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Established and Novel Approaches for Sarcopenia
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Established and Novel Approaches for Sarcopenia

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Clinical Rehabilitation".

Deadline for manuscript submissions: closed (30 October 2023) | Viewed by 12955

Special Issue Editor

Dr. Anastassios Philippou

E-Mail Website
Guest Editor
Department of Physiology, National and Kapodistrian University of Athens, 11527 Athens, Greece
Interests: skeletal and cardiac muscle physiology; exercise physiology; clinical exercise physiology; molecular exercise physiology; mechanotransduction
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Sarcopenia represents the progressive age-related wasting of skeletal muscle mass accompanied by the loss of muscle strength. A decline in muscle strength and function is associated with increased risk of adverse health outcomes, and sarcopenia patients are faced with mobility disorders, disability, a loss of independence, and reduced quality of life, while they are at a higher risk for morbidity (e.g., falls, bone fractures, and metabolic diseases, as skeletal muscle is one of the most important tissues for metabolic control), and mortality. Considering the growing elderly population and the increasing life expectancy, the prevalence of sarcopenia will escalate in the upcoming years. This provides the rationale for further characterizing the molecular mechanisms and abnormalities of sarcopenia, including abnormal energy metabolism, mitochondrial dysfunction, and myofibers type transition, as the basis for revealing and effectively treating its risk factors and thus developing efficient preventive and therapeutic strategies. Herein, we set up a Special Issue to incorporate papers focusing on the Established and Novel Approaches for Sarcopenia, including but not limited to nutrition supplementation, pharmacological approaches, and physical exercise as interventions for sarcopenia. The Special Issue aims to present established, advanced, and novel insights for preventing or treating sarcopenia to decrease its comorbidities, and hence improve quality of life, increase life expectancy, and limit healthcare costs for these patients.

Dr. Anastassios Philippou
Guest Editor

Manuscript Submission Information

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • sarcopenia
  • skeletal muscle wasting
  • muscle atrophy
  • myopathy
  • muscle protein catabolism
  • abnormal energy metabolism
  • mitochondrial dysfunction
  • myofiber type transition
  • morbidity
  • treatment strategies

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Related Special Issue

Published Papers (6 papers)

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Research

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14 pages, 329 KiB  
Article
Association of Physical Activity and Exercise with Physical Performance and Muscle Mass in Older Adults: Results from the Longevity Check-Up (Lookup) 7+ Project
by Hélio José Coelho-Júnior, Riccardo Calvani, Anna Picca, Matteo Tosato, Francesco Landi and Emanuele Marzetti
J. Clin. Med. 2023, 12(24), 7521; https://doi.org/10.3390/jcm12247521 - 5 Dec 2023
Viewed by 1497
Abstract
Regular engagement in physical activity (PA) or physical exercise (PE) is effective at improving physical performance and body composition in older adults. Less is known about the benefits that may be obtained through combining PA with PE and whether the effects of activity [...] Read more.
Regular engagement in physical activity (PA) or physical exercise (PE) is effective at improving physical performance and body composition in older adults. Less is known about the benefits that may be obtained through combining PA with PE and whether the effects of activity habits differ between men and women. This study cross-sectionally investigated the association of PA and/or PE with physical performance and anthropometric measures in a large and relatively unselected sample of older adults enrolled in the Longevity Check-up (Lookup) 7+ project. Participants were individuals 65 years and older living in the community who were recruited in unconventional settings across Italy. Adherence to PA or PE was operationalized as involvement in light walking or various types of exercise, respectively, at least twice weekly for a minimum of 30 min per session throughout the last 12 months. Physical performance measures included handgrip strength and five-time sit-to-stand (5STS) tests. Lower-limb muscle power and appendicular skeletal muscle mass (ASM) were estimated through validated equations. We analyzed data of 4119 participants, of whom 2222 (53.4%) were women. The mean age was 72.8 ± 5.8 years in men and 72.1 ± 5.4 years in women. Regular engagement in PA + PE was reported by 139 (7.3%) men and 100 (4.5%) women. Results indicated that regular walking activity and/or PE were significantly associated with better physical performance and greater ASM with sex-specific patterns. Associations were also influenced by the type of activity, physical performance assessment tool, and anthropometric parameters. Men engaged in PA + PE performed better on the 5STS test and had greater handgrip strength, ASM, and relative and specific muscle power than those practicing either PA or PE. In women, the combination of PA and PE was associated with greater handgrip strength. The findings of this study indicate that older adults regularly practicing PA + PE had better physical performance than those who only engaged in either modality. In men, the combination of PA and PE was also associated with greater ASM. Full article
(This article belongs to the Special Issue Established and Novel Approaches for Sarcopenia)
12 pages, 970 KiB  
Article
The Association between the L3 Skeletal Muscle Index Derived from Computed Tomography and Clinical Outcomes in Patients with Urinary Tract Infection in the Emergency Department
by Jinjoo An, Seung Pill Choi, Jae Hun Oh, Jong Ho Zhu, Sung Wook Kim and Soo Hyun Kim
J. Clin. Med. 2023, 12(15), 5024; https://doi.org/10.3390/jcm12155024 - 31 Jul 2023
Viewed by 1211
Abstract
The occurrence of a critical event during a urinary tract infection (UTI) can have a significant impact on mortality. This study aimed to investigate the association between the skeletal muscle index (SMI) and critical events in patients with a UTI. From April 2019 [...] Read more.
The occurrence of a critical event during a urinary tract infection (UTI) can have a significant impact on mortality. This study aimed to investigate the association between the skeletal muscle index (SMI) and critical events in patients with a UTI. From April 2019 to March 2022, a total of 478 patients who met the diagnostic criteria of a UTI and underwent an abdominal CT were included in this study. Multivariate binary logistic regression analysis was used to assess independent predictors of critical events. The primary outcome was any critical event, defined as the initiation of dialysis, invasive ventilation, initiation of vasoactive medications, cardiac arrest, or death. The UTI patients were divided into two groups: those with a low SMI (n = 93) and those with a high SMI (n = 385). In multivariate analysis, a low SMI, diabetes mellitus, altered mentality, lactate levels, and creatinine levels were identified as significant predictors of critical events. A low SMI is an independent factor associated with the occurrence of critical events in UTI patients during hospitalization. Patients with a low SMI, indicating muscle wasting, may have less resilience to infections and a higher risk of experiencing severe complications. Considering the SMI along with other clinical factors can help health care providers assess and manage UTI patients. Full article
(This article belongs to the Special Issue Established and Novel Approaches for Sarcopenia)
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11 pages, 441 KiB  
Article
Association between Dietary Habits and Sarcopenia in Patients with Liver Cirrhosis
by Mirabela-Madalina Topan, Ioan Sporea, Mirela Dănilă, Alina Popescu, Ana-Maria Ghiuchici, Raluca Lupușoru and Roxana Șirli
J. Clin. Med. 2023, 12(14), 4693; https://doi.org/10.3390/jcm12144693 - 14 Jul 2023
Cited by 2 | Viewed by 1353
Abstract
Sarcopenia and sarcopenic obesity are frequent complications of cirrhosis, and the dietary patterns of patients with these diseases significantly impact the development of both conditions. This study aims to evaluate the adequacy of the dietary intake of patients with liver cirrhosis. A total [...] Read more.
Sarcopenia and sarcopenic obesity are frequent complications of cirrhosis, and the dietary patterns of patients with these diseases significantly impact the development of both conditions. This study aims to evaluate the adequacy of the dietary intake of patients with liver cirrhosis. A total of 201 patients with liver cirrhosis were included in this analysis. We evaluated the nutritional status of the patients as stated by EWGSOP2 criteria. Subjects were divided into three groups: non-sarcopenic, sarcopenic, and with sarcopenic obesity. We conducted a dietary assessment three times over nonconsecutive 24 h periods within a month. According to EWGSOP2 criteria, combining low handgrip strength with low skeletal muscle index, the prevalence of sarcopenia was 57.2%. Sarcopenic obesity was found in 25.3% of patients. In the sarcopenic group of patients, the energy intake was lower than the current recommendations. Regarding protein intake, the consumption was relatively low in both sarcopenia and sarcopenic obesity samples of patients (0.85 g/kg body weight and 0.77 g/kg BW, p < 0.0001). Patients had a median of 2–3 eating episodes daily, and they often missed late-evening snacks. In conclusion, diet quality in cirrhotic patients was relatively poor, and energy and protein intakes were lower than suggested. Full article
(This article belongs to the Special Issue Established and Novel Approaches for Sarcopenia)
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11 pages, 506 KiB  
Article
The Presence of Myosteatosis Is Associated with Age, Severity of Liver Disease and Poor Outcome and May Represent a Prodromal Phase of Sarcopenia in Patients with Liver Cirrhosis
by Eleni Geladari, Theodoros Alexopoulos, Meropi D. Kontogianni, Larisa Vasilieva, Iliana Mani, Roxane Tenta, Vasilios Sevastianos, Ioannis Vlachogiannakos and Alexandra Alexopoulou
J. Clin. Med. 2023, 12(9), 3332; https://doi.org/10.3390/jcm12093332 - 7 May 2023
Cited by 11 | Viewed by 2103
Abstract
Background/Aims: Myosteatosis implies impaired muscle quality. The aim of the study was to investigate the association of myosteatosis with other muscle abnormalities and its role in the prognosis of liver cirrhosis (LC). Method: Skeletal muscle index (SMI) and myosteatosis were measured by computed [...] Read more.
Background/Aims: Myosteatosis implies impaired muscle quality. The aim of the study was to investigate the association of myosteatosis with other muscle abnormalities and its role in the prognosis of liver cirrhosis (LC). Method: Skeletal muscle index (SMI) and myosteatosis were measured by computed tomography. Myosteatosis was defined as muscle radiodensity and evaluated according to dry body mass index (BMI). Median values and interquartile range were used for continuous and count (percentage) for categorical variables. Results: A total of 197 consecutive patients were included (age 61 (IQR 52–68); 67% male; MELD score 11 (interquartile range 7.5–16)). Myosteatosis was identified in 73.6% and sarcopenia in 44.6% of patients. Myosteatosis was positively associated with age (p = 0.024) and Child–Pugh (p = 0.017) and inversely associated with SMI (p = 0.026). Patients with myosteatosis exhibited lower 360-day survival (log-rank p = 0.001) compared to those without it. MELD (p < 0.001) and myosteatosis (p = 0.048) emerged as negative prognostic factors of survival in multivariate model. Individuals combining low muscle strength and impaired muscle quality and quantity displayed more advanced LC, impaired muscle performance, lower BMI (p < 0.001 each) and a three times higher mortality rate compared to those with low muscle quality alone. Conclusions: The presence of myosteatosis was associated with advanced age, low skeletal mass and more severe LC. Myosteatosis was associated with poor prognosis and may represent a prodromal phase of muscle degeneration before the development of sarcopenia. Full article
(This article belongs to the Special Issue Established and Novel Approaches for Sarcopenia)
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Review

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16 pages, 615 KiB  
Review
Mitochondrial Dysfunction and Sarcopenic Obesity: The Role of Exercise
by Spyridon Hadjispyrou, Antonios Giannopoulos, Anastassios Philippou and Apostolos Theos
J. Clin. Med. 2023, 12(17), 5628; https://doi.org/10.3390/jcm12175628 - 29 Aug 2023
Cited by 8 | Viewed by 3229
Abstract
Sarcopenic obesity (SO) constitutes the coexistence of skeletal muscle mass loss (sarcopenia) and excess adiposity (obesity). It is mainly considered as a condition in the elderly with health-threatening impacts ranging from frailty to mortality. Mitochondrial dysfunction consists one of the basic pathophysiological mechanisms [...] Read more.
Sarcopenic obesity (SO) constitutes the coexistence of skeletal muscle mass loss (sarcopenia) and excess adiposity (obesity). It is mainly considered as a condition in the elderly with health-threatening impacts ranging from frailty to mortality. Mitochondrial dysfunction consists one of the basic pathophysiological mechanisms leading to the development of SO and its consequences. Indirect indicators of mitochondrial function, such as VO2max and exercise capacity, have been demonstrated to be negatively affected in individuals with SO, while the positive effect of exercise on mitochondrial function has been widely proved; thus, in this review, we aimed at investigating the effects of endurance, resistance, and concurrent exercise training on indexes of mitochondrial dysfunction in SO patients. The results of the clinical trials evaluated reveal positive effects of chronic exercise on VO2max and physical capacity, as well as mitochondrial biogenesis and activity. It has been concluded that utilizing a systematic exercise training program that includes both aerobic and strength exercises can be an effective strategy for managing SO and promoting overall health in these patients. Full article
(This article belongs to the Special Issue Established and Novel Approaches for Sarcopenia)
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Other

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16 pages, 899 KiB  
Systematic Review
Diagnostic Criteria and Prognostic Relevance of Sarcopenia in Patients with Inflammatory Bowel Disease—A Systematic Review
by Claudia-Gabriela Potcovaru, Petruța Violeta Filip, Oana-Maria Neagu, Laura Sorina Diaconu, Teodor Salmen, Delia Cinteză, Anca Pantea Stoian, Florin Bobirca, Mihai Berteanu and Corina Pop
J. Clin. Med. 2023, 12(14), 4713; https://doi.org/10.3390/jcm12144713 - 16 Jul 2023
Cited by 10 | Viewed by 2713
Abstract
Background: Sarcopenia is a syndrome characteristic in elderly patients and is also associated with a significant proportion of chronic disorders such as inflammatory bowel disease (IBD). In this case, it can lead to a worse prognosis of the disease and a decreased quality [...] Read more.
Background: Sarcopenia is a syndrome characteristic in elderly patients and is also associated with a significant proportion of chronic disorders such as inflammatory bowel disease (IBD). In this case, it can lead to a worse prognosis of the disease and a decreased quality of life. Study Aim: This study aims to identify the best ways to diagnose sarcopenia in patients with IBD, establish its impact on the course of the disease, and find preventive methods to counteract the effects of sarcopenia in the outcome of patients with IBD and, therefore, minimize disabilities and increase the health-related quality of life (HRQoL). Material and Methods: A systematic review with the Prospero registration number CRD42023398886 was performed in PubMed and Web of Science databases, evaluating all original articles published in the last 10 years (clinical trials and randomized control trials) that describe sarcopenia and IBD in the human adult population. Results: From the 16 articles that were included, 5 articles defined sarcopenia by the skeletal muscle index (SMI) and reported data regarding its correlation with body composition: BMI; visceral fat (VF); subcutaneous fat (SC); and VF/SC index. Other articles evaluated the link between sarcopenia and the total psoas muscle area, thigh circumference, calf circumference, subjective global assessment, hand grip strength, and appendicular SMI, alongside inflammatory markers such as IL-6 and C-reactive protein, level of disability, malnutrition, frailty, resistance training alone and in combination with whey protein, and infliximab treatment. Discussions and Conclusions: There is a great heterogeneity regarding the assessment criteria and methods used to diagnose sarcopenia due to the variability of population characteristics, both anthropometric and socio-cultural, alongside the high variability in the cut-offs. Therefore, any method which identifies sarcopenia in IBD patients, thus enabling intervention, may provide good results for patient quality of life and outcomes. Full article
(This article belongs to the Special Issue Established and Novel Approaches for Sarcopenia)
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