scholarly journals The Effect of 12 Weeks of β-Hydroxy-β-Methyl-Butyrate Supplementation after Liver Transplantation: A Pilot Randomized Controlled Study

Nutrients ◽  
2019 ◽  
Vol 11 (9) ◽  
pp. 2259 ◽  
Author(s):  
Barbara Lattanzi ◽  
Michela Giusto ◽  
Carlina Albanese ◽  
Gianluca Mennini ◽  
Daria D’Ambrosio ◽  
...  

Sarcopenia is a frequent complication in liver transplant (LT) recipients. β-hydroxy-β-methyl-butyrate (HMB) has the potential to increase muscle-performance and tropism. Our study aims at evaluating the effect on muscle mass and functioning, and the safety of 12 weeks of HMB supplementation in patients after LT. This is a pilot, randomized study. Male patients undergoing LT were randomly assigned to the HMB or control group. A diet interview, anthropometry and body composition by dual energy X-ray absorptiometry (DEXA) were performed at enrollment (T0), after 12 weeks (T1) and after 12 months (T12). Twenty-two liver transplant male patients were enrolled in the study: 12 in the HMB group and 10 as the control group. At enrollment, demographic, clinical and nutritional data were similar. According to the appendicular skeletal muscle index, sarcopenia was present in 50% of patients. The appendix skeletal muscle mass index (ASMI) showed a significant increase at T1 and T12 in HMB patients, but not in controls. The mid-arm muscle-circumference and hand grip strength also increased at T1 and T12 versus T0 only in the HMB group. No side effects were reported in either group. The study showed a positive effect of HMB in the recovery of muscle mass and strength after LT. HMB supplement in patients after LT was safe and well tolerated.

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Alice S Ryan ◽  
Joseph Hartstein ◽  
Charlene Hafer-Macko ◽  
Frederick Ivey

Sarcopenia is defined as an age-related loss in skeletal lean muscle mass and strength and is as a leading contributor to the development of frailty. Stroke survivors have muscle atrophy in paretic (P) vs. nonparetic (P) legs that could contribute to whole body sarcopenia. The purpose of this study was to determine the sarcopenic index in a large population of chronic stroke survivors and compare this group to age, gender, and BMI-matched non-stroke controls. Chronic stroke survivors aged 40 to 84 yrs (n=180, 61% female, 59% African American, BMI: 29±1 kg/m 2 , X±SEM) with mild to moderate gait deficits underwent whole body DXA scans to assess sarcopenic index (appendicular lean mass/ht 2 ). The cutoffs for sarcopenia, by the European Working Group on Sarcopenia, were used and defined as a skeletal muscle index of <7.23 kg/m 2 in men and <5.67 kg/m 2 in women. In the entire group, the prevalence of sarcopenia in stroke survivors (13%) did not differ significantly from that of populations reported previously in the literature. In 61-70 year olds, 87% (n=63) had normal muscle mass and 13% (n=9) were sarcopenic. In 71-80 year olds, 79% (n=30) had normal skeletal muscle index and 21% (n=8) were sarcopenic. Stroke survivors (n=39) were matched with 39 controls on the basis of race, gender, age ±4 years and BMI±2.5 units. After matched pair analysis, 5.1% of the controls had sarcopenia while 12.8% of the control group were sarcopenic (P<0.0001). Sarcopenic index was related to six-minute walking speed (r=0.28, P<0.01). In conclusion, stroke survivors may be at an elevated risk for sarcopenia when considering age, gender, and race to non-stroke individuals which is related to functional mobility in this population.


Diagnostics ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. 2158
Author(s):  
Massimiliano Leigheb ◽  
Alessandro de Sire ◽  
Matteo Colangelo ◽  
Domenico Zagaria ◽  
Federico Alberto Grassi ◽  
...  

Sarcopenia is a skeletal muscle disorder characterized by reduced muscle mass, strength, and performance. Muscle ultrasound can be helpful in assessing muscle mass, quality, and architecture, and thus possibly useful for diagnosing or screening sarcopenia. The objective of this study was to evaluate the reliability of ultrasound assessment of tibialis anterior muscle in sarcopenia diagnosis. We included subjects undergoing total or partial hip replacement, comparing measures with a healthy control group. We measured the following parameters: tibialis anterior muscle thickness, echogenicity, architecture, stiffness, skeletal muscle index (SMI), hand grip strength, and sarcopenia related quality of life evaluated through the SarQoL questionnaire. We included 33 participants with a mean age of 54.97 ± 23.91 years. In the study group we found reduced tibialis anterior muscle thickness compared to the healthy control group (19.49 ± 4.92 vs. 28.94 ± 3.63 mm, p < 0.05) with significant correlation with SarQoL values (r = 0.80, p < 0.05), dynamometer hand strength (r = 0.72, p < 0.05) and SMI (r = 0.76, p < 0.05). Moreover, we found reduced stiffness (32.21 ± 12.31 vs. 27.07 ± 8.04 Kpa, p < 0.05). AUC measures of ROC curves were 0.89 predicting reduced muscle strength, and 0.97 predicting reduced SMI for tibialis anterior muscle thickness, while they were 0.73 and 0.85, respectively, for muscle stiffness. Our findings showed that ultrasound assessment of tibialis anterior muscle might be considered a reliable measurement tool to evaluate sarcopenia.


2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Akira Nemoto ◽  
Toru Goyagi

Abstract Background Sarcopenia promotes skeletal muscle atrophy and exhibits a high mortality rate. Its elucidation is of the highest clinical importance, but an animal experimental model remains controversial. In this study, we investigated a simple method for studying sarcopenia in rats. Results Muscle atrophy was investigated in 24-week-old, male, tail-suspended (TS), Sprague Dawley and spontaneously hypertensive rats (SHR). Age-matched SD rats were used as a control group. The skeletal muscle mass weight, muscle contraction, whole body tension (WBT), cross-sectional area (CSA), and Muscle RING finger-1 (MuRF-1) were assessed. Enzyme-linked immunosorbent assay was used to evaluate the MuRF-1 levels. Two muscles, the extensor digitorum longus and soleus muscles, were selected for representing fast and slow muscles, respectively. All data, except CSA, were analyzed by a one-way analysis of variance, whereas CSA was analyzed using the Kruskal-Wallis test. Muscle mass weight, muscle contraction, WBT, and CSA were significantly lower in the SHR (n = 7) and TS (n = 7) groups than in the control group, whereas MuRF-1 expression was dominant. Conclusions TS and SHR presented sarcopenic phenotypes in terms of muscle mass, muscle contraction and CSA. TS is a useful technique for providing muscle mass atrophy and weakness in an experimental model of sarcopenia in rats.


2021 ◽  
Vol 39 (3_suppl) ◽  
pp. 56-56
Author(s):  
Hiroaki Nozawa ◽  
Shigenobu Emoto ◽  
Koji Murono ◽  
Yasutaka Shuno ◽  
Soichiro Ishihara

56 Background: Systemic chemotherapy can cause loss of skeletal muscle mass in colorectal cancer (CRC) patients in the neoadjuvant and palliative settings. However, it is largely unknown how the body composition is changed by chemotherapy rendering unresectable CRC to resectable disease or how it affects the prognosis. This study aimed at elucidating the effects of systemic chemotherapy on skeletal muscles and survival in stage IV CRC patients who underwent conversion therapy. Methods: We reviewed 98 stage IV CRC patients who received systemic chemotherapy in our hospital. According to the treatment setting, patients were divided into the ‘Conversion’, ‘Neoadjuvant chemotherapy (NAC)’, and ‘Palliation’ groups. The cross-sectional area of skeletal muscles at the third lumbar level and changes in the skeletal muscle index (SMI), defined as the area divided by height squared, during chemotherapy were compared among patient groups. The effects of these parameters on prognosis were analyzed in the Conversion group. Results: The mean SMI increased by 8.0% during chemotherapy in the Conversion group (n = 38), whereas it decreased by 6.2% in the NAC group (n = 18) and 3.7% in the Palliation group (n = 42, p < 0.0001). Moreover, patients with increased SMI during chemotherapy had a better overall survival (OS) than those whose SMI decreased in the Conversion group (p = 0.021). The increase in SMI was an independent predictor of favorable OS on multivariate analysis (hazard ratio: 0.26). Conclusions: Stage IV CRC patients who underwent conversion to resection often had an increased SMI. As such an increase in SMI further conveys a survival benefit in conversion therapy, it may be important to make efforts to preserve muscle mass by meticulous approaches, such as nutritional support, muscle exercise programs, and pharmacological intervention even during chemotherapy in patients with metastatic CRC.


2021 ◽  
Vol 13 (1) ◽  
pp. 37-44
Author(s):  
ZBIGNIEW M. OSSOWSKI

Background: The loss of muscle function and reduced mobility levels are the main reasons for the limitations of independence and disability in older people. The main aim of this study was to determine the relationship between the skeletal muscle index and mobility in older women. Material and methods: ‪The study involved 166 older women. Skeletal muscle mass and other body components were determined by bioimpedance using an InBody 720 device. Functional mobility was evaluated with the timed up-and-go test. 30-second chair stand was also used to measure the level of functional strength in lower extremities. Results: ‪The skeletal muscle index was positively correlated with functional mobility (r=-0.22; p=0.00) and 30-second chair stand (r=-0.47; p=0.00). However, the strength of lower extremities was a significantly better parameter in predicting mobility in older women than the skeletal muscle index and skeletal muscle mass. Conclusions: The functional strength of lower extremity muscles and the skeletal muscle index can have a positive effect on functional mobility in older people. The results may be helpful in clinical practice when diagnosing mobility limitations and in the process of programming physical activity of older women aimed at the prevention of sarcopenia.


Author(s):  
Zhenzhen Tu ◽  
Yanzhe Tan ◽  
Lifei Liu ◽  
Jia Xie ◽  
Ying Xu ◽  
...  

Objective This prospective randomized controlled study aimed to compare the ultrasound-guided (USG) technique with the standard single-wall puncture technique for epicutaneo-caval catheter (ECC) placement in neonates. Study Design A total of 100 neonates were included in this study. All enrolled neonates were randomly divided into two groups (n = 50): the USG group and the control group. The control group underwent standard single-wall puncture for ECC placement procedures, and the USG group underwent USG ECC placement procedures. Results The first attempt success rates (62 vs. 38%; p = 0.016) and the total success rates (92 vs. 74%; p = 0.017) were higher in the USG group than in the control group. The procedure time was shorter in the USG group than in the control group: 351.43 (112.95) versus 739.78 seconds (369.13), p < 0.001. The incidence of adverse events was not significantly different between the two groups. Conclusion Compared with the standard single-wall puncture method, USG cannulation is superior for neonatal ECC placement, with a higher success rate, and decreases the total procedural time. Key Points


2020 ◽  
Author(s):  
Hong Chen ◽  
Bin Wang ◽  
Qin Li ◽  
Juan Zhou ◽  
Rui Li ◽  
...  

Abstract Background: The catheter-related bladder discomfort (CRBD) of male patients is a common clinical problem, albeit lacking effective solutions. The present study aimed to investigate whether intravesical dexmedetomidine instillation alleviates the postoperative urinary discomfort in male patients with catheter under general anesthesia.Methods: This single-blinded, prospective, randomized study included a total of 167 male patients American Society of Anesthesiologists (ASA) physical status I-II scheduled for surgery under general anesthesia were allocated to two groups: 84 in the dexmedetomidine group and 83 in the control group. Dexmedetomidine group patients received intravesical instillation of the drug 0.5 μg/kg and normal saline 20 mL, while the control group received intravesical instillation of 20 mL normal saline. The catheter was clamped for 30 min after intravesical instillation for all patients. CRBD scores and urethra pain numerical rating scale (NRS) scores were measured at admittance to post-anesthesia care unit (PACU) (T0), intravesical instillation (T1), 30 min (T2), 60 min (T3), 2 h (T4) after intravesical instillation, discharged from PACU (T5), and 6 h (T6) and 24 h (T7) after the operation. Patient satisfaction at discharge from PACU and 24 h post-operation were compared between the two groups. Results: CRBD scores and urethra pain NRS scores after 30 min of intravesical dexmedetomidine instillation to 24 h post-operation were significantly lower than the control group (p<0.001), and patient satisfaction was higher at discharge from PACU and 24 h post-operation (p<0.001). No differences were detected in Steward score out of PACU (p=0.213) and from the time of the end of operation to fully awake (p=0.417).Conclusion: Intravesical dexmedetomidine instillation reduces postoperative urinary discomfort and urethra pain and improves satisfaction in male patients under general anesthesia.Clinical Trial Registration: Chinese Clinical Trial Registry (No. ChiCTR1800016429), date of registration 1st June 2018


2020 ◽  
Vol 16 ◽  
pp. 174550652096200
Author(s):  
Tomohiro Yasuda

Objectives: The purpose of this study was to examine the prediction of skeletal muscle mass and maximum muscle strength using simplified morphology evaluation in young Japanese women from the thigh and calf perspective. Methods: A total of 249 Japanese young women (aged 18–25 years) were used for data analyses in this study. Thigh and calf girths were measured using a tape measure at 50% of thigh length and at 30% proximal of calf length, respectively. Muscle thickness was measured using B-mode ultrasound at the anterior and posterior thigh (at 50% of thigh length) and at the posterior lower leg (at 30% proximal of calf length), respectively. The measurements were carried out on the right side of the body while the participants stood with their elbows extended and relaxed. A stepwise multiple regression analysis (method of increasing and decreasing the variables; criterion set at p < 0.05) was performed for skeletal muscle index (defined by appendicular skeletal muscle mass/height2), handgrip strength, or sit-to-stand test and five variable factors (girth (thigh and calf) and muscle thickness (anterior and posterior thigh and posterior calf)). Results: Unlike the sit-to-stand test, skeletal muscle index or handgrip strength was correlated ( p < 0.001) with the girth or muscle thickness for both thigh and calf. Unlike the sit-to-stand test, the prediction equations for skeletal muscle index and handgrip strength estimation showed significant correlations with multiple regression analysis of data obtained from the calf girth and muscle thickness. In both skeletal muscle index and handgrip strength, calf girth was adopted as a Step 1, respectively. Conclusion: Our results indicated that skeletal muscle index and handgrip strength could be evaluated by the simplified morphology methods, especially that for the calf girth measurement, which may be a good indicator of screening/preventing for sarcopenia in healthy Japanese young women.


Cancers ◽  
2019 ◽  
Vol 11 (5) ◽  
pp. 709 ◽  
Author(s):  
Patrick Naumann ◽  
Jonathan Eberlein ◽  
Benjamin Farnia ◽  
Thilo Hackert ◽  
Jürgen Debus ◽  
...  

Background: Surgical resection offers the best chance of survival in patients with pancreatic cancer, but those with locally advanced disease (LAPC) are usually not surgical candidates. This cohort often receives either neoadjuvant chemotherapy or chemoradiation (CRT), but unintended weight loss coupled with muscle wasting (sarcopenia) can often be observed. Here, we report on the predictive value of changes in weight and muscle mass in 147 consecutive patients with LAPC treated with neoadjuvant CRT. Methods: Clinicopathologic data were obtained via a retrospective chart review. The abdominal skeletal muscle area (SMA) at the third lumbar vertebral body was determined via computer tomographic (CT) scans as a surrogate for the muscle mass and skeletal muscle index (SMI) calculated. Uni- and multi-variable statistical tests were performed to assess for impact on survival. Results: Weight loss (14.5 vs. 20.3 months; p = 0.04) and loss of muscle mass (15.1 vs. 22.2 months; p = 0.007) were associated with poor outcomes. The highest survival was observed in patients who had neither cachectic weight loss nor sarcopenia (27 months), with improved survival seen in those who ultimately received a resection (23 vs. 10 months; p < 0.001). Cox regression revealed that either continued weight loss or continued muscle wasting (SMA reduction) was predictive of poor outcomes, whereas a sarcopenic SMI was not. Conclusions: Loss of weight and lean muscle in patients with LAPC is prognostic when persistent. Therefore, both should be assessed longitudinally and considered before surgery.


2002 ◽  
Vol 87 (8) ◽  
pp. 3667-3671 ◽  
Author(s):  
G. E. Krassas ◽  
N. Pontikides ◽  
V. Deligianni ◽  
K. Miras

The aim of this prospective controlled study was to ascertain the effect of hyperthyroidism on sperm quality and composition. We studied 23 thyrotoxic male patients, aged 43.8 ± 2.4 yr (mean ± sem), and 15 healthy male controls of approximately the same age (42.2 ± 2.2 yr). Two semen analyses at intervals of 2–3 wk were obtained before and about 5 months after euthyroidism was achieved either by methimazole alone (14 patients) or 131I plus methimazole (9 patients). Total fructose, zinc (Zn), and magnesium (Mg) were also measured in seminal plasma in 16 patients, because 7 had semen volume less than 2 ml. In the control group semen analysis was performed only once. Mean (±sem) semen volume was within normal range both in patients (3.3 ± 0.2 ml) and controls (3.5 ± 0.4 ml; P = NS). Mean sperm density was lower in patients, although the difference compared with controls did not reach statistical significance (35.7 ± 5.3 vs. 51.5 ± 6.1 × 106/ml; P = 0.062). The same was found with sperm morphology (68 ± 7% vs. 78 ± 8%; P = NS). Finally, mean motility was lower in thyrotoxic males than in controls (28 ± 8% vs. 57 ± 7%; P &lt; 0.01). After treatment, sperm density and motility improved [35.7 ± 5.3 vs. 43.3 ± 6.5 × 106/ml (P = NS) and 28 ± 8% vs. 45 ± 7% (P &lt; 0.05), respectively], but sperm morphology did not change (68 ± 7% vs. 70 ± 6%; P = NS). Mean values for fructose, Zn, and Mg did not differ between controls and patients either before or after achievement of euthyroidism [9.2 ± 0.7, 3.0 ± 0.5, and 4.2 ± 0.7 nmol/liter vs. 8.6 ± 0.9, 3.0 ± 0.5, and 4.7 ± 0.8 nmol/liter (patients before) and 9.1 ± 0.7, 3.1 ± 0.6, and 4.5 ± 0.9 nmol/liter (patients after treatment) for fructose, Zn, and Mg, respectively]. Moreover, according to the treatment given, no statistically significant differences were found before or after treatment. Finally, seminal plasma fructose, Zn, and Mg levels did not correlate with sperm parameters or with pretreatment thyroid hormone levels. In conclusion, the results of our study indicate that male patients with hyperthyroidism have abnormalities in seminal parameters, mainly sperm motility. These abnormalities improve or normalize when the patients become euthyroid. Restoration of sperm parameters was independent of the treatment provided for the hyperthyroid syndrome. Moreover, seminal plasma elements, such as fructose, Zn, and Mg, did not correlate with sperm density, motility, or morphology.


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