The Correlation of Serum Myostatin Levels with Gait Speed in Kidney Transplantation Recipients

The primary role of myostatin is to negatively regulate skeletal muscle growth. The gait speed is a noninvasive, reliable parameter that predicts cardiovascular risk and mortality. This study evaluated the relationship between serum myostatin concentrations and gait speeds in patients who had undergone kidney transplantation (KT). A total of 84 KT recipients were evaluated. A speed of less than 1.0 m/s was categorized into the low gait speed group. We measured serum myostatin concentrations with a commercial enzyme-linked immunosorbent assay. KT recipients in the low gait speed group had significantly older age, as well as higher body weight, body mass index (BMI), skeletal muscle index, serum triglyceride levels, glucose levels, and blood urea nitrogen levels, lower estimated glomerular filtration rates and serum myostatin levels, a higher percentage of steroid use, and a lower proportion of mycophenolate mofetil use. Multivariable logistic regression analysis revealed that lower myostatin levels and lower frequency of mycophenolate mofetil use were independently associated with low gait speed. In multivariable stepwise linear regression analysis, myostatin levels were positively correlated with gait speeds, and age and BMI were negatively correlated with gait speeds. In the study, serum myostatin levels were significantly lower in the low gait speed group. Subjects in the low gait speed group also had greater BMI and older age.

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Simplified morphological evaluation of skeletal muscle mass and maximum muscle strength in healthy young women: Comparison between thigh and calf

Women s Health ◽

10.1177/1745506520962009 ◽

2020 ◽

Vol 16 ◽

pp. 174550652096200

Author(s):

Tomohiro Yasuda

Keyword(s):

Skeletal Muscle ◽

Regression Analysis ◽

Muscle Mass ◽

Young Women ◽

Skeletal Muscle Mass ◽

Handgrip Strength ◽

Muscle Thickness ◽

Skeletal Muscle Index ◽

Stand Test ◽

Sit To Stand

Objectives: The purpose of this study was to examine the prediction of skeletal muscle mass and maximum muscle strength using simplified morphology evaluation in young Japanese women from the thigh and calf perspective. Methods: A total of 249 Japanese young women (aged 18–25 years) were used for data analyses in this study. Thigh and calf girths were measured using a tape measure at 50% of thigh length and at 30% proximal of calf length, respectively. Muscle thickness was measured using B-mode ultrasound at the anterior and posterior thigh (at 50% of thigh length) and at the posterior lower leg (at 30% proximal of calf length), respectively. The measurements were carried out on the right side of the body while the participants stood with their elbows extended and relaxed. A stepwise multiple regression analysis (method of increasing and decreasing the variables; criterion set at p < 0.05) was performed for skeletal muscle index (defined by appendicular skeletal muscle mass/height2), handgrip strength, or sit-to-stand test and five variable factors (girth (thigh and calf) and muscle thickness (anterior and posterior thigh and posterior calf)). Results: Unlike the sit-to-stand test, skeletal muscle index or handgrip strength was correlated ( p < 0.001) with the girth or muscle thickness for both thigh and calf. Unlike the sit-to-stand test, the prediction equations for skeletal muscle index and handgrip strength estimation showed significant correlations with multiple regression analysis of data obtained from the calf girth and muscle thickness. In both skeletal muscle index and handgrip strength, calf girth was adopted as a Step 1, respectively. Conclusion: Our results indicated that skeletal muscle index and handgrip strength could be evaluated by the simplified morphology methods, especially that for the calf girth measurement, which may be a good indicator of screening/preventing for sarcopenia in healthy Japanese young women.

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P1664ASSOCIATED WITH SERUM MYOSTATIN LEVEL WITH GAIT SPEED IN RENAL TRANSPLANT RECIPIENTS

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p1664 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Chi-Chong Tang ◽

Jia-Sian Hou ◽

Yu-Chi Chang ◽

Chia-Wen Lu ◽

Ming-Che Lee ◽

...

Keyword(s):

Regression Analysis ◽

Mycophenolate Mofetil ◽

Renal Transplant ◽

Gait Speed ◽

Filtration Rate ◽

Walking Speed ◽

Estimated Glomerular Filtration Rate ◽

Renal Transplant Recipients ◽

Transplant Recipients ◽

Speed Test

Abstract Background and Aims Walking speed test is a usefulness tool for cardiovascular risk stratification in older adults. The inhibition of myostatin in adult significantly increases muscle mass and confers benefits upon measures of performance and metabolism. The present study evaluated the relationship between walking speed test and serum myostatin levels in renal transplant recipients. Method Fasting blood samples were collected from 84 renal transplant recipients. Handgrip strength (HGS) was measured using a Jamar Plus Digital Hand Dynamometer for assessment of muscle strength. Gait speed was measured by walking 6 meters at the usual speed. Gait speed < 1 m/s was defined as low gait speed group according to the European Working Group on Sarcopenia in Older People (EWGSOP) criteria. Serum myostatin levels were measured using a commercial enzyme-linked immunosorbent assay. Results Thirty-one renal transplant recipients (36.9%) had low gait speed, and they included a lower percentage of use of mycophenolate mofetil (p = 0.003), higher percentage of use of steroid (p = 0.037), older age (p = 0.0090, higher body weight (p = 0.044), body mass index (p = 0.017), skeletal muscle index (p = 0.027), serum triglyceride (p = 0.029), glucose (p = 0.007), blood urea nitrogen (p = 0.041), cystatin C (p = 0.015), while lower estimated glomerular filtration rate from serum creatinine (eGFRcre, p = 0.047) and estimated glomerular filtration rate from serum cystatin C (eGFRcys, p = 0.006) compared with renal transplant recipients with normal gait speed. After adjusting for cofounders associated with low gait speed in these patients by multivariable logistic regression analysis, serum myostatin levels (Odds ratio (OR): 0.943, 95% confidence interval (CI): 0.898–0.990, p = 0.018), and mycophenolate mofetil used (OR: 0.199, 95% CI: 0.050–0.795, p = 0.022) were independently associated with low gait speed in renal transplant recipients. The area under the receiver-operating characteristic (ROC) curve indicates the diagnostic power of serum myostatin levels at predicting low gait speed of renal transplant recipients was 0.769 (95% CI: 0.664-0.854, p < 0.001). Multivariable forward stepwise linear regression analysis also showed that serum myostatin levels (β = 0.353, adjusted R2 change: 0.245, p = 0.001) was positively associated with gait speed values in renal transplant recipients. Conclusion In this study, serum myostatin levels is found to be positively correlated with gait speed values and is identified as serum low myostatin levels is associated with low gait speed in renal transplant patients.

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Association of endothelial dysfunction with sarcopenia and muscle function in a relatively young cohort of kidney transplant recipients

PeerJ ◽

10.7717/peerj.12521 ◽

2021 ◽

Vol 9 ◽

pp. e12521

Author(s):

Siok-Bin Khoo ◽

Yu-Li Lin ◽

Guan-Jin Ho ◽

Ming-Che Lee ◽

Bang-Gee Hsu

Keyword(s):

Skeletal Muscle ◽

Endothelial Dysfunction ◽

Kidney Transplant ◽

Muscle Mass ◽

Gait Speed ◽

Vascular Reactivity ◽

Multivariate Logistic Regression Analysis ◽

Reactivity Index ◽

Young Cohort ◽

Skeletal Muscle Index

Background Sarcopenia and endothelial dysfunction are both common among kidney transplant (KT) recipients. We aimed to evaluate the association between endothelial dysfunction and sarcopenia, as well as its individual components. Methods Vascular reactivity index (VRI), skeletal muscle index (SMI = skeletal muscle mass/height2), handgrip strength (HGS), and 6-meter usual gait speed (GS) were measured in 95 KT recipients. Low SMI was defined as SMI less than 10% of the sex-specific reference values from Chinese adults; low HGS as HGS < 28 kg for men and < 18 kg for women; slow GS as GS below 1.0 m/s. Sarcopenia was diagnosed based on the presence of low SMI as an essential criterion, accompanied by either low HGS or slow GS. Vascular reactivity was classified as being indicative of poor (VRI < 1.0), intermediate (1.0 ≤ VRI < 2.0), or good (VRI ≥ 2.0) vascular reactivity. Results Of the 95 patients, aged 45.2 ± 10.9 years, 11.6% had sarcopenia and 13.7% had poor vascular reactivity. Patients with sarcopenia were lower in body mass index (p = 0.001) and VRI (p = 0.041), and have a higher proportion of low muscle mass (p < 0.001), low HGS (p < 0.001), and slow GS (p = 0.001). Patients with poor vascular reactivity have a higher proportion of sarcopenia (p = 0.005), low HGS (p = 0.006), and slow GS (p = 0.029). Multivariate logistic regression analysis showed that patients in the poor VRI group were significantly associated with sarcopenia (odds ratio, OR = 6.17; 95% confidence interval [1.06–36.04]; p = 0.043), comparing to those with good VRI. We further analysed the effects of VRI on individual components of sarcopenia and found that VRI predicted slow GS significantly (OR = 0.41; 95% CI = [0.21–0.79]; p = 0.007), but not low SMI (OR = 1.15; 95% CI [0.53–2.49]; p = 0.718) and HGS (OR = 0.59; 95% CI [0.31–1.16]; p = 0.125). Conclusions We concluded that endothelial dysfunction is a key determinant of sarcopenia in KT recipients. Furthermore, endothelial dysfunction is more closely related to gait speed than muscle mass and strength.

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Sarcopenia and Predictors of Skeletal Muscle Mass in Elderly Men With and Without Obesity

Gerontology and Geriatric Medicine ◽

10.1177/2333721417713637 ◽

2017 ◽

Vol 3 ◽

pp. 233372141771363 ◽

Cited By ~ 4

Author(s):

Katja Stoever ◽

Anke Heber ◽

Sabine Eichberg ◽

Klara Brixius

Keyword(s):

Physical Activity ◽

Skeletal Muscle ◽

Muscle Mass ◽

Gait Speed ◽

Strong Correlations ◽

Elderly Men ◽

Skeletal Muscle Index ◽

European Working ◽

Upper And Lower Extremities ◽

Definition Of

Objectives: The aim of this study was to determine the variables which show the highest association with muscle mass and to identify the most important predictors for muscle mass in elderly men with and without sarcopenia. Methods: A total of 71 men participated, aged ≥65 years. Sarcopenia was assessed using the definition of the European Working Group on Sarcopenia in Older People with determining skeletal muscle index (SMI), hand-grip strength (HGS), and Short Physical Performance Battery. In addition, maximum strength at upper and lower extremities and physical activity were measured. Results: Strong correlations existed between SMI and gait speed, HGS, maximum isometric strength at leg and chest press. Physical activity showed low correlations with muscle strength. Regression analysis revealed HGS and gait speed as key predictors for SMI. Discussion: The recommendation is measuring gait speed and HGS in clinical practice at first followed by measuring muscle mass for determining sarcopenia.

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Skeletal Muscle Index as a Prognostic Marker for Kidney Transplantation in Older Patients

Journal of Renal Nutrition ◽

10.1053/j.jrn.2020.08.014 ◽

2020 ◽

Author(s):

Pierre-Guillaume Deliège ◽

Antoine Braconnier ◽

Floriane Chaix ◽

Yohann Renard ◽

Andreaa Petrache ◽

...

Keyword(s):

Skeletal Muscle ◽

Kidney Transplantation ◽

Prognostic Marker ◽

Older Patients ◽

Skeletal Muscle Index

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Correlation between the Charlson comorbidity index and skeletal muscle mass/physical performance in hospitalized older people potentially suffering from sarcopenia

BMC Geriatrics ◽

10.1186/s12877-019-1395-5 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 3

Author(s):

Ge Gong ◽

Wenhui Wan ◽

Xinghu Zhang ◽

Yu Liu ◽

Xinhui Liu ◽

...

Keyword(s):

Skeletal Muscle ◽

Older People ◽

Muscle Mass ◽

Physical Performance ◽

Charlson Comorbidity Index ◽

Gait Speed ◽

Skeletal Muscle Mass ◽

Skeletal Muscle Index ◽

Comorbidity Index ◽

Mass Group

Abstract Background Sarcopenia is a decrease in skeletal muscle mass, physical performance, and muscle strength in older people. In this study, we aimed to explore the correlation between comorbidity and skeletal muscle mass and physical performance in older people. Methods This retrospective study included 168 subjects. Their medical history, physical function, computed tomography (CT) chest scans, and blood tests for nutrition were evaluated. The patients were divided into two groups: (1) a low muscle mass group and (2) a normal muscle mass group. Multivariate analysis of variance was used to compare multiple sets of mean vectors. Results Overall, 72.02% of the subjects had a low skeletal muscle index (SMI) and low gait speed. The patients with low skeletal muscle mass and physical performance were older, had more serious comorbidities, and had longer average hospitalization periods and lower albumin and hemoglobin levels. Subjects with a high Charlson comorbidity index (CCI) were more likely to be in the sarcopenic group than in the non-sarcopenic group. In addition, there was a linear correlation between the CCI and SMI (r = − 0.549, P < 0.05), and between the CCI and gait speed (r = − 0.614, P < 0.05). The area under the curve (AUC) value for low skeletal muscle mass with the CCI was 0.879. Conclusions We identified an independent association between comorbidity and skeletal muscle mass/physical performance by researching the correlation between the CCI and SMI/gait speed. Our results suggested that the CCI score may have important clinical diagnostic value for sarcopenia.

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Anthropometric, body composition, and somatotype characteristics of Japanese young women: Implications for normal-weight obesity syndrome and sarcopenia diagnosis criteria

Interventional Medicine and Applied Science ◽

10.1556/1646.11.2019.14 ◽

2019 ◽

Vol 11 (2) ◽

pp. 117-121

Author(s):

Tomohiro Yasuda

Keyword(s):

Skeletal Muscle ◽

Body Composition ◽

Body Fat ◽

Young Women ◽

Gait Speed ◽

Normal Weight ◽

Skeletal Muscle Index ◽

Normal Weight Obesity ◽

Diagnosis Criteria ◽

Obesity Syndrome

Aims The purpose of this study was to examine the anthropometric, body composition, and somatotype characteristics of Japanese young women and to focus on normal-weight obesity syndrome and sarcopenia diagnosis criteria. Methods A total of 124 Japanese university freshmen women were measured at body mass index (BMI), percent body fat and skeletal muscle index (SMI), usual gait test, and handgrip strength. The subjects were divided into obesity (≥30% body fat; BMI: ≥25.0 kg/m2), normal-weight obesity (≥30% body fat; BMI: 18.5–24.9 kg/m2), sarcopenia (handgrip, <18 kg; gait speed: ≤0.8 m/s; SMI: <5.7 kg/m2), or presarcopenia (SMI: <5.7 kg/m2). There were no subjects below the sarcopenia diagnosis criteria in usual gait speed, but not for handgrip (0.8%) and SMI (36.3%). Results The prevalence of presarcopenia group (36.3%) is higher than in the normal-weight obesity (16.9%) and obesity (4.8%) groups. Anthropometry and sarcopenia diagnosis assessments were significantly higher in normal-weight obesity and standard groups compared with presarcopenia group. Discussion The number of young women was higher in the presarcopenia group than in the normal-weight obesity group, suggesting that the improvement of intrinsic skeletal muscle mass rather than fat mass is important for Japanese young women.

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Factors Affecting Energy Metabolism and Prognosis in Patients with Amyotrophic Lateral Sclerosis

Annals of Nutrition and Metabolism ◽

10.1159/000518908 ◽

2021 ◽

pp. 1-8

Author(s):

Mika Kurihara ◽

Shigeki Bamba ◽

Shoko Yasuhara ◽

Akihiko Itoh ◽

Taishi Nagao ◽

...

Keyword(s):

Skeletal Muscle ◽

Amyotrophic Lateral Sclerosis ◽

Regression Analysis ◽

Energy Metabolism ◽

Energy Expenditure ◽

Skeletal Muscle Index ◽

Factors Affecting ◽

Factors Associated ◽

Respiratory Status ◽

Lateral Sclerosis

Background/Aims: Nutritional status is a factor affecting prognosis in patients with amyotrophic lateral sclerosis (ALS). Here, we aimed to clarify the factors associated with hypermetabolism and the prognosticators of ALS. Methods: Forty-two inpatients (22 men, 20 women) diagnosed with ALS according to the revised El-Escorial criteria were investigated. The following data were retrospectively analyzed: anthropometric measurements, blood biochemistry, disease severity, basal energy expenditure (BEE), resting energy expenditure (REE) measured by indirect calorimetry, spirometry, and bioelectrical impedance analysis. Single and multiple regression analysis was performed to examine factors affecting REE and metabolic changes (defined as the ratio of REE to fat-free mass [FFM]). The Kaplan-Meier method was used to examine factors associated with the occurrence of cumulative events (death or tracheostomy). Results: Among the 42 inpatients, REE was significantly higher than BEE, indicating hypermetabolism in ALS. Multiple regression analysis revealed that REE/FFM is strongly associated with the skeletal muscle index (−3.746 to −1.532, p < 0.0001) and percent forced vital capacity (%FVC) (−0.172 to −0.021, p = 0.013). Moreover, both the skeletal muscle index and %FVC were significant prognosticators associated with the occurrence of cumulative events. Conclusions: Energy metabolism was elevated in ALS, and respiratory status and muscle mass were associated with the hypermetabolism and poor prognosis. Adequate nutritional support may improve outcomes in ALS by preventing deterioration of respiratory status and reduction in muscle mass.

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Preoperative nutritional risk index and postoperative one-year skeletal muscle loss can predict the prognosis of patients with gastric cancer: a registry based study

10.21203/rs.3.rs-91131/v1 ◽

2020 ◽

Author(s):

Kyung Won Kim ◽

Koeun Lee ◽

Jung-Bok Lee ◽

Taeyong Park ◽

Seungwoo Khang ◽

...

Keyword(s):

Gastric Cancer ◽

Skeletal Muscle ◽

Overall Survival ◽

Regression Analysis ◽

Risk Index ◽

Nutritional Risk ◽

Muscle Loss ◽

Skeletal Muscle Index ◽

Nutritional Risk Index ◽

Skeletal Muscle Loss

Abstract Background: Patients with gastric cancer have increased nutritional risk and experience a significant skeletal muscle loss after surgery. We aimed to determine whether muscle loss during the first postoperative year and nutritional status are indicators for predicting prognosis. Methods: From a gastric cancer registry, a total of 958 patients who received curative gastrectomy followed by chemotherapy for stage 2 and 3 gastric cancer and survived longer than 1 year were investigated. Clinical and laboratory data were collected. Skeletal muscle index (SMI) was assessed based on the muscle area at the L3 level on abdominal computed tomography. Results: Preoperative nutritional risk index (NRI) and postoperative decrement of SMI (dSMI) were significantly associated with overall survival (hazards ratio: 0.972 [95% CI: 0.958-0.986] and 1.058 [95% CI: 1.033-1.085], respectively) in a multivariate Cox regression analysis. Recurrence, tumor stage, comorbidity, and the preoperative muscle and subcutaneous fat area were also significant prognostic indicators. Kaplan-Meier analyses exhibited that patients with higher NRI had a significantly longer survival than those with lower NRI (3-year overall survival: 84.6% vs. 72.9%, P < 0.001). In addition, a significantly better prognosis was observed in a patient group with less decrease of SMI (3-year overall survival: 85.6% vs. 74.5%, P = 0.009). A logistic regression analysis demonstrated that the performance of preoperative NRI and dSMI in mortality prediction was quite significant (AUC: 0.63, P < 0.001) and the combination of clinical factors enhanced the predictive accuracy to the AUC of 0.90 (P < 0.001). This prognostic relevance of NRI and dSMI was maintained in patients experiencing tumor recurrence. Conclusions: Skeletal muscle loss during the first postoperative year and preoperative NRI are predictors of overall survival in stage 2 or 3 gastric cancer patients regardless of relapse. Our results support the potential importance of exercise and nutritional support along with standard treatment.

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Role of the Appendicular Skeletal Muscle Index for Predicting the Recurrence-Free Survival of Head and Neck Cancer

Diagnostics ◽

10.3390/diagnostics11020309 ◽

2021 ◽

Vol 11 (2) ◽

pp. 309

Author(s):

Kun-Yun Yeh ◽

Hang Huong Ling ◽

Shu-Hang Ng ◽

Cheng-Hsu Wang ◽

Pei-Hung Chang ◽

...

Keyword(s):

Skeletal Muscle ◽

Body Composition ◽

Head And Neck Cancer ◽

Mass Loss ◽

Lean Mass ◽

Recurrence Free Survival ◽

Skeletal Muscle Index ◽

Free Survival ◽

Prognostic Predictor ◽

Appendicular Skeletal Muscle

Background: This study investigates whether the appendicular skeletal muscle index (ASMI) was an independent prognostic predictor for patients with locally advanced head and neck cancer (LAHNC) receiving concurrent chemoradiotherapy (CCRT) and whether there were any differences in lean mass loss in different body regions during CCRT. Methods: In this prospective study, we analyzed the clinicopathological variables and the total body composition data before and after treatment. The factors associated with the 2-year recurrence-free survival rate (RFSR) were analyzed via logistic regression analysis. Results: A total of 98 patients were eligible for analysis. The body weight, body mass index, and all parameters of body composition significantly decreased after CCRT. The pretreatment ASMI was the only independent prognostic factor for predicting the 2-year RFSR (hazard ratio, 0.235; 95% confidence interval, 0.062–0.885; p = 0.030). There was at least 5% reduction in total lean and fat mass (p < 0.001); however, the highest lean mass loss was observed in the arms (9.5%), followed by the legs (7.2%), hips (7.1%), waist (4.7%), and trunk (3.6%). Conclusions: The pretreatment ASMI was the only independent prognostic predictor for the 2-year RFSR of LAHNC patients undergoing CCRT. Asynchronous loss of lean mass may be observed in different body parts after CCRT.

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