ObjectiveTo summarize the research progress of the pathogenesis, diagnosis and treatment of sarcopenia in liver cirrhosis. MethodThe relevant literatures on studies of the pathogenesis, diagnosis and treatment of sarcopenia in liver cirrhosis in recent years were searched and reviewed. ResultsThe sarcopenia was a major complication that could not be ignored in patients with liver cirrhosis, and was closely related to the patient’s quality of life and prognosis. Various mechanisms such as metabolic abnormalities, malnutrition, myostatin, hyperammonemia, hormonal regulation of muscle homeostasis, ubiquitin-proteasome system and autophagy, physical activity, and dysbiosis of the intestinal flora were involved in the development of sarcopenia. There were various diagnostic methods for sarcopenia, but a unified gold standard was still lacking. In addition, some progress had been made in the treatment of sarcopenia in recent years. ConclusionsAlthough current studies obtains preliminary results about relation between liver cirrhosis and sarcopenia, there still exists many problems to be solved. Further research in future will benefit diagnosis and treatment of patients with sarcopenia in liver cirrhosis.
The incidence of sarcopenia and frailty in maintenance hemodialysis patients are high, and there are often comorbidities, which easily lead to more complications, thus increasing the hospitalization rate and reducing the quality of life of patients. This article reviews the definition, physiological mechanism, incidence and diagnosis, relationship and treatment strategies of sarcopenia and frailty in maintenance hemodialysis patients, in order to better prevent and intervene the occurrence of sarcopenia and frailty and provide a reference for prevention and treatment.
Objective To investigate the effect of sarcopenia on postoperative complications in patients undergoing pancreaticoduodenectomy（PD）. Methods The data of 225 patients who underwent pancreaticoduodenectomy in the Nanjing Hospital Affiliated to Nanjing Medical University (Nanjing First Hospital) from March 2012 to February 2020 were retrospectively analyzed. The total area of the skeletal muscle was measured by CT images at the level of the third lumbar vertebra for the diagnosis of sarcopenia. The patients were divided into sarcopenia group and non-sarcopenia group. The clinical data and surgical complications were compared between the two groups to explore the relationship between sarcopenia and postoperative complications. Results Compared with the non-sarcopenia group, the patients in the sarcopenia group were older and had lower hemoglobin concentration, lower serum albumin concentration, and higher total bilirubin levels (P<0.05). The incidences of clinically relevant pancreatic fistula (grade B and C fistula), pulmonary infection, atelectasis and hypoxemia in the sarcopenia group were significantly higher than those in the non-sarcopenia group (P<0.05). The length of ICU stay and perioperative mortality in the sarcopenia group were significantly higher than those in the non-sarcopenia group (P<0.05). Multivariate analysis showed that sarcopenia, preoperative total bilirubin level, pancreatic duct diameter and pancreatic texture were independent risk factors for clinically relevant pancreatic fistula (P<0.05). Sarcopenia, intraoperative blood loss and postoperative abdominal infection were independent risk factors for pulmonary complications after PD (P<0.05). Conclusions Sarcopenia is an independent risk factor for increased incidence of clinically relevant pancreatic fistula and pulmonary complications after PD. Strengthening perioperative nutritional therapy and rehabilitation exercise in patients with sarcopenia is of great significance to reduce postoperative complications of PD.
Objective To explore the effect of corn oligopeptide (COP) on dexamethasone-induced muscle atrophy. Methods Forty-nine male Sprague-Dawley rats aged 8 weeks were divided into blank group (n=10) and model group (n=39). The rats in the model group were intraperitoneally injected with dexamethasone (1.0 mg/kg), and the rats in the blank group were injected with normal saline. After 19 days, one rat in the blank group and three rats in the model group were taken to observe whether the model was successfully constructed. After successful modeling, the rats in the model group were randomly divided into model control group, COP low-dose group (COP-L group, 0.5 g/kg), COP medium-dose group (COP-M group, 1.0 g/kg) and COP high-dose group (COP-H group, 2.0 g/kg), with 9 rats in each group. After 33 days, the grip strength of the rats was measured, and then the gastrocnemius, soleus, tibialis anterior and metatarsal muscles were separated and weighed, and muscle fiber diameter, relative expression of Atrogin-1 and MuRF-1 mRNA were measured. Non-targeted metabolomics of gastrocnemius muscle were measured. Results Compared with that in the blank group, the body weight of rats in the model group reduced (P<0.05), and myofibril rupture was observed, indicating that the model was successful. Compared with those in the model control group, the grip strength increased in the COP-L and COP-M groups (P<0.05); the muscle coefficients of gastrocnemius and soleus in the COP-L and COP-H groups increased (P<0.05), and the muscle coefficients of plantaris in the COP-L and COP-M groups increased (P<0.05); the muscle fiber diameter of the tibial anterior muscle increased in the three doses of COP groups (P<0.05), and the muscle fiber diameter of the plantaris muscle increased in the COP-M and COP-H groups (P<0.05); the relative expression of Atrogin-1 mRNA decreased in the three doses of COP groups (P<0.05), while the relative expression of MurF-1 mRNA in the COP-L and COP-H groups decreased (P<0.05). The amino acid synthesis pathway, glycolysis pathway, and acid metabolism pathway were activated in gastrocnemius muscle. Conclusions COP can significantly improve the muscle atrophy induced by dexamethasone. The mechanism may be related to the decrease of Atrogin-1 and MuRF-1 expression in ubiquitin-proteasome pathway and the increase of amino acid biosynthesis.
ObjectiveTo explore the research progress of sarcopenia in breast cancer patients, with a view to providing new ideas for the treatment and prognosis of patients with sarcopenia in breast cancer. MethodThe literature relevant to studies on sarcopenia and breast cancer at home and abroad was searched and reviewed in recent years. ResultsSarcopenia was highly prevalent in breast cancer patients and was associated with multiple poor prognoses in breast cancer patients. Exercise, nutritional support, and medication-assisted treatment could significantly improve the survival quality in breast cancer patients with sarcopenia. ConclusionsAs a common concomitant disease of breast cancer, sarcopenia seriously affects the survival quality and prognosis of patients. The development of sarcopenia in breast cancer patients should be closely monitored, and its mechanisms of action should continue to be studied and clarified in order to identify new therapeutic targets.
ObjectiveTo explore the value of geriatric nutritional risk index (GNRI) and sarcopenia on predicting postoperative complications in elderly patients with gastric cancer. MethodsAccording to the inclusion and exclusion criteria, the elderly (aged ≥60 years) patients with gastric cancer underwent radical gastrectomy in the Department of Gastrointestinal Surgery of Xuzhou Central Hospital from January 1, 2017 to December 31, 2021 were retrospectively gathered. The occurrence of postoperative complications (grade 2 or beyond by the Clavien-Dindo classification) was analyzed. The risk factors affecting postoperative complications were analyzed by univariate and multivariate logistic regression analyses to construct the prediction model, then was visualized by drawing a nomogram. The differentiation of the nomogram between the patients with postoperative complications and without postoperative complications was evaluated by the receiver operating characteristic (ROC) curve. The accuracy of the nomogram was evaluated by the calibration curve. Further, the clinical net benefit rate was analyzed by the decision curve analysis (DCA) to evaluate the clinical practicability. ResultsA total of 236 patients were gathered, 97 (41.1%) of whom had postoperative complications during hospitalization. The results of multivariate logistic regression analysis showed that the age, gender, GNRI, sarcopenia, surgical mode, and American Society of Aneshesiologists classification were the factors influencing the postoperative complications (P<0.05). The differentiation of nomogram based on the influencing factors was well, the area under the ROC curve was 0.732. The calibration curve showed that the model prediction curve was close to the ideal curve. The clinical net benefit rate by the DCA was higher when the probability of postoperative complications was 0.18 to 0.72. ConclusionsThe efficiency of nomogram based on GNRI and sarcopenia is well for predicting the occurrence of postoperative complications in elderly patients with gastric cancer. However, the nomogram needs to be further validated by prospective studies and external data.