◽  
Russian Industry ◽  
Control Premium ◽  
And Performance ◽  
The Impact

The paper provides new survey evidence on effects of concentrated ownership upon investment and performance in Russian industrial enterprises. Authors trace major changes in their ownership profile, assess pace of post-privatization redistribution of shareholdings and provide evidence on ownership concentration in the Russian industry. The major econometric findings are that the first largest shareholding is negatively associated with the firm’s investment and performance but surprisingly the second largest shareholding is positively associated with them. Moreover, these relationships do not depend on identity of majority shareholders. These results are consistent with the assumption that the entrenched controlling owners are engaged in extracting "control premium" but sizable shareholdings accumulated by other blockholders may put brakes on their expropriating behavior and thus be conductive for efficiency enhancing. The most interesting topic for further more detailed analysis is formation, stability and roles of coalitions of large blockholders in the corporate sector of post-socialist countries.

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