• Korean Journal of Radiology
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• v.24 no.9
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• pp.849-859
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• 2023

Objective: The prognostic value of the volume and density of skeletal muscles in the abdominal waist of patients with colon cancer remains unclear. This study aimed to investigate the association between the automated computed tomography (CT)-based volume and density of the muscle in the abdominal waist and survival outcomes in patients with colon cancer. Materials and Methods: We retrospectively evaluated 474 patients with colon cancer who underwent surgery with curative intent between January 2010 and October 2017. Volumetric skeletal muscle index and muscular density were measured at the abdominal waist using artificial intelligence (AI)-based volumetric segmentation of body composition on preoperative pre-contrast CT images. Patients were grouped based on their skeletal muscle index (sarcopenia vs. not) and muscular density (myosteatosis vs. not) values and combinations (normal, sarcopenia alone, myosteatosis alone, and combined sarcopenia and myosteatosis). Postsurgical disease-free survival (DFS) and overall survival (OS) were analyzed using univariable and multivariable analyses, including multivariable Cox proportional hazard regression. Results: Univariable analysis showed that DFS and OS were significantly worse for the sarcopenia group than for the non-sarcopenia group (P = 0.044 and P = 0.003, respectively, by log-rank test) and for the myosteatosis group than for the non-myosteatosis group (P < 0.001 by log-rank test for all). In the multivariable analysis, the myosteatotic muscle type was associated with worse DFS (adjusted hazard ratio [aHR], 1.89 [95% confidence interval, 1.25-2.86]; P = 0.003) and OS (aHR, 1.90 [95% confidence interval, 1.84-3.04]; P = 0.008) than the normal muscle type. The combined muscle type showed worse OS than the normal muscle type (aHR, 1.95 [95% confidence interval, 1.08-3.54]; P = 0.027). Conclusion: Preoperative volumetric sarcopenia and myosteatosis, automatically assessed from pre-contrast CT scans using AI-based software, adversely affect survival outcomes in patients with colon cancer.

• Journal of The Korean Society of Integrative Medicine
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• v.8 no.2
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• pp.199-209
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• 2020

Purpose : This study used a sarcopenia diagnostic algorithm proposed by the Asia working group in adults over 50 to diagnose sarcopenia and analyze body function. The purpose of this study is to prepare basic data for the management and prevention of sarcopenia. Methods : We performed a diagnostic evaluation of sarcopenia in 97 adults over the age of 50 years with the cooperation of the Seongnam senior experience complex in Seongnam-si, Gyeonggi-do. As a result of the diagnostic process, 24 subjects were placed into the sarcopenia group, while 73 subjects were placed into the normal group. We measured each subject's body, performed the timed up and go test to evaluate functional mobility, and conducted a questionnaire on the pre-symptom of locomotive syndrome and locomotive syndrome. Results : There were statistically significant differences in height, weight, and skeletal muscle mass between the two groups. There was also a statistically significant difference in the timed up and go test, which confirmed the difference in functional mobility between the two groups. In addition, there was a statistically significant difference between the two groups in the proportion and the mean score of subjects with pre-symptom of locomotive syndrome and locomotive syndrome. In the correlation analysis, grip strength was statistically significantly correlated with height, weight, skeletal muscle mass, waist circumference, timed up and go test, pre-symptom of locomotive syndrome and locomotive syndrome. Gait speed was significantly correlated with the timed up and go test and locomotive syndrome. Appendicular skeletal muscle index was significantly correlated with height, weight, waist circumference, hip circumference, and the pre-symptom of locomotive syndrome. Conclusion : In conclusion, sarcopenia is closely related to height, weight, skeletal muscle mass and functional mobility, as well as the pre-symptom of locomotive syndrome and, locomotive syndrome. In consideration of this, the prevention and management of sarcopenia should be made accordingly.

• Biomedical Science Letters
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• v.14 no.1
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• pp.7-12
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• 2008

We examined the prevalence of sarcopenia and age-related changes in body composition in Korean older persons. Community dwelling 77 men and 65 women($60{\sim}88\;yr$) were recruited for this study. Fat-free mass and the percent body fat were determined using bioelectrical impedance analysis. Isometric grip strength was measurement using grip strength dynamometer. Serum levels of fasting glucose, total cholesterol, HDL-cholesterol, and triglyceride were assayed. The prevalence of sarcopenia was found to increase with aging (men in their sixties 82.6%, seventies 96.6% and eighties 100%, and women in their sixties 47.4%, seventies 63%). In both gender groups, handgrip strength was inversely correlated with age and positively correlated with height, lean mass, and fat free mass. Better handgrip strength was related with higher weight in the men and with lower heart rate in the women. Fat free mass, age, and gender were found to be independent factors significantly associated with handgrip strength in the multivariate analysis. In summary, results of the present study suggest that handgrip strength is well associated with age, gender, and fat free mass and the prevalence of sarcopenia is increased with age and is exceeded by 40% among Korean persons older than 60 years.

• PNF and Movement
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• v.19 no.3
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• pp.311-319
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• 2021

Purpose: The study examined the effects of the proprioceptive neuromuscular facilitation pattern exercise and protein intake on balance, gait ability, and lower extremity muscular strength for sarcopenia in the elderly. Methods: A total of 30 elderly people (65~74years) with sarcopenia were recruited and randomized to Group I (n=10), Group II (n=10), and Group III (n=10). Their balance ability was measured using the functional reach test. Group I performed the proprioceptive neuromuscular facilitation pattern exercise and protein intake. Group II performed the proprioceptive neuromuscular facilitation pattern exercise. Group III performed protein intake. Their gait ability was measured using the Timed Up and Go test. Lower extremity muscular strength was measured using the Five Times Sit to Stand test. Results: As a result of comparison within groups, Group I and Group II showed a significant difference in balance, gait, and lower extremity muscular strength after the experiment (p<0.05), and Group I showed a more effectively significant difference than either Group II or Group III in balance, gait, and lower extremity muscular strength before and after the experiment (p<0.05). Conclusion: This study showed that the proprioceptive neuromuscular facilitation patterns exercise and protein intake was effective in balance, gait ability, and lower extremity muscular strength for sarcopenia in the elderly.

• Journal of Veterinary Clinics
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• v.40 no.3
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• pp.182-188
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• 2023

Sarcopenia and myosteatosis can increase the risk of adverse effects in dogs and humans. However, such imaging study results for evaluating sarcopenia and myosteatosis in small dogs have not yet been available. The objective of this study was to assess age-related changes according to the breed in epaxial muscle cross-sectional area (CSA) and fat infiltration using CT to evaluate sarcopenia and age-related myosteatosis in small breed dogs. In 144 dogs (92 Maltese dogs, 27 Poodle dogs, and 25 Shih Tzu dogs), Hounsfield Unit (HU) values and CSA of left epaxial muscle were measured at the thirteenth thoracic vertebral level on non-contrast transverse CT images. Differences in HU values and CSA according to age and breed were analyzed. The geriatric group (≥12 years) had significantly lower HU values of epaxial muscle than mature adult group (2 to 6 years) of all breeds. The geriatric group had significantly lower CSA of epaxial muscle than mature adult and senior groups (7 to 11 years) of Maltese dogs. HU values of epaxial muscle were not significantly different among all age groups of all breeds. Maltese dogs had significantly lower CSA of epaxial muscle than Poodle and Shih Tzu dogs in all age groups. Results of this study showed that as age increased in small breed dogs, muscle mass and density decreased.

• Women's Health Nursing
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• v.29 no.4
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• pp.328-336
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• 2023

Purpose: This study aimed to identify factors influencing the health-related quality of life (HRQoL) of older adult women with sarcopenia. Methods: The study was secondary data analysis using data from the 2019 Korea National Health and Nutrition Examination Survey. The final sample consisted of 142 women aged 60 years and older with sarcopenia and were selected from 8,110 women. The participants was analyzed using complex descriptive statistics, independent t-test, and regression. Results: In terms of HRQoL, three general characteristics were found to be influential, with an explanatory power of 56.0%: difficulty climbing stairs, difficulty working, and perceived health status. Having no or mild difficulty when climbing stairs (B=.20, p=.001; B=.21, p<.001) and no or mild difficulty when working (B=.25, p=. 002; B=.208, p=.013) had a significant effect on HRQoL compared to severe difficulty. Having good or ordinary perceived health status had a significant effect on the HRQoL (B=.11, p<.001; B=.09, p<.001). Conclusion: Based on study findings that the HRQoL of older adult women with sarcopenia were influenced by difficulty climbing stairs and working, as well as good perceived health status, healthcare providers should assist elderly women to maintain physical activities in their daily lives.

• Journal of Gastric Cancer
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• v.18 no.3
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• pp.242-252
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• 2018

Purpose: Surgical resection for gastric adenocarcinoma is associated with significant post-operative morbidity and mortality. The aim of this study was to assess the prognostic significance of sarcopenia in patients undergoing resection for gastric adenocarcinoma with respect to post-operative morbidity and survival. Materials and Methods: A retrospective analysis was conducted on a cohort of consecutive patients who underwent surgical resection for gastric adenocarcinoma between 2008 and 2014. Patient demographics, radiological parameters, and pathological data were collected. OsiriX software (Pixmeo) was used to measure skeletal muscle area, which was normalized for height to calculate skeletal muscle index. Results: A total of 56 patients (41 male, 15 female; mean age, $68.4{\pm}11.9years$) met the inclusion criteria. Of these, 36% (20 of 56) of the patients were sarcopenic pre-operatively. Both sarcopenic and non-sarcopenic patient groups were equally matched with the exception of weight and body mass index (P=0.036 and 0.001, respectively). Sarcopenia was associated with a decreased overall survival (log-rank P=0.003) and was an adverse prognostic predictor of overall survival in multivariate analysis (hazard ratio, 10.915; P=0.001). Sarcopenia was a predictor of serious in-hospital complications in multivariate analysis (odds ratio, 3.508; P=0.042). Conclusions: In patients undergoing curative resection for gastric cancer, there was a statistically significant association between sarcopenia and both decreased overall survival and serious post-operative complications. The measurement and reporting of skeletal muscle index on pre-operative computed tomography should be considered.

• Journal of the Optical Society of Korea
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• v.18 no.1
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• pp.55-59
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• 2014

Sarcopenia, or reduced muscle mass and volume, is due to various factors such as senile change, neuronal degeneration, drug, malignancy, and sepsis. Sarcopenia with the aging process has been evidenced by the decline in muscle mass by 0.5 to 1% per year with 3-5% reduction in muscle strength for 10 years between the ages of 40 and 50, and a 1-2% of decline of mass every year in people aged 60-70. Therefore, early diagnosis and understanding the mechanism of sarcopenia are crucial in the prevention of muscle loss. However, it is still difficult to image changes of muscle microstructure due to a lack of techniques. In this study, we developed an animal model using denervated rats to induce a rapid atrophy in the tibialis anterior (TA) and imaged its structural changes using optical coherence tomography (OCT) along with histologic and ultrasound analyses. Ultrasound showed changes of overall muscle size. Histology revealed that the atrophic TA muscle displayed an increased size variability of muscle fiber and inflammatory changes. Three dimensional OCT imaged the changes of perimysial grid and muscle fiber structure in real time without sacrifice. These observed advantages of multimodal imaging using OCT and ultrasound would provide clinical benefits in the diagnosis of sarcopenia.

• Journal of Korean Medical Science
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• v.33 no.50
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• pp.299.1-299.13
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• 2018

Background: Sarcopenia is associated with a poor prognosis in patients with liver cirrhosis. However, it is not known whether the rate of skeletal muscle depletion is also associated with a poor prognosis. We investigated the prognostic impact of the rate of skeletal muscle depletion in patients with liver cirrhosis. Methods: We included retrospectively all patients with liver cirrhosis who underwent both multiple computed tomography scans and hepatic venous pressure gradient (HVPG) measurements. Results: A total of 131 patients with liver cirrhosis were enrolled. The mean age of the patients was 53.7 years and alcoholic liver disease was the most common cause (61.8%). Sixty-four patients (48.9%) were diagnosed with sarcopenia. The median changes in skeletal muscle area per year (${\Delta}SMA/y$) were -0.89%. During a median follow-up period of 46.2 months (range, 3.4-87.6), 45 patients (34.4%) died. In multivariate analyses, age, Child-Pugh score, HVPG, presence of sarcopenia and ${\Delta}SMA/y$ were independently associated with mortality. Cumulative mortality was significantly higher in patients with ${\Delta}SMA/y$ < -2.4% than those with ${\Delta}SMA/y{\geq}-2.4%$ (log-rank test, P < 0.001). Conclusion: Both the presence and rate of change of sarcopenia are independently associated with long-term mortality in patients with liver cirrhosis.

• Nutrition Research and Practice
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• v.13 no.1
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• pp.47-57
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• 2019

BACKGROUND/OBJECTIVES: The aim of this study was to analyze the factors related to sarcopenic obesity among the elderly in South Korea. SUBJECTS/METHODS: A total of 3,367 elderly (${\geq}65years$) from the Korea National Health and Nutrition Examination Survey (2008-2011) were included in this analysis. The subjects were assessed to determine their sarcopenia and obesity status. Sarcopenia was assessed by determining their appendicular skeletal muscle mass (ASM). Obesity was defined by the waist circumference. An association of sarcopenic obesity and the related factors was analyzed using multiple logistic regression models. RESULTS: The risk of sarcopenic obesity of the subjects was decreased by active physical activity. After adjusting for age, smoking, and alcohol consumption, the risk of sarcopenic obesity in men of the highest level group (Q4) decreased by 45% (OR = 0.550, 95% CI = 0.334-0.905, P trend 0.018) compared to that in the reference group (Q1). Among the women, the risk of sarcopenic obesity in the Q3 and Q4 groups decreased by 29.0% (OR = 0.710, 95% CI = 0.512-0,984) and 56.7% (OR = 0.433, 95% CI = 0.281-0.668), respectively, compared to that in the Q1 group (P trend < 0.001). The mean daily energy intake was higher in the non-sarcopenia group than in the sarcopenia group. The risk of sarcopenic obesity in subjects not meeting the recommended intakes of energy, riboflavin, and vitamin C increased significantly by 25.4%, and 36.6%, and 32.6%, respectively, compared to that in the subjects meeting the recommended nutrient intake. CONCLUSION: Active physical activity as well as an adequate intake of energy and some vitamins might be negatively associated with the development of sarcopenia and sarcopenic obesity in the elderly.