• Journal of The Korean Society of Integrative Medicine
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• v.11 no.4
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• pp.95-104
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• 2023

Purpose : This study aimed to introduce a 12-week muscular endurance exercise program and β-glucan consumption to obese elderly people with sarcopenia. We evaluated the program's impact on appendicular skeletal muscle strength and function, muscle function-related physical strength, blood lipids, and IGF-1. The results will serve as foundational data for preventing and improving sarcopenia. Methods : Forty elderly people aged 65 or older were recruited and underwent dual-energy X-ray absorptiometry. Based on criteria related to appendicular skeletal muscle mass (ASM/Height2: less than 5.4 kg/m2) and body fat percentage (at least 30% for women and 25% for men), we selected 24 obese elderly people with sarcopenia and excluded 56 who did not meet the criteria. Variables related to sarcopenia, blood lipids, IGF-1, and muscle function were measured before the 12-week muscular endurance exercise program. Results : In sarcopenic obese elderly participants, the 12-week muscular endurance exercise program significantly increased bone density and muscle mass while decreasing fat mass and percentage (p<.05). This program also improved grip strength, static balance, and SPPB in sarcopenic obese older adults. Furthermore, their 6-minute walk distance significantly increased (p<.05). Conclusion : Muscular endurance exercises combined with supplement intake can increase appendicular skeletal muscle and improve muscle strength and function, thereby improving the daily physical performance of the elderly.

• Journal of the Korean Society of Radiology
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• v.16 no.3
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• pp.309-317
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• 2022

It is reported that social distancing caused by the corona pandemic has resulted in a decrease in physical activity, and a decrease in muscle mass due to this increases the risk of vascular disease. Therefore, in this study, the risk of carotid intima media thickness was evaluated by measuring the thickness of CIMT, and the differences in variables according to gender were analyzed. From January 2022 to May 2022, a total of 220 people (121 males, 99 females) who performed blood tests, carotid ultrasound, and body composition analysis among those who visited the health check-up center of Busan H Hospital were included in this study. Significant differences in risk factors according to gender were analyzed using the chi-square test. The cut-off values of variables that can predict the risk of carotid intima media thickness were calculated, and the accuracy was evaluated by calculating the area under the curve, sensitivity, and specificity. As a result of the difference analysis, the higher the total cholesterol in men and the appendicular skeletal muscle index in women, the higher the risk of carotid intima media thickness. The cut-off value for predicting the risk of carotid intima media thickness was calculated to be greater than 199 mg/dL of total cholesterol in the male group and less than 5.9 kg/m² of the appendicular skeletal muscle index in the female group. As a result of this study, the higher the total cholesterol in men and the lower the appendicular skeletal muscle index in women, the higher the risk of increased CIMT. Therefore, in women, the appendicular skeletal muscle index is expected to serve as an indicator to predict and prevent vascular changes at an early stage.

• Nutrition Research and Practice
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• v.15 no.2
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• pp.203-212
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• 2021

BACKGROUND/OBJECTIVES: The branched-chain amino acids (BCAA), including isoleucine, leucine, and valine, promote muscle protein synthesis. However, obesity may interfere with protein synthesis by dysregulating mitochondrial function in the muscles. This study aimed to examine the association between dietary intake levels of BCAA and skeletal muscle mass index (SMI) in middle-aged participants, and the effect of obesity/abdominal obesity on this association. SUBJECTS/METHODS: The data of 3,966 men and women aged 50-64 years who participated in the 2008-2011 Korea National Health and Nutrition Examination Survey were analyzed. Intake levels of energy-adjusted dietary amino acids were obtained using a 24-hour dietary recall. SMI was calculated by dividing the appendicular skeletal muscle mass by body weight (kg) and multiplying the result by 100%. Multivariable general linear models were used to analyze the association of dietary BCAA intake levels with SMI. RESULTS: The beneficial effects of energy-adjusted dietary BCAA intakes on SMI were greater in the non-obesity/non-abdominal obesity groups; however, no significant associations were observed in the obesity/abdominal obesity groups (P > 0.05). CONCLUSIONS: Healthy weight and sufficient intake of dietary BCAA are recommended to maintain muscle mass.

• Endocrinology and Metabolism
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• v.37 no.2
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• pp.333-343
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• 2022

Background Homocysteine has been drawing attention with a closed linkage with skeletal muscle. However, the association of hyperhomocysteinemia with decreased skeletal muscle mass remains unclear. We aimed to investigate the association of hyperhomocysteinemia with low skeletal muscle mass (LMM) in asymptomatic adults. Methods This was a cross-sectional study of 114,583 community-dwelling adults without cancer, stroke, or cardiovascular diseases who underwent measurements of plasma homocysteine and body composition analysis from 2012 to 2018. Hyperhomocysteinemia was defined as >15 µmol/L. Skeletal muscle mass index (SMI) was calculated based on appendicular muscle mass (kg)/height (m)². Participants were classified into three groups based on SMI: "normal," "mildly low," and "severely low." Results The prevalence of hyperhomocysteinemia was the highest in subjects with severely LMM (12.9%), followed by those with mildly LMM (9.8%), and those with normal muscle mass (8.5%) (P for trend <0.001). In a multivariable logistic regression model, hyperhomocysteinemia was significantly associated with having a mildly LMM (odds ratio [OR], 1.305; 95% confidence interval [CI], 1.224 to 1.392) and severely LMM (OR, 1.958; 95% CI, 1.667 to 2.286), respectively. One unit increment of log-transformed homocysteine was associated with 1.360 and 2.169 times higher risk of having mildly LMM and severely LMM, respectively. Conclusion We demonstrated that elevated homocysteine has an independent association with LMM in asymptomatic adults, supporting that hyperhomocysteinemia itself can be a risk for decline in skeletal musculature.

• Journal of the Korean Society of Physical Medicine
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• v.19 no.1
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• pp.43-51
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• 2024

PURPOSE: Sarcopenic obesity (SO) is a clinical condition that combines sarcopenia and obesity. This study examined the frequency of SO in young Korean females between 20 and 29 years of age. METHODS: The study involved 1,000 participants. The height, weight, body mass index (BMI), waist circumference, skeletal muscle mass index, fasting glucose, triglyceride, total cholesterol levels, systolic and diastolic blood pressure, alcohol consumption, and smoking status were the research variables. The skeletal muscle mass index was calculated as appendicular skeletal muscle mass (ASM) divided by the BMI. The ASM was assessed using dual X-ray absorptiometry. Complex sampling analysis and multiple logistic regression were used for analysis. RESULTS: A .74(.30-1.80) frequency of SO was observed. The statistically significant risk factors in females were height, weight, BMI, waist circumference, skeletal muscle mass index, total cholesterol, systolic blood pressure, and diastolic blood pressure (p < .05). CONCLUSION: Young Korean adults with SO have a .74(.30-1.80) frequency of occurrence that is linked to specific risk factors. Hence, primary care clinicians and health care professionals should consider these factors when patients require a referral for early detection and treatment. Healthcare professionals and clinicians can identify potential SO patients by acknowledging these risk factors.

• Physical Therapy Rehabilitation Science
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• v.13 no.3
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• pp.304-314
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• 2024

Objective: This study aimed to investigate the association of explosive strength with muscle mass and muscle function measured using traditional methods such as peak torque (PT) and joint angular velocity (PAV). Design: Cross-sectional study Methods: Twenty-nine healthy adults (14 males and 15 females) participated in this study. Body mass index and appendicular skeletal muscle index (ASMI) were measured using bioelectrical impedance analysis. The explosive strength of the knee extensors was evaluated by measuring the rate of torque development (RTD) and rate of velocity development (RVD). RTD was analyzed by dividing it into early (0-50 ms) and late (100-200 ms) muscle contraction phases. In addition, PT and PAV were measured as traditional methods for assessing muscle function. Results: According to regression analysis, PAV accounts for 24.7% and 66.9% of the variance of RTD 0-50 (p=0.006) and RVD (p<0.001), respectively. On the other hand, ASMI (p=0.035) and isometric PT (p=0.001) explained 49.2% of the RTD 100-200. Conclusions: Early RTD is mainly predicted by PAV, which is thought to be a result of muscle fiber type. Therefore, PAV presents the possibility of an alternative method to evaluate explosive performance. Late RTD seems to be related to ASMI or isometric PT. The findings of this study are expected to contribute to musculoskeletal rehabilitation and evaluation in that they revealed factors contributing to early and late muscle contraction.

• Korean Journal of Community Nutrition
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• v.21 no.4
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• pp.378-385
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• 2016

Objectives: This study was conducted to investigate the association between sarcopenia and sarcopenic obesity and cardiovascular disease risk in Korean postmenopausal women. Methods: We analyzed data of 2,019 postmenopausal women aged 50-64 years who participated in the Korea National Health and Nutrition Examination Survey in 2008-2011 and were free of cardiovascular disease history. Blood pressure, height, and weight were measured. We analyzed the serum concentrations of glucose, total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol and triglyceride levels. Waist circumference was used to measure obesity. Appendicular skeletal muscle mass was measured by dual-energy X-ray absorptiometry. Sarcopenia was defined as the appendicular skeletal muscle mass/body weight<1 standard deviation below the gender-specific means for healthy young adults. The estimated 10-year risk of cardiovascular disease risk was calculated by Pooled Cohort Equation. Subjects were classified as non-sarcopenia, sarcopenia, or sarcopenic obesity based on status of waist circumference and appendicular skeletal muscle mass. Results: The prevalence of sarcopenia and sarcopenic obesity was 16.3% (n=317) and 18.3% (n=369), respectively. The 10-year risk of cardiovascular disease risk in the sarcopenic obesity group was higher ($3.82{\pm}0.22%$) than the normal group ($2.73{\pm}0.09%$) and sarcopenia group ($3.17{\pm}0.22%$) (p < 0.000). The odd ratios (ORs) for the ${\geq}7.5%$ 10-year risk of cardiovascular disease risk were significantly higher in the sarcopenic obesity group (OR 3.609, 95% CI: 2.030-6.417) compared to the sarcopenia group (OR 2.799, 95% CI: 1.463-5.352) (p for trend < 0.000) after adjusting for independent variables (i.e., exercise, period of menopausal, alcohol use disorders identification test (AUDIT) score, income, education level, calorie intake, %fat intake and hormonal replacement therapy). Conclusions: Sarcopenia and sarcopenic obesity appear to be associated with higher risk factors predicting the 10-year risks of cardiovascular disease risk in postmenopausal women. These findings imply that maintaining normal weight and muscle mass may be important for cardiovascular disease risk prevention in postmenopausal women.

• Clinical Nutrition Research
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• v.5 no.2
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• pp.126-136
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• 2016

Due to poor nutrition and abnormal energy metabolism, cancer patients typically experience the loss of muscle mass. Although the diabetic conditions or dyslipidemia have been reported as a causal link of cancer but the consequence of such conditions in relation to gain or loss of skeletal muscle mass in cancer patients has not been well documented. The purpose of this study was to investigate the relationship of lean body mass and systemic parameters related to lipid metabolism in non-diabetic cancer patients using data from the Korean National Health and Nutrition Examination Survey (KNHANES) 2008-2011. As results the level of serum total cholesterol (total-C) was negatively associated with both total lean body mass and appendicular lean body mass in cancer patients after adjustment for sex, physical activity, energy intake and comorbidity. The associations between consumption of dietary factors (energy, carbohydrate, protein and fat) and lean body mass were disappeared after adjusting comorbidities of cancer patients. Multivariate-adjusted linear regression analysis by quartiles of serum total-C showed that higher quartile group of total-C had significantly lower percent of lean body mass than reference group in cancer patients. The data indicate that serum lipid status can be the potential estimate of loss of skeletal muscle mass in cancer patients and be referenced in nutrition care of cancer patients under the onset of cachexia or parenteral/enteral nutrition. This data need to be confirmed with large pool of subjects and should be specified by stage of cancer or the site of cancer in future studies.

• Culinary science and hospitality research
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• v.23 no.1
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• pp.66-78
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• 2017

"Sarcopenia", sarcopenia is an old age syndrome, and used to describe the reduction of skeletal muscle. Initially, it was thought that sarcopenia was only a senile disease characterized by degeneration of muscle tissue. However, its cause is widely regarded as multifactorial, with neurological decline, hormonal changes, inflammatory pathway activation, declines in activity, chronic illness, fatty infiltration, and poor nutrition, all shown to be contributing factors. Skeletal muscle mass can be measured by a variety of methods, currently, the commonly used methods are dual-energy X-ray scanning (DXA), computer tomography (CT), magnetic resonance imaging (MRI), etc. Muscular skeletal disorders can also be assessed by measuring appendicular skeletal muscle (ASM), particularly muscle tissue content. At the same time, sarcopenia refers to skeletal muscle cell denervation, mitochondrial dysfunction, inflammation, hormone synthesis and secretion changes and a series of consequences caused by the above process and is a progressive loss of skeletal muscle syndrome, which can lead to the decrease of muscle strength, physical and functional disorders, and increase the risk of death. Sarcopenia is mainly associated with the aging process, but also related to other causes such as severe malnutrition, neurodegenerative diseases, and disuse and endocrine diseases associated with muscular dystrophy, and it is the comprehensive results of multi-factors, so it is difficult to define that sarcopenia is caused by a specific disease. With the aging problem of the population, the incidence of this disease is increasingly common, and seriously affects the quality of the life of the elderly. This paper reviews the etiology and pathogenesis of myopathy, screening methods and diagnosis, the influence of eating habits, etc, and hopes to provide reference for the diagnosis and treatment of this disease. At present, adequate nutrition and targeted exercise remain the gold standard for the therapy of sarcopenia.

• Annals of Geriatric Medicine and Research
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• v.22 no.4
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• pp.194-199
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• 2018

Background: The aim of this study was to examine the correlation between the number of remaining natural teeth (NRT) and the appendicular skeletal muscle mass index (SMI) in older adults. Methods: This study was based on data from the 2008-2010 Korea National Health and Nutritional Examination Surveys. The participants were 2,378 older participants (984 men and 1,394 women) aged over 65 years. Survey dentists conducted oral health examinations, and ASM was measured using dual-energy X-ray absorptiometry. Results: The participants with $NRT{\geq}20$ had more ASM and SMI than those with NRT<20 in both sexes. SMI was correlated with NRT in men (r=0.018, p<0.001) and in women (r=-0.007, p<0.001). The positive correlation between the NRT and SMI remained significant in men even after adjusting for age, marital status, income, smoking, drinking, physical activity, protein intake, energy intake, calcium intake, body mass index, fasting blood glucose level, medications, and prostheses (${\beta}=0.011$, p=0.001). In women, the correlation disappeared after adjustment for smoking, alcohol, physical activity, protein intake, energy intake, calcium intake, marital status, income, fasting basal glucose, medication administration, and prostheses. Conclusion: This study showed a correlation between NRT and SMI in those ${\geq}65$ years of age in Korea. The relationship persisted in men, but not in women, even after adjusting for confounders.