Journal of Cachexia, Sarcopenia and Muscle最新文献

{"title":"Intermittent Hypoxic-Hyperoxic Training During Inpatient Rehabilitation Improves Exercise Capacity and Functional Outcome in Patients With Long Covid: Results of a Controlled Clinical Pilot Trial.","authors":"Wolfram Doehner, Azadeh Fischer, Banafsheh Alimi, Jasmin Muhar, Jochen Springer, Christoph Altmann, Per Otto Schueller","doi":"10.1002/jcsm.13628","DOIUrl":"https://doi.org/10.1002/jcsm.13628","url":null,"abstract":"<p><strong>Introduction: </strong>Long COVID-19 illness is a severely disabling disease with shortness of breath, weakness and fatigue as leading symptoms, resulting in poor quality of life and substantial delay in return to work. No specific respiratory therapy has been validated for patients with long COVID. The intermittent hypoxia-hyperoxia training (IHHT) is a respiratory therapeutic modality to improve exercise performance via controlled respiratory conditioning. The purpose of the present study is to investigate the therapeutic effect of IHHT on functional and symptomatic recovery of patients with long COVID syndrome.</p><p><strong>Methods: </strong>A prospective, controlled, open-treatment interventional study was conducted in patients with long COVID who were admitted to an inpatient rehabilitation programme. Patients were assigned nonrandomized to receive IHHT in addition to the standardized rehabilitation programme (IHHT group) or standard rehabilitation alone (control group). The IHHT group received supervised sessions of intermittent hypoxic (10-12% O₂) and hyperoxic (30-35% O₂) breathing three times per week throughout the rehabilitation period. Primary endpoint was improved walking distance in a 6-min walk test (6MWT) between study groups. Secondary endpoints were change in stair climbing power, dyspnoea (Borg dyspnoea Scale), fatigue assessment scale (FAS) and change in health-related quality of life (HRQoL) assessed by patient global assessment (PGA), EQ-5D analogue scale and the MEDIAN Corona Recovery Score (MCRS). Further assessments included maximum handgrip strength, nine hole peg test, timed up-and-go, respiratory function and functional ambulation category (FAC), serum analyses and safety of the intervention.</p><p><strong>Results: </strong>A total of 145 patients were included in the study (74% female, mean age 53 ± 12 years) and assigned to IHHT (n = 70) or standard care (n = 75). The 6MWT distance improved 2.8-fold in the IHHT group compared to the control group (91.7 ± 50.1 m vs. 32.6 ± 54.2 m, ANCOVA p < 0.001). Stair climbing power improved 3.7-fold in the IHHT group compared to controls (-1.91 ± 2.23 s vs. -0.51 ± 1.93 s, p < 0.001). Secondary endpoints on dyspnoea, fatigue and HRQoL (PGA, EQ-5D and MCRS) improved significantly in the IHHT group compared to controls. The IHHT group exhibited a significant decrease in blood pressure, heart rate and increase in haemoglobin levels that was not observed in the control group. No adverse events were observed.</p><p><strong>Conclusion: </strong>Respiratory treatment with IHHT in addition to a multidisciplinary rehabilitation programme improves functional capacity, symptomatic status and quality of life in patients with disabling long COVID. IHHT has been demonstrated to be safe, well tolerated and feasible to be integrated in an inpatient rehabilitation programme to improve outcome in long COVID.</p>","PeriodicalId":186,"journal":{"name":"Journal of Cachexia, Sarcopenia and Muscle","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142666555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anabolic Sensitivity in Healthy, Lean, Older Men Is Associated With Higher Expression of Amino Acid Sensors and mTORC1 Activators Compared to Young.","authors":"Oscar Horwath, Marcus Moberg, Nathan Hodson, Sebastian Edman, Mats Johansson, Eva Andersson, Gerrit van Hall, Olav Rooyackers, Andrew Philp, William Apró","doi":"10.1002/jcsm.13613","DOIUrl":"https://doi.org/10.1002/jcsm.13613","url":null,"abstract":"<p><strong>Background: </strong>Sarcopenia is thought to be underlined by age-associated anabolic resistance and dysregulation of intracellular signalling pathways. However, it is unclear whether these phenomena are driven by ageing per se or other confounding factors.</p><p><strong>Methods: </strong>Lean and healthy young (n = 10, 22 ± 3 years, BMI; 23.4 ± 0.8 kg/m²) and old men (n = 10, 70 ± 3 years, BMI; 22.7 ± 1.3 kg/m²) performed unilateral resistance exercise followed by intake of essential amino acids (EAA). Muscle biopsies were collected from the rested and the exercised leg before, immediately after and 60 and 180 min after EAA intake. Muscle samples were analysed for amino acid concentrations, muscle protein synthesis (MPS) and associated anabolic signalling.</p><p><strong>Results: </strong>Following exercise, peak plasma levels of EAA and leucine were similar between groups, but the area under the curve was ~11% and ~28% lower in Young (p < 0.01). Absolute levels of muscle EAA and leucine peaked 60 min after exercise, with ~15 and ~21% higher concentrations in the exercising leg (p < 0.01) but with no difference between groups. MPS increased in both the resting (~0.035%·h^-1 to 0.056%·h^-1, p < 0.05) and exercising leg (~0.035%·h^-1 to 0.083%·h^-1, p < 0.05) with no difference between groups. Phosphorylation of S6K1^Thr389 increased to a similar extent in the exercising leg in both groups but was 2.8-fold higher in the resting leg of Old at the 60 min timepoint (p < 0.001). Phosphorylation of 4E-BP1^Ser65 increased following EAA intake and exercise, but differences between legs were statistically different only at 180 min (p < 0.001). However, phosphorylation of this site was on average 78% greater across all timepoints in Old (p < 0.01). Phosphorylation of eEF2^Thr56 was reduced (~66% and 39%) in the exercising leg at both timepoints after EAA intake and exercise, with no group differences (p < 0.05). However, phosphorylation at this site was reduced by ~27% also in the resting leg at 60 min, an effect that was only seen in Old (p < 0.01). Total levels of Rheb (~45%), LAT1 (~31%) and Rag B (~31%) were higher in Old (p < 0.001).</p><p><strong>Conclusion: </strong>Lean and healthy old men do not manifest AR as evidenced by potent increases in MPS and mTORC1 signalling following EAA intake and exercise. Maintained anabolic sensitivity with age appears to be a function of a compensatory increase in basal levels of proteins involved in anabolic signalling. Therefore, our results suggest that age per se does not appear to cause AR in human skeletal muscle.</p>","PeriodicalId":186,"journal":{"name":"Journal of Cachexia, Sarcopenia and Muscle","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142666553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on 'Systematic Druggable Genome-Wide Mendelian Randomization Identifies Therapeutic Targets for Sarcopenia' by Yin Et Al.","authors":"Tianrui Liu, Feixiang Yang, Kun Wang, Peng Guo, Jialin Meng","doi":"10.1002/jcsm.13589","DOIUrl":"https://doi.org/10.1002/jcsm.13589","url":null,"abstract":"","PeriodicalId":186,"journal":{"name":"Journal of Cachexia, Sarcopenia and Muscle","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142666554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distinctive Gait Variations and Neuroimaging Correlates in Alzheimer's Disease and Cerebral Small Vessel Disease.","authors":"Xia Zhou, Wen-Wen Yin, Chao-Juan Huang, Si-Lu Sun, Zhi-Wei Li, Ming-Xu Li, Meng-Meng Ren, Ya-Ting Tang, Jia-Bin Yin, Wen-Hui Zheng, Chao Zhang, Yu Song, Ke Wan, Yue Sun, Xiao-Qun Zhu, Zhong-Wu Sun","doi":"10.1002/jcsm.13616","DOIUrl":"https://doi.org/10.1002/jcsm.13616","url":null,"abstract":"<p><strong>Background: </strong>Both Alzheimer's disease (AD) and cerebral small vessel disease (CSVD) manifest in cognitive impairment and gait disorders. The precise similarities and differences in gait characteristics and underlying neuroimaging mechanisms remain unclear.</p><p><strong>Methods: </strong>A total of 399 participants were enrolled: 132 with probable AD, including 98 with mild cognitive impairment due to AD (AD-MCI) and 34 with AD dementia, and 185 with CSVD and 82 healthy controls. CSVD patients with cognitive impairment, including subcortical vascular mild cognitive impairment (svMCI) and subcortical vascular dementia, were grouped as subcortical vascular cognitive impairment (SVCI). Voxel-based morphology analysis assessed grey matter volume (GMV), while cerebral blood flow (CBF) was derived from 3D-arterial spin labelling data. Gait metrics included the timed up and go (TUG) test, dual-task TUG (DTUG) test, Berg balance scale (BBS), dual-task cost (DTC), step length, gait speed, cadence and coefficient of variation of gait. The relationships among structural and perfusion variations, gait metrics and cognitive function were examined.</p><p><strong>Results: </strong>SVCI patients exhibited greater gait impairments and variability than those with AD, while AD patients experienced higher DTC (p < 0.05). These differences were most evident in the MCI stage. In AD, gait speed correlated with GMV in the left middle occipital gyrus (F = 6.149), middle temporal gyrus (F = 4.595), right precuneus (F = 5.174) and other regions (all p < 0.025). In SVCI, gait speed was linked to thalamic GMV (F = 6.004, p < 0.025). Altered CBF in the parietal lobe and precuneus was associated with DTUG (F = 5.672), gait speed (F = 4.347) and BBS (F = 4.153) in AD, while cerebellar CBF related to TUG (F = 6.042), DTUG (F = 4.857) and BBS (F = 7.097) in SVCI (all p < 0.025). In AD-MCI, memory mediated the effect of hippocampal volume on DTC (indirect effect: -2.432, 95% CI [-5.503, -0.438]), while executive function (indirect effect: -2.920, 95% CI [-7.227, -0.695]) and processing speed (indirect effect: -2.286, 95% CI [-5.174, -0.484]) mediated the effect on DTUG. In svMCI, executive function mediated the effect of thalamic volume on step length (indirect effect: 2.309, 95% CI [0.486, 4.685]) and gait speed (indirect effect: 2.029, 95% CI [0.142, 4.588]), while processing speed mediated the effect on step length (indirect effect: 1.777, 95% CI [0.311, 4.021]).</p><p><strong>Conclusions: </strong>Different gait disorder characteristics and mechanisms were observed in AD and CSVD patients. In AD, gait is associated with volume/perfusion in posterior brain regions, whereas in SVCI, it relates to thalamic volume and cerebellar perfusion. Cognitive impairment mediates the effect of hippocampal and thalamic volumes on gait in AD-MCI and svMCI, respectively.</p>","PeriodicalId":186,"journal":{"name":"Journal of Cachexia, Sarcopenia and Muscle","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142646304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic Influence of the Brain on Muscle Structure: A Mendelian Randomization Study of Sarcopenia","authors":"Ting Lei, Zichao Jiang, Jiahao Wang, Jiangyu Nan, Long Hua, Zewu Zhu, Yihe Hu","doi":"10.1002/jcsm.13647","DOIUrl":"https://doi.org/10.1002/jcsm.13647","url":null,"abstract":"The association between brain and sarcopenia has not been clarified. We aim to investigate the causal association between brain structure, function, gene expression and sarcopenia-related traits.","PeriodicalId":186,"journal":{"name":"Journal of Cachexia, Sarcopenia and Muscle","volume":"4 1","pages":""},"PeriodicalIF":8.9,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142601155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lean Mass Longitudinally Confounds Sedentary Time and Physical Activity With Blood Pressure Progression in 2513 Children","authors":"Andrew O. Agbaje","doi":"10.1002/jcsm.13639","DOIUrl":"https://doi.org/10.1002/jcsm.13639","url":null,"abstract":"Randomized controlled trials have reported no effect of moderate-to-vigorous physical activity (MVPA) on reducing blood pressure (BP) in youth, probably due to short trial durations. This study examined the longitudinal effect of sedentary time (ST), light PA (LPA) and MVPA on BP in 11-year-old children followed up for 13 years to determine the confounding and mediating role of body composition.","PeriodicalId":186,"journal":{"name":"Journal of Cachexia, Sarcopenia and Muscle","volume":"17 1","pages":""},"PeriodicalIF":8.9,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142601156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sarcopenia Is a Prognostic Factor of Adverse Effects and Mortality in Patients With Tumour: A Systematic Review and Meta-Analysis","authors":"Yujie Zhang, Jingjing Zhang, Yunfan Zhan, Zhe Pan, Qiaohong Liu, Wei'an Yuan","doi":"10.1002/jcsm.13629","DOIUrl":"https://doi.org/10.1002/jcsm.13629","url":null,"abstract":"The relationship between sarcopenia and the prognosis of patients with tumours who received radio- and/or chemotherapy still needs to be determined. In this study, we aim to investigate the relationship between sarcopenia and adverse effects and mortality in patients with tumours that received radio- and/or chemotherapy, stratified by study design, tumour category, the method sarcopenia assessed, treatment options, study location and among other factors.","PeriodicalId":186,"journal":{"name":"Journal of Cachexia, Sarcopenia and Muscle","volume":"63 1","pages":""},"PeriodicalIF":8.9,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142599911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tocilizumab for Advanced Non‐Small‐Cell Lung Cancer With Concomitant Cachexia: An Observational Study","authors":"Yang Du, Xiao‐Yan Liu, Rui‐Li Pan, Xiao‐Tong Zhang, Xiao‐Yan Si, Min‐Jiang Chen, Meng‐Zhao Wang, Li Zhang","doi":"10.1002/jcsm.13638","DOIUrl":"https://doi.org/10.1002/jcsm.13638","url":null,"abstract":"BackgroundCancer cachexia significantly contributes to morbidity and mortality in patients with non‐small‐cell lung cancer (NSCLC). Inflammatory pathways mediated by interleukin‐6 (IL‐6) play a crucial role in the development of cancer cachexia. This study aimed to investigate the use of tocilizumab in the management of NSCLC with coexisting IL‐6‐elevated cachexia.MethodsIn this retrospective study, data were collected from patients with NSCLC and concurrent IL‐6‐elevated cachexia who received either tocilizumab plus antitumour therapy or antitumour therapy alone. The primary endpoints were overall survival (OS) and improved modified Glasgow Prognostic Score (mGPS) at Week 12. The secondary endpoints included changes from baseline over 12 weeks in body weight, albumin, C‐reactive protein (CRP) and mGPS. Qualitative improvements in patient self‐rated appetite and fatigue were reported as exploratory analysis.ResultsThe study included 49 patients diagnosed with NSCLC and IL‐6‐elevated cachexia, Eastern Cooperative Oncology Group performance status of 2–4. Of these, 26 received tocilizumab in combination with antitumour therapy, and 23 received antitumour therapy alone. The majority of these patients were male (87.8%). Baseline characteristics were almost identical between the two groups. The tocilizumab group demonstrated a significantly longer median OS compared to the control group (15.1 vs. 3.2 months; hazard ratio 0.18, 95% confidence interval 0.08–0.38; &lt;jats:italic&gt;p&lt;/jats:italic&gt; &lt; 0.001). The rate of patients surviving with mGPS improvement at Week 12 was significantly higher in the tocilizumab group than in the control group (risk difference 0.88, 95% confidence interval 0.75–1.00; &lt;jats:italic&gt;p&lt;/jats:italic&gt; &lt; 0.001). Over the 12‐week period, significant improvements were observed in body weight, albumin, CRP and mGPS in the tocilizumab group compared to the control group (body weight: 5.15 ± 0.53 kg vs. −5.69 ± 0.76 kg, &lt;jats:italic&gt;p&lt;/jats:italic&gt; = 0.041; albumin: 5.89 ± 0.70 g/L vs. −2.97 ± 0.71 g/L, &lt;jats:italic&gt;p&lt;/jats:italic&gt; &lt; 0.001; CRP: −91.50 ± 7.15 mg/L vs. 9.47 ± 13.69 mg/L, &lt;jats:italic&gt;p&lt;/jats:italic&gt; &lt; 0.001; mGPS: −1.61 ± 0.15 vs. 0.03 ± 0.08, &lt;jats:italic&gt;p&lt;/jats:italic&gt; &lt; 0.001). The tocilizumab group also displayed significantly higher rates of improvement in appetite and fatigue (both &lt;jats:italic&gt;p&lt;/jats:italic&gt; &lt; 0.001). The incidence of Grade 3 or higher adverse events was 34.6% in the tocilizumab group compared to 78.3% in the control group. Tocilizumab‐related adverse events were observed in three patients (11.5%), including two cases of neutropenia and one case of skin and subcutaneous tissue infection.ConclusionTocilizumab demonstrated significant benefits in survival and various clinical parameters, including body weight, albumin, CRP, mGPS and symptom burden in patients with NSCLC and concurrent IL‐6‐elevated cachexia. Given the existing unmet medical need for effective interventions for ca","PeriodicalId":186,"journal":{"name":"Journal of Cachexia, Sarcopenia and Muscle","volume":"9 1","pages":""},"PeriodicalIF":8.9,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142598291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound-Defined Sarcopenia Independently Predicts Acute Decompensation in Advanced Chronic Liver Disease","authors":"Juliana Gödiker, Lea Schwind, Torid Jacob, Nina Böhling, Sara Noemi Reinartz Groba, Markus Kimmann, Jörn Arne Meier, Kai-Henrik Peiffer, Jonel Trebicka, Johannes Chang, Michael Praktiknjo","doi":"10.1002/jcsm.13630","DOIUrl":"https://doi.org/10.1002/jcsm.13630","url":null,"abstract":"It has been shown that in patients with liver cirrhosis, sarcopenia is a predictor of acute decompensation (AD), acute-on-chronic liver failure (ACLF) and death. However, computer tomography (CT), as a suggested standard method for diagnosing sarcopenia, is resource intensive and involves radiation exposure. Therefore, in this study, we evaluate the muscle thickness of quadriceps femoris measured by ultrasound (US) as a prognostic parameter for AD and all-cause mortality in chronic liver disease.","PeriodicalId":186,"journal":{"name":"Journal of Cachexia, Sarcopenia and Muscle","volume":"159 1","pages":""},"PeriodicalIF":8.9,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142599908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction of Fragility Fractures and Mortality in a Cohort of Geriatric Patients","authors":"Peter Dovjak, Bernhard Iglseder, Anna Rainer, Gregor Dovjak, Michael Weber, Peter Pietschmann","doi":"10.1002/jcsm.13631","DOIUrl":"https://doi.org/10.1002/jcsm.13631","url":null,"abstract":"BackgroundRisk factors of refracture after fragility fractures include osteoporosis, female gender and advanced age among others. We hypothesized that the assessment of functionality, muscle health and nutrition status contribute to the risk prediction for further fractures and death.MethodsWe assessed 334 patients admitted to the department of acute geriatrics for sociodemographic data, bone fragility, selected laboratory tests, body composition and data on functionality using the comprehensive geriatric assessment. Patients had follow‐ups until the occurrence of further fractures or death. Dual‐energy X‐ray absorptiometry and pulse echo measurements were performed to assess bone mineral density. Fracture risk was assessed using the FRAX score and muscle strength according to published guidelines on sarcopenia.ResultsThe mean age was 81 years (70–95), and 82.3% (275/334) were women. An incidence of 10.4% (35/334) new fragility fractures was observed within 24 months, and the mortality rate was 12.2% (41/334). A significantly higher rate of further fractures was associated with lower BMI (body mass index) (HR 0.925, CI 0.872–0.98; <jats:italic>p</jats:italic> = 0.009), lower parathyroid hormone levels (HR 0.986, CI 0.973–0.998; <jats:italic>p</jats:italic> = 0.026) and with the diagnosis of osteoporosis (HR 2.546, CI 1.192–5.438; <jats:italic>p</jats:italic> = 0.016). No significant associations were present in patients with previous fractures, with higher age, higher FRAX scores, sarcopenia, in women, sarcopenic obesity, frail patients, lower grip strength, lower walking speed, lower Barthel index or lower DI (density index) values. The predictive power for further fractures was 10.7% higher adding osteosarcopenia, BMI and parathyroid hormone levels to standard assessment parameters osteoporosis, age and the status of previous fractures. Mortality was significantly higher with advanced age (HR 1.101, CI 1.052–1.151; <jats:italic>p</jats:italic> &lt; 0.001), in men (HR 6.464, CI 3.141–13.305; p &lt; 0.001), in smokers (<jats:italic>p</jats:italic> = 0.002), higher FRAX score (HR 1.039, CI 1.009–1.070; <jats:italic>p</jats:italic> = 0.010), lower renal function (HR 0.987, CI 0.976–0.997; p = 0.010), lower Tinetti test scores (HR 0.943, CI 0.900–0.987; <jats:italic>p</jats:italic> = 0.012), lower walking speed (HR 0.084, CI 0.018–0.382; <jats:italic>p</jats:italic> = 0.001), lower hand grip (HR 0.876, CI 0.836–0.919; <jats:italic>p</jats:italic> &lt; 0.001) and lower Barthel index scores (HR 0.984, CI 0.971–0.997; <jats:italic>p</jats:italic> = 0.015).ConclusionsIn a cohort of geriatric patients, the addition of BMI, low parathyroid hormone levels and osteosarcopenia increases the predictive power for further fractures by 10.7%. These parameters are a valuable addition to the standard assessment parameters age and history of sustained fractures. Mortality is partly associated with potentially treatable functional parameters.","PeriodicalId":186,"journal":{"name":"Journal of Cachexia, Sarcopenia and Muscle","volume":"19 1","pages":""},"PeriodicalIF":8.9,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142596897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}