Prevalence and risk factors of sarcopenia in patients with diabetes: A meta-analysis

Context The prevalence of sarcopenia in patients with diabetes is three times higher than that in non-diabetic patients and is associated with a poor prognosis. Objective To investigate the global pooled prevalence and risk factors of sarcopenia in patients with diabetes. Data Sources Relevant studies published until November 30, 2020, were identified from the PubMed, Embase, Web of Science, WanFang, CNKI, VIP, and CBM databases. Study Selection Participants with age ≥18 years with clinically diagnosed diabetes. Sex and diabetes type were not restricted. Data Extraction The data were extracted by two reviewers independently using a standard data collection form. Data Synthesis The pooled prevalence of sarcopenia in patients with diabetes was 18% (95% CI,16-20); subgroup analysis showed that sarcopenia was more prevalent in males than in females, as well as being more prevalent in Asia than in South America and Oceania. Age (OR, 1.10), HbA1c (OR, 1.16), visceral fat area (VFA) (OR, 1.03), diabetic nephropathy (OR, 2.54), duration of diabetes (OR, 1.06), and HS-CRP (OR, 1.33) were risk factors for sarcopenia in patients with diabetes. Conclusions Sarcopenia was more prevalent in patients with diabetes. Age, HbA1c, visceral fat area (VFA), diabetic nephropathy, duration of diabetes, and HS-CRP were the probable risk factors. In the future, medical staff should not only pay attention to the early screening of sarcopenia in high-risk groups but also provide information on its prevention.

The Relationship between Initial Tacrolimus Metabolism Rate and Recipients Body Composition in Kidney Transplantation

There are several premises that the body composition of kidney transplant recipients may play a role in tacrolimus metabolism early after transplantation. The present study aimed at analyzing the relationship between the body composition parameters assessed by bioimpedance analysis (BIA) and initial tacrolimus metabolism. Immediately prior to transplantation, BIA using InBody 770 device was performed in 122 subjects. Tacrolimus concentration-to-dose (C/D) ratio was calculated based on the first blood trough level measurement. There was no difference in phase angle, visceral fat area, lean body mass index (LBMI) and the proportion of lean mass as a percentage of total body mass between the subgroups of slow and fast metabolizers. However, subjects with LBMI ≥ median value of 18.7 kg/m2, despite similar initial tacrolimus dose per kg of body weight, were characterized by a significantly lower tacrolimus C/D ratio (median 1.39 vs. 1.67, respectively; p < 0.05) in comparison with the subgroup of lower LBMI. Multivariate regression analysis confirmed that age (rpartial = 0.322; p < 0.001) and LBMI (rpartial = −0.254; p < 0.01) independently influenced the tacrolimus C/D ratio. A LBMI assessed by BIA may influence the tacrolimus metabolism in the early post-transplant period and can be a useful in the optimization of initial tacrolimus dosing.

Gender differences in the association between sleep duration and body mass index, percentage of body fat and visceral fat area among chinese adults: a cross-sectional study

Background The relationship between sleep duration and anthropometric indices are still unclear. This study aimed to explore the association between sleep duration and body mass index (BMI), percentage of body fat (PBF) and visceral fat area (VFA) among Chinese adults, further to explore gender difference in it. Methods We analyzed part of the baseline data of a cohort study among adult attendees at two health-screening centers in China. Sleep duration was self-reported and categorized into short (< 7 h/day), optimal (7-9 h/day) and long sleep (≥ 9 h/day). BMI, PBF and VFA were assessed by bioelectric impedance analysis. Demographic characteristics, chronic diseases and medication history, physical activity, smoking and alcohol drinking behaviors were measured by an investigator-administrated questionnaire. Results A total of 9059 adult participants (63.08% were females) were included in the analysis. The participants aged from 19 to 91 years with the mean age of 45.0 ± 14.6 years. Short sleep was independently associated with elevated odds of general obesity (defined using BMI) and visceral obesity (defined using VFA) among the total study population, and gender differences were observed in these associations. Among women, short sleep was associated with 62% increased odds of general obesity (OR = 1.62, 95% CI: 1.24-2.12) and 22% increased odds of visceral obesity (OR = 1.22, 95% CI: 1.02-1.45). Among men, long sleep duration was associated with 21% decreased odds of visceral obesity (OR = 0.79, 95% CI: 0.64-0.99). No association was observed between sleep duration and PBF in both sexes. Conclusions Sleep duration was associated with increased odds of general and visceral obesity, and this association differed between men and women. No association was observed between sleep duration and PBF among either males or females.

Association between combat-related traumatic injury and cardiovascular risk

ObjectiveThe association between combat-related traumatic injury (CRTI) and cardiovascular risk is uncertain. This study aimed to investigate the association between CRTI and both metabolic syndrome (MetS) and arterial stiffness.MethodsThis was a prospective observational cohort study consisting of 579 male adult UK combat veterans (UK-Afghanistan War 2003–2014) with CRTI who were frequency-matched to 565 uninjured men by age, service, rank, regiment, deployment period and role-in-theatre. Measures included quantification of injury severity (New Injury Severity Score (NISS)), visceral fat area (dual-energy X-ray absorptiometry), arterial stiffness (heart rate-adjusted central augmentation index (cAIx) and pulse wave velocity (PWV)), fasting venous blood glucose, lipids and high-sensitivity C reactive protein (hs-CRP).ResultsOverall the participants were 34.1±5.4 years, with a mean (±SD) time from injury/deployment of 8.3±2.1 years. The prevalence of MetS (18.0% vs 11.8%; adjusted risk ratio 1.46, 95% CI 1.10 to 1.94, p<0.0001) and the mean cAIx (17.61%±8.79% vs 15.23%±8.19%, p<0.0001) were higher among the CRTI versus the uninjured group, respectively. Abdominal waist circumference, visceral fat area, triglycerides, estimated insulin resistance and hs-CRP levels were greater and physical activity and high-density lipoprotein-cholesterol lower with CRTI. There were no significant between-group differences in blood glucose, blood pressure or PWV. CRTI, injury severity (↑NISS), age, socioeconomic status (SEC) and physical activity were independently associated with both MetS and cAIx.ConclusionsCRTI is associated with an increased prevalence of MetS and arterial stiffness, which are also influenced by age, injury severity, physical activity and SEC. The longitudinal impact of CRTI on clinical cardiovascular events needs further examination.

Novel Adiposity and Biochemical–Anthropometric Indices to Identify Cardiometabolic Risk and Metabolic Syndrome in Mexican Adults

Although several indices used in clinical practice identify cardiometabolic risk (CR) and metabolic syndrome (MetS), it is imperative to develop indices for specific populations. Therefore, we proposed and validated sex-specific indices to identify CR associated with visceral adipose tissue (VAT) accumulation or MetS in Mexican adults. Additionally, a cut-off value for the visceral fat area (VFA) to identify CR was proposed. Clinical, anthropometric, biochemical, and body composition variables were evaluated in 904 subjects (25–45 years old) (84.4% men). Multiple and logistic regressions were used to model the indices and ROC curve analysis to determine predictive performance. An additional cohort (n = 186) was used for indices validation, and Cohen’s kappa coefficient was employed for agreement analysis. The proposed sex-specific indices, called Mexican adiposity indices (MAIs) and biochemical–anthropometric indices (BAIs), were good predictors for CR and MetS. The kappa coefficients showed a moderate agreement level. The VFA cut-off value chosen to identify CR was 100.3 cm2 because it had the best combination of sensitivity (66.8%) and specificity (64.4%). MAIs and BAIs could be clinical tools to identify either CR associated to VAT accumulation or MetS, respectively. A VFA cut-off value of 100.3 cm2 could identify CR in Mexican men.

Connectedness to Nature Does Not Explain the Variation in Physical Activity and Body Composition in Adults and Older People

Connectedness to nature (CN) is a significant predictor of pro-environmental behaviours, human health and well-being. However, research on how this connection to the natural world might promote a more active lifestyle and improve body mass composition according to gender is lacking. This study investigated the influence of CN on physical activity (PA) and body composition in adults and older people. We recruited a sample of 219 individuals (77 men and 142 women), and a self-administered questionnaire was used to measure CN and obtain demographic data. Body composition was assessed by bioimpedance, and PA was assessed by accelerometry. Correlations and stepwise multiple regressions were used in data analysis. CN’s association with other variables was more pronounced in women than in men, and we only identified significant associations with steps/day and body composition. However, this variable would not be included in the regression models that we developed. Adiposity levels and muscle status were significant predictors of PA in women. In both genders, age, percentage of fat mass and fat-free mass were selected as regressors in the models developed for visceral fat area and muscle condition (R2 Adjusted ≥ 0.908).

Opposing Immune-Metabolic Signature in Visceral Versus Subcutaneous Adipose Tissue in Patients with Adenocarcinoma of the Oesophagus and the Oesophagogastric Junction

Oesophageal adenocarcinoma (OAC) is an exemplar model of obesity-associated cancer. Previous work in our group has demonstrated that overweight/obese OAC patients have better responses to neoadjuvant therapy, but the underlying mechanisms are unknown. Unravelling the immune–metabolic signatures of adipose tissue may provide insight for this observation. We hypothesised that different metabolic pathways predominate in visceral (VAT) and subcutaneous adipose tissue (SAT) and inflammatory secretions will differ between the fat depots. Real-time ex vivo metabolic profiles of VAT and SAT from 12 OAC patients were analysed. These samples were screened for the secretion of 54 inflammatory mediators, and data were correlated with patient body composition. Oxidative phosphorylation (OXPHOS) was significantly higher in VAT when compared to SAT. OXPHOS was significantly higher in the SAT of patients receiving neoadjuvant treatment. VEGF-A, VEGF-C, P1GF, Flt-1, bFGF, IL-15, IL-16, IL-17A, CRP, SAA, ICAM-1, VCAM-1, IL-2, IL-13, IFN-γ, and MIP-1β secretions were significantly higher from VAT than SAT. Higher levels of bFGF, Eotaxin-3, and TNF-α were secreted from the VAT of obese patients, while higher levels of IL-23 and TARC were secreted from the SAT of obese patients. The angiogenic factors, bFGF and VEGF-C, correlated with visceral fat area. Levels of OXPHOS are higher in VAT than SAT. Angiogenic, vascular injury and inflammatory cytokines are elevated in VAT versus SAT, indicating that VAT may promote inflammation, linked to regulating treatment response.