BackgroundSarcopenia has garnered increasing attention in ulcerative colitis (UC) owing to its association with adverse clinical outcomes; however, its pathogenesis in the context of UC remains insufficiently characterized.MethodsHospitalized patients aged 18–70 years with active UC were consecutively enrolled at the Department of Gastroenterology, Peking Union Medical College Hospital, and age-matched healthy controls (HCs) were recruited. Body composition was assessed by bioelectrical impedance analysis (BIA), and muscle strength was evaluated by handgrip strength. Sarcopenia was diagnosed in accordance with the Asian Working Group for Sarcopenia (AWGS) 2025 consensus. Serum high-sensitivity C-reactive protein (hsCRP) of patients was recorded at admission. Intestinal barrier function was evaluated by serum diamine oxidase (DAO). Serum metabolites were profiled by ultra-performance liquid chromatography–tandem mass spectrometry (UPLC-MS/MS). Gut microbiota composition and functional pathways were analyzed using metagenomic sequencing.ResultsFifty-seven patients with active UC and 35 HCs were enrolled. The prevalence of sarcopenia, myopenia, and low muscle strength in the UC cohort was 40.4, 50.9, and 64.9%, respectively. Serum hsCRP was significantly higher in UC patients with sarcopenia (p = 0.011), whereas serum DAO showed no significant difference between UC patients with and without sarcopenia. Primary bile acids (BAs), conjugated BAs, and conjugated primary BAs were significantly increased, while hippuric acid, valerylcarnitine, and 2-methylbutyrylcarnitine were significantly decreased, in sarcopenic relative to non-sarcopenic UC patients (all p < 0.05). However, the association between serum hippuric acid and sarcopenia was not significant after adjusting for disease activity and hsCRP. At the genus level, Bacteroides and Streptococcus were the most prominently decreased and increased taxa in sarcopenic UC patients, respectively. Metagenomic functional analysis revealed that the relative abundance of the protein digestion and absorption pathway was significantly lower in sarcopenic UC patients (p = 0.030).ConclusionUC-related sarcopenia exhibits notable associations with systemic inflammation, gut dysbiosis, and perturbations in circulating metabolites, including BAs and acylcarnitines.

Sarcopenia and muscle loss are prevalent in patients with cervical cancer. This study aimed to evaluate the prognostic significance of early muscle changes during concurrent chemoradiotherapy (CCRT) in cervical cancer, utilizing an automated deep-learning tool applied on routine CT scans. In this retrospective cohort study, treatment-naïve cervical cancer patients (International Federation of Gynecology and Obstetrics staging IB-IVA) undergoing CCRT were analyzed. A two-stage deep learning pipeline (3D UNet for L3 localization; 2D DPNUNet for segmentation) was used to automatically quantify skeletal muscle, muscle density, visceral fat, and subcutaneous fat at baseline and after 4 weeks of CCRT. Model performance was validated (Dice = 0.92; radiologist audit). The relationship between body composition parameters and overall survival (OS) and disease-free survival (DFS) was assessed through Kaplan–Meier analysis and Cox regression. Among 505 patients (mean age 53.4 years), pretreatment sarcopenia (34.1

ABSTRACT Background Cachexia is a wasting syndrome associated with imbalanced energy metabolism and loss of adipose and muscle tissues and contributes to morbidity and mortality in ageing as well as in patients with severe chronic diseases, including cancer. At present, there are no treatments addressing cachexia that have reached validation to be used in the clinic. In this study, we investigate the protective role of SIRT6, an important regulator of energy homeostasis and health preservation, against Lewis lung carcinoma (LLC)–induced cachexia. Methods SIRT6 levels of serum from gastric cancer patients (n = 22, 65.27 ± 12.50 years old, 40.9% females) and healthy controls (n = 22, 63.50 ± 10.77 years old, 45.4% females) were measured to evaluate the correlation between circulating SIRT6 levels and cancer cachexia development. Ten‐week‐old SIRT6 transgenic (TG) and wild type (WT) male mice injected with LLC cells (1.5 × 106 per mouse) were used to investigate the protective effects of SIRT6 on cachexia‐associated adipose browning and lipolysis and the underlying mechanisms. We explored the effect of SIRT6 on LLC‐conditioned medium induced lipolysis in mature adipocytes, differentiated from primary mouse embryonic fibroblasts (MEFs). We evaluated the in vitro effect of a SIRT6 activator by treatment of MDL800. Results SIRT6 concentrations were significantly higher in non‐cachectic cancer patients (3.41 ± 0.30 ng/mL) compared to cachectic cancer patients (3.20 ± 0.23 ng/mL, p < 0.01), suggesting the negative correlation between SIRT6 level and cachexia in patients with cancer. SIRT6 overexpression significantly ameliorated tumour‐induced wasting and energy expenditure in white adipose tissues (eWAT mass loss: 66% in WT vs. 32% in TG; iWAT mass loss: 69% in WT vs. 40% in TG) through suppression of browning and lipolysis. In LLC‐induced cachexia, tumour necrosis factor‐α receptor 2 (TNFR2) mediated the inhibition of SIRT6 on lipolytic signalling, because the difference in lipolysis between the WT and SIRT6 knockout group was almost eliminated by TNFR2 neutralizing antibody. Increased serum TNFR2 concentration was found in cachectic cancer patients (690.41 pg/mL in non‐cachectic vs. 1166.98 pg/mL in cachectic patients, p < 0.05). A selective SIRT6 pharmaceutical activator, MDL800, could completely reverse LLC‐induced lipolysis in adipocytes. Conclusion We found an unexpected beneficial function of SIRT6 in cancer cachexia, demonstrating that increased SIRT6 expression or activity is capable of protecting the host against cachexia‐associated tissue wasting, providing a concept of future therapies for cachexia.

Background and Objectives: Sarcopenia is the progressive loss of muscle mass and strength that can adversely affect an individual's health and quality of life. The objective of this study was to evaluate the effectiveness of a combined nutritional and exercise intervention among older adults who were at risk of sarcopenia. Methods and Study Design: 46 older adults were included in a 30 +/- 3 days intervention that combined oral nutritional supplements with resistance exercise. Parameters were measured at baseline (day 0) and after intervention (day 30 +/- 3), including routine parameters of sarcopenia, blood tests, and body measurements. The ITT analysis method was used, and the data were analysed using paired t-tests/paired Wilcoxon test, and ANOVA. Results: Among the 46 participants, there were no significant changes in hip circumference (HC), muscle mass of both lower limbs, appendicular skeletal muscle mass index (ASMI), and hemoglobin (Hb) after intervention. However, both hand grip strength (GS) significantly increased, as did muscle mass of both upper limbs and the total muscle strength. Blood tests showed a slight increase in albumin (ALB) levels and a significant increase in 25-OH-D levels, while the waist (WC) and calf circumferences (CC) also increased significantly after intervention. Somatic motor performance improved significantly in the 6-meter walk and 5 sit-ups tests. Conclusions: The combined nutritional and exercise intervention was feasible and effective in improving muscle mass and strength, especially in the upper limbs, as well as somatic motor performance among older adults at risk of sarcopenia. It could be beneficial among three stages of sarcopenia.

ABSTRACTBackgroundSarcopenia is a condition characterized by inadequate muscle and function decline and is often associated with ageing and cancer. It is established that sarcopenia and muscle loss occurred during treatment are associated with the clinical outcomes of patients with cancer. This systematic review and meta‐analysis aims to evaluate the association between sarcopenia at pretreatment and during treatment and overall survival or disease progression in patients with cervical cancer.MethodsThe Web of Science, Embase, Medline and Cochrane Library databases were searched until 4 July 2024. Studies evaluating the prognostic effect of muscle mass at pretreatment or muscle change during treatment on survival or disease progression for patients with cervical cancer were included. Study quality was evaluated with the Newcastle–Ottawa Scale (NOS). Forest plots and summary effect models were used to show the effect size of sarcopenia on clinical outcomes.ResultsThe search strategy yielded 1721 studies in four databases. Eleven and seven studies were included in the quantitative analysis of pretreatment sarcopenia and muscle change on clinical outcomes, respectively. A total of 1907 patients underwent pretreatment muscle assessment, but 1016 were monitored for muscle changes; however, none of the studies involved measures of muscle strength or function. Meta‐analysis showed a significant association between pretreatment sarcopenia and OS [hazard ratio (HR) 1.58, 95% confidence interval (CI): 1.16–2.14, p = 0.003] and PFS (HR 1.63, 95%CI 1.16–2.29, p = 0.005) according to data of univariate analysis. In the meta‐analysis of the multivariate data, pretreatment sarcopenia remained associated with poor OS (HR 3.09, 95% CI: 2.07–4.61, p < 0.00001) and PFS (HR: 1.55, 95%CI 1.06–2.28, p = 0.03). Additionally, muscle loss was significantly associated with OS (HR 5.18, 95%CI 3.54–7.56, p < 0.00001) and PFS (HR 2.62, 95%CI 1.63–4.22, p < 0.00001). Subgroup analysis showed that the association between pretreatment sarcopenia and OS, as well as PFS, was influenced by muscle mass measurements and cut‐off values, whereas muscle loss consistently predicted worse OS and PFS when stratified by varying degrees of reduction. The NOS scores of all included studies were ≥ 6.ConclusionsPretreatment sarcopenia and muscle change during treatment are significantly associated with both overall survival and disease progression. Therefore, muscle assessment and monitoring should be conducted for appropriate diagnosis and intervention to improve clinical outcomes in patients with cervical cancer.

Background:The optimal composition of a hypocaloric diet for women with polycystic ovary syndrome (PCOS) remains uncertain. The aim of this study was to evaluate and compare the impacts of a hypocaloric high-protein diet (HPD) versus an isocaloric conventional calorie-restricted diet (CRD) with normal protein intake on the body composition and biochemical profiles of women diagnosed with PCOS combined with overweight or obesity. Methods:This was a dietary intervention study evaluating the effects of two types of diets on women with PCOS who initiated weight loss independently at the Clinical Nutrition Clinic of Peking Union Medical College Hospital from March 2023 to March 2024 was carried out. Specifically, the records of 72 women with PCOS who were overweight or obese and underwent a 3-month weight management program were examined in a retrospective manner. The hypocaloric dietary intervention was adopted to achieve weight reduction, with either HPD or CRD. Body composition, serum lipids, glucose, insulin, and total testosterone (TT) were evaluated at baseline and post-intervention, and the differences were compared between and within groups. Results:Both groups achieved significant weight loss, with the HPD group losing an average of -8.9 ± 4.6 kg and the CRD group losing -10.0 ± 9.4 kg, without a significant difference between them (P > 0.05). However, the HPD was superior in preserving fat-free mass (FFM) and fat-free mass index (FFMI), with losses of -1.5 ± 1.6 kg and -0.7 ± 1.1 kg/m², respectively, compared to the CRD group's losses of -4.4 ± 4.2 kg and -2.1 ± 1.9 kg/m² (P < 0.01). Additionally, the HPD group showed a more significant reduction in body fat percentage (-5.3 ± 3.3% vs -3.2 ± 4.5%, P < 0.05). Biochemical indicators were comparable in both groups. Conclusion:Compared to an isocaloric standard-protein CRD, the dietary intervention with a HPD appears to be more helpful in preserving FFM in women with PCOS during a short-term weight loss program. Further well-designed trials are needed to verify our findings.

Objective:Limited information exists on the association among frailty, cancer history, and health care utilization in older adults, particularly cancer survivors. This study aimed to examine the relationship between frailty level, cancer history, and health care utilization among older adults. Methods:A total of 14,562 older adults were identified from the 2019 and 2020 National Health Interview Survey, including cancer survivors (n = 3944) and those without a cancer history (n = 10,618). Frailty was assessed using a modified FRAIL Scale (Fatigue, Resistance, Ambulation, Illness, and Low body mass index). Health care utilization outcomes included urgent care, emergency care, hospitalization, delayed care, and needed but did not get care due to cost. Multivariate logistic regressions examined the association between cancer-frailty characteristics and health care utilization. Results:Participants with cancer were more likely to be older, with a higher proportion aged 75-84 (37.1% vs. 27.4%) and 85+ (12.6% vs. 9.4%) years, compared to those without a cancer history. Cancer survivors also showed higher rates of frailty (23.8% vs. 14.5%) and pre-frailty (36.0% vs. 33.7%). In adjusted analyses, both higher frailty severity and cancer history were independently associated with increased odds of emergency care and hospitalization. Frail older cancer survivors had the highest likelihood of these outcomes, with odds ratios of 4.738 for emergency care and 5.643 for hospitalization. Sensitivity analyses confirmed the robustness of these findings. Conclusions:Using nationally representative data, this study demonstrates that frailty and cancer history are independently associated with increased emergency care and hospitalization among older adults.

Background and Objectives: Large-scale studies on the role of multivitamin-mineral (MVM) supplementation in preventing and managing acute respiratory infections (AURIs) are limited in Chinese populations. This study evaluated the impact of routine MVM use on AURI prevalence and symptom severity in a community-based Chinese cohort. Methods and Study Design: This retrospective study was conducted among community-based populations across China (n=3,415). Using a structured questionnaire, participants self-reported episodes of AURIs over three months. Based on regular use of MVM for at least 3 months, eligible participants were categorized into the MVM group and the control group. The impact of MVM on the frequency and severity of AURIs was assessed. Rigorous methodological approaches were applied to minimize potential biases. Results: The period prevalence of AURIs was significantly lower in the MVM group (29.9%) compared to controls (45.6%), odds ratio (OR) =0.508 (p<0.001). After propensity score matching, demographic and lifestyle factors were comparable between groups. The period prevalence of AURIs was 31.7% and 44.8% in the MVM and control groups (OR=0.572, p<0.001). Subgroup analysis indicated the protective effect of MVM supplementation was particularly significant among participants aged >= 45 years (OR=0.407, p<0.001). The MVM group reported lower prevalence of nasal congestion 0.026), sneezing (OR=0.651, p=0.002), and fatigue (OR=0.694, p=0.004) relative to the control group. Conclusions: Daily MVM supplementation for at least 3 months reduced the period prevalence of the common cold and influenza and may contribute to enhanced immune resilience in the Chinese population.

BackgroundSarcopenia, a progressive loss of skeletal muscle mass and strength, needs to initially prevent in the twenties. Meanwhile, there is a lack of research on the effects of fat consumption on skeletal muscle mass and strength in adults aged 20–59. We aimed to assess associations between dietary fat intake and skeletal muscle mass, as measured by appendicular lean mass adjusted for body mass index (ALMBMI), and muscle strength, as represented by handgrip strength adjusted for body mass index (GSMAXBMI), among adults aged 20–59.MethodsDietary fat intake per kilogram of actual body weight was assessed using two 24h recalls, while ALM and GSMAX were measured using DXA and a handgrip dynamometer, respectively. A weighted multiple linear regression model was employed to analyze the association between dietary fat intake and skeletal muscle mass, utilizing data from the National Health and Nutrition Examination Survey spanning from 2011 to 2014. To assess the non-linear relationship and saturation value between dietary fat intake and skeletal muscle mass, a smooth curve fitting approach and a saturation effect analysis model were utilized.ResultsThe study comprised a total of 5356 subjects. After adjusting for confounding factors, there was a positive association observed between dietary fat intake and ALMBMI as well as GSMAXBMI. The relationship between dietary fat intake and ALMBMI showed an inverted U-shaped curve, as did the association with GSMAXBMI. Turning points were observed at 1.88 g/kg/d for total fat intake and ALMBMI, as well as at 1.64 g/kg/d for total fat intake and GSMAXBMI. Furthermore, turning points were still evident when stratifying by gender, age, protein intake, and physical activity. The turning points were lower in individuals with low protein intake(<0.8 g/kg/d) and high levels of physical activity.ConclusionThe moderate dietary fat intake can be beneficial for muscle mass and strength in adults aged 20–59 under specific conditions. Special attention should be directed toward the consumption of fats in individuals with low protein intake and those engaged in high levels of physical activity.

ContextThe beneficial effects of probiotic supplementation on bone health in postmenopausal women require further validation.ObjectiveThis study systematically reviewed and conducted a meta-analysis of randomized controlled trials (RCTs) to assess the relationship between probiotic supplementation and changes in bone mineral density (BMD) and bone turnover markers (BTMs) among postmenopausal women.MethodsA systematic search was conducted across four databases to retrieve data on lumbar spine BMD, hip BMD, collagen type 1 cross-linked C-telopeptide (CTX), receptor activator of nuclear factor-κB ligand (RANKL), osteocalcin (OC), osteoprotegerin (OPG), N-terminal propeptide of type 1 procollagen (P1NP), and bone-specific alkaline phosphatase (BALP) in postmenopausal women. Eligible RCTs were quantitatively analyzed using random-effects meta-analyses. Additional analyses, including subgroup, sensitivity, and meta-regression analyses, were performed.ResultsTwelve RCTs involving 1183 postmenopausal women were included. Compared with the control group, postmenopausal women who received probiotic supplementation showed significantly greater BMD in both the lumbar spine (standardized mean difference [SMD] = 0.60, 95% confidence interval [CI] 0.14 to 1.05) and the hip (SMD = 0.74, 95%CI 0.15 to 1.33). Additionally, probiotic supplementation was associated with reduced levels of CTX (SMD = -1.51, 95%CI -1.88 to -0.41) and BALP (SMD = -1.80, 95%CI -2.78 to -0.81). No significant differences were found between the probiotic and control groups in terms of other BTMs. Subgroup analyses revealed that the increase in BMD due to probiotic supplementation was more significant in postmenopausal women with osteopenia than in those with osteoporosis. The meta-analysis results for both lumbar spine and hip BMD remained robust after conducting sensitivity analyses and meta-regressions.ConclusionSupplementation with probiotics may increase BMD among postmenopausal women, with stronger evidence in women with osteopenia than osteoporosis. Further RCTs are suggested to confirm and refine these findings.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD42024576764.

Objectives: Low muscle mass (MM) is significant in cancer patients, and computed tomography (CT) is considered the reference standard for MM assessment. We investigated the consistency of CT and multifrequency bioelectrical impedance analysis (mBIA) in detecting body composition at baseline and during anticancer treatment and the relationship between MM and malnutrition as well as complications in lung and cervical cancer patients. Methods: Abdominal CT and mBIA were conducted to assess body composition at baseline for all patients and repeated for patients with cervical cancer after 4 wk of chemoradiotherapy. Concordance was compared by intraclass correlation coefficient and Bland-Altman plots. Receiver operating characteristic analysis was used to assess the diagnostic efficacy of mBIA for low MM. Correlation analysis was conducted to assess the relationship between MM and Nutritional Risk Screening 2002 and Global Leadership Initiative on Malnutrition. Furthermore, we assessed whether there was a difference in the incidence of chemoradiotherapy side effects in the low MM group derived by CT or mBIA. Results: A total of 77 cervical and 73 lung cancer patients were enrolled. mBIA showed fair discriminative capacity (area under the curve = 0.651) for detecting low MM, the concordance of skeletal MM and visceral fat area between CT and mBIA was good (intraclass correlation coefficient = 0.712 and 0.698, respectively), and mBIA and CT had consistent observations of muscle and fat changes (P = 0.051 and 0.124, respectively). There was no difference in the incidence of chemoradiotherapy side effects in the low MM group compared with controls regardless of whether derived by CT or mBIA (P > 0.05). MM was correlated with Nutritional Risk Screening 2002 and Global Leadership Initiative on Malnutrition but showed unsatisfactory prediction of malnutrition (area under the curve <0.7). Conclusions: mBIA- and CT-derived body composition was highly correlated, and agreement was reached on body composition changes during treatment. (c) 2024 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.

Background and Objectives: Sarcopenia has garnered extensive attention in clinical practice since its high prevalence and significant impact on clinical outcomes. Multiple organizations have published guidance documents on sarcopenia, offering evidence-based recommendations for clinical practice and/or research. We aimed to appraise the methodological quality of the included documents and synthesize available recommendations for the screening, diagnosis, and intervention of sarcopenia. Methods and Study Design: We conducted a search and guideline organizations and professional societies websites for clinical practices, consensus statements and position papers in terms of sarcopenia, muscle atrophy or muscle loss published before April 17, 2023. The AGREE II instrument was used by three independent reviewers to assess the methodological quality of these documents. Results: Thirty-six guidance documents published between 2010 and 2023 were included. Seven documents fulfilled >= 50% of all the AGREE II domains. Seven underwent a Delphi process and six graded the strength of the recommendations. The process of screening (n=21), early diagnosis of sarcopenia (n=12), diagnosis of sarcopenia and severe sarcopenia (n=10), and management (n=21) were increasingly recommended. SARC-F (n=14) was the most recommended screening tool, and the assessment of muscle function was considered the first step in diagnosing sarcopenia. The management strategy for both age-related and disease-related sarcopenia mainly focused on exercise and nutrition intervention. Conclusions: The guidance documents have provided referential recommendations that have great guiding significance. But the inconsistency in recommendations and variation in methodological rigour suggests that high-quality evidence is lacking yet.

Sarcopaenia is an age-related disease affected by many factors, nutrition being one. Reduced protein intake and decreased diet quality are correlated with sarcopaenia. Protein, amino acid, or peptide supplementation is a commonly used clinical practice to increase protein intake. However, whether supplementation plays a key role in preventing and treating sarcopaenia and whether it needs to be combined with other interventions is worthy of study. This review focuses on protein, amino acid, and peptide supplementation for the prevention and treatment of sarcopaenia.

ObjectiveTo investigate the status quo of chemotherapy⁃related taste changes in patients with hematological malignancies and analyze its influencing factors.Methods200 patients with hematological malignancies undergoing chemotherapy in the department of hematology in a tertiary grade A hospital in Beijing were selected by convenient sampling method. Demographic data and disease related data were collected with self⁃designed general information questionnaire.The Chinese version of the Chemotherapy⁃Induced Taste Alteration Scale was used to evaluate the taste changes of the patients，and the Health Promotion Strategy Scale was used to evaluate the self⁃efficacy of the patients.Binary logistic regression equation was used to explore the factors affecting taste changes in patients with hematological malignancies.ResultsAmong the 200 patients，166 patients had taste changes， the incidence was 83.0%.The total score of chemotherapy⁃induced taste alteration scale was 7.47±2.98，most of which were mild to moderate changes.The results of multivariate regression analysis showed that the presence or absence of xerostomia after chemotherapy，the presence or absence of oral mucositis， disease diagnosis and chemotherapy course were the influencing factors of chemotherapy-related taste changes in patients with hematological malignancies（P<0.05）.At the same time， patients' self-efficacy levels were negatively correlated with taste changes（P<0.05）.ConclusionsThe incidence of chemotherapy⁃related taste changes in patients with hematological malignancies was high. Medical staff should focus on leukemia patients with long chemotherapy course， xerostomia and（or） oral mucositis after chemotherapy， and timely evaluate and intervene to reduce the adverse effects caused by taste changes.

(1) Background: The Global Leadership Initiative on Malnutrition (GLIM) was published in 2019, and its application has been explored in several diseases. However, the data on malnutrition based on the GLIM in ulcerative colitis (UC) patients are sparse. (2) Methods: This single-center, retrospective cohort study included 605 hospitalized UC patients. Demographics and clinical data were collected from electronic medical records. Nutritional Risk Screening 2002 (NRS 2002) was used as a screening tool, and malnutrition was diagnosed according to the GLIM criteria. The skeletal muscle area of the third lumber cross-section in abdominal computed tomography was used to evaluate muscle mass within one week before or after admission. (3) Results: The prevalence of malnutrition was 64.1% in this cohort, and the prevalences were 34.2, 57.7, and 86.7% in UC patients with mild, moderate, and severe disease activity, respectively. Malnourished patients tended to need surgical treatment (p = 0.080) and had a 2.4 times greater risk of opportunistic infection. The multivariate logistic regression analysis showed that UC patients with malnutrition had a 1.7-fold increased risk of readmission. (4) Conclusions: Nutritional problems deserve more attention in hospitalized UC patients. Malnutrition identified through the GLIM criteria was associated with opportunistic infection, tended to be associated with surgical treatment, and showed a prognosis value for readmission.

BackgroundSarcopenia, frailty, and malnutrition are associated with undesirable clinical outcomes in cancer patients. Sarcopenia-related measurements may be promising fast biomarkers for frailty. Our objectives were to assess the prevalence of nutritional risk, malnutrition, frailty, and sarcopenia in lung cancer inpatients, and describe the relationship of them.MethodsStage III and IV lung cancer inpatients were recruited before chemotherapy. The skeletal muscle index (SMI) was assessed by multi-frequency bioelectric impedance analysis (m-BIA). Sarcopenia, frailty, nutritional risk, and malnutrition were diagnosed according to the Asian Working Group for Sarcopenia 2019 (AWGS 2019), Fried Frailty Phenotype (FFP), nutritional risk screening-2002 (NRS-2002), and Global Leadership Initiative on Malnutrition criteria (GLIM), and correlation analysis was performed between them with Pearson’s r correlation coefficients. A univariate and multivariate logistic regression analysis was conducted for all patients, gender and age-stratified subgroups to obtain odds ratios (ORs) and 95% confidence intervals (95%CIs).ResultsThe cohort included 97 men (77%) and 29 women (23%), with mean age of 64.8 ± 8.7 years. Among the 126 patients, 32 (25.4%) and 41 (32.5%) had sarcopenia and frailty, and the prevalence of nutritional risk and malnutrition was 31.0% (n = 39) and 25.4% (n = 32). Adjusted for age and gender, SMI was correlated with FFP (r = −0.204, p = 0.027), and did not remain significantly when stratified by gender. Stratification according to age revealed in ≥65-years-old population, SMI and FFP were significantly correlated (r = −0.297, p = 0.016), which is not seen in <65-years-old group (r = 0.048, p = 0.748). The multivariate regression analysis showed FFP, BMI, and ECOG were the independent variables associated with sarcopenia (OR 1.536, 95%CI 1.062–2.452, p = 0.042; OR 0.625, 95%CI 0.479–0.815, p = 0.001; OR 7.286, 95%CI 1.779–29.838, p = 0.004).ConclusionComprehensively assessed sarcopenia is independently associated with frailty based on FFP questionnaire, BMI, and ECOG. Therefore, sarcopenia assessment including m-BIA based SMI, and muscle strength and function could be used to indicate frailty to help select the targeting patients for care. Moreover, in addition to muscle mass, muscle quality should not be ignored in clinical practice.

Introduction The clinical symptoms and nutritional status of patients with Parkinson's disease (PwP) are interrelated, and the clinical outcomes in malnourished patients are often poor. Only a few studies have reviewed the prevalence of malnutrition and nutrition-related risk factors in PwP. Objective To explore the prevalence of malnutrition/ malnutrition risk among PwP, and estimate nutrition-related risk factors. Methods PubMed, EMBASE, and Cochrane Library were systematically searched. Literatures published between 1 January 1995 and 1 November 2020, subjects were patients with idiopathic PD underwent Mini Nutritional Assessment (MNA) were included. Result Sixteen articles, including 1650 PwP from 13 countries/regions, were included in the meta-analysis. The prevalence of malnutrition and malnutrition risk were 8.8% (Confidence interval [CI] 95%, 5.3%-12.2%) and 35.3% (CI 95%, 29.0%-41.7%), and the prevalence of nutritional disorders was 42.3% (CI 95%, 33.7%-51%). The prevalence of malnutrition in developing countries was higher than that in the developed countries. Meta-analysis reveals there were significant differences in the course of the disease (0.88 years; 95% CI, 0.26-1.50), levodopa equivalent daily dose (LEDD; 60.77 mg/day; 95% CI, 2.7-118.8), Hoehn and Yahr (H&Y) staging (0.323; CI 95%, 0.164-0.482), and unified Parkinson's disease rating scale (UPDRS) scores (total: 13.66, CI 95%: 10.57-16.75 and part III: 5.52, CI 95%: 3.79-7.25) between normal and nutritional disorder groups. Conclusions Malnutrition/malnutrition risk prevalence in PwP are high. The duration of the disease, LEDD, H&Y staging, and UPDRS score (part III and total) may be nutrition-related risk factors in PwP.

Purposes:This study investigated the nutritional problems and risks of Chinese non-hospitalized cancer survivors through an online survey.Methods:The survey included nutritional and clinical questions distributed to non-hospitalized cancer survivors. All data were screened and analyzed with strict quality control. Nutrition Risk Screening-2002 (NRS-2002) was adopted and the related factors were analyzed.Results:Six thousand six hundred eighty-five questionnaires were included. The prevalence of nutritional risk was 33.9%, which varied according to age, sex, cancer type, TNM staging, oncologic treatment, time interval since last treatment, etc. In the regression analysis, nutritional risk was associated with age, TNM staging, and nutrition support. Patients with leukemia and digestive cancer had the highest NRS-2002 score (3.33 ± 1.45 and 3.25 ± 1.61); the prevalence of nutritional risk (NRS-2002 ≥ 3) was 66.7 and 55.1%, respectively. Patients with a higher TNM stage had higher NRS-2002 scores in non-digestive cancer, which was not seen in digestive cancer. Among digestive, bone, nervous, and respiratory cancer patients, the NRS-2002 score mainly consisted of "impaired nutritional status," which coincided with the "disease severity score" in leukemia patients. Nutrition intervention was achieved in 79.7 and 15.2% of patients with nutritional risk and no risk. Of the patients, 60.3% exhibited confusion about nutritional problems, but only 25.1% had professional counseling.Conclusions:Regular nutritional risk screening, assessment, and monitoring are needed to cover non-hospitalized cancer survivors to provide nutrition intervention for better clinical outcome and quality of life. By online survey, the nutritional risk of non-hospitalized cancer survivors was found high in China, but the nutrition support or professional consultation were not desirable. The composition of nutritional risk should also be aware of.

This study aimed to determine the impact of nutrition supplementation (whey protein, fish oil, vitamin D) and physical exercise (resistance and aerobic exercise) on muscle mass, muscle strength and fat mass among sarcopenic elderly. Participants (N = 241) with sarcopenia (aged ≥ 60 y) enrolled from 2 centers were randomized into groups undergoing nutrition supplementation (Nutr), physical exercise (Ex), nutrition combined with exercise (Nutr+Ex), or routine consultation for 12 weeks. Muscle-related indicators, grip strength as well as fat-related indicators were compared pre- and post-intervention. The per-protocol analysis showed that all indicators were significantly different between groups (P < 0.001). Further pairwise comparisons showed that compared with controls, appendicular muscle mass and grip strength were significantly higher in Nutr (P < 0.001, 95% CI: 0.578, 1.475; P < 0.001, 95% CI: 3.614∼9.118), Ex (P = 0.010, 95% CI: 0.157, 1.153; P < 0.001, 95% CI: 2.904, 8.732), and Nutr+Ex (P < 0.001, 95% CI: 0.564, 1.471; P < 0.001, 95% CI: 3.441, 8.907) groups, while fat mass was significantly lower in the Nutr (P < 0.001, 95% CI: -4.676, -2.358) and Nutr+Ex (P < 0.001, 95% CI: -4.717,-1.790) groups. When compared with Ex, fat mass decreased significantly in the Nutr (P = 0.001, 95% CI: -4.856,-1.359) and Nutr+Ex (P = 0.005, 95% CI: -4.810, -0.878) groups. The findings indicate that nutrition supplementation and physical exercise could improve muscle mass, strength and fat mass among sarcopenic elderly. Nutrition supplementation might be better at decreasing fat mass in this population. ClinicalTrials.gov registration no.: NCT02873676. Novelty: Nutrition supplementation improved muscle mass, strength and fat mass among sarcopenic elderly. Aerobic and resistance exercise improved muscle mass and strength in sarcopenic elderly. Combined nutrition supplementation and physical exercise improved muscle mass, strength and fat mass among sarcopenic elderly.

Objective:To explore the prevalence of sarcopenia and its impact on clinical outcomes among patients with pancreatic cancer.Methods:PubMed, Embase and Cochrane were searched for studies focused on prevalence of sarcopenia and its impact on clinical outcomes in pancreatic cancer patients since database inception to Oct. 26, 2020. The studies were selected according to inclusion and exclusion criteria and assessed for quality using Newcastle-Ottawa Scale. The primary outcome was overall survival, and the secondary outcomes were postoperative pancreatic fistula (POPF), major and overall complication incidence, post-operative 30-day mortality and duration of post-operative hospital stay.Results:A total of 18 studies from Asia ( n=12), Europe ( n=1) and North America ( n=5) with 4 346 participants were included. Sarcopenia was diagnosed using height-adjusted L3 skeletal muscle index (SMI), total psoas area (TPA), psoas muscle index (PMI) or appendicular skeletal muscle mass (ASM), respectively. The average prevalence of sarcopenia in pancreatic cancer patients was 42% (95% CI: 32%-53%). Sarcopenia was significantly associated with lower overall survival ( HR=1.62, 95% CI: 1.34-1.95, P< 0.01). There were no significant differences between groups with or without sarcopenia in POPF ( RR=0.86, 95% CI: 0.58-1.28, P=0.459), duration of postoperative hospital stay (SMD = 0.02, 95% CI: -0.12-0.16, P=0.743), major complications ( RR=0.95, 95% CI: 0.79-1.15, P=0.604), postoperative 30-day mortality ( RR=1.39, 95% CI: 0.42-4.59, P=0.590), and total complications ( RR=1.00, 95% CI: 0.88-1.12, P=0.962). Conclusions:The prevalence of sarcopenia was higher in patients with pancreatic cancer. The overall survival of pancreatic cancer patients with sarcopenia is significantly shorter.