Relationship between Nonexercise Activity Thermogenesis and Calf Circumference in Older Women

Purpose: Frailty is a state of declined vitality of the body and mind with age in which life functions are impaired. In addition, there is a difference in the susceptibility of older women to frailty compared with that of older men. Therefore, assessing and encouraging physical activity in older adults before they become frail is essential. We aimed to clarify the relationship between calf circumference and body composition and assess the potential association between calf circumference and physical activity indices in older women. Methods: This cross-sectional study included 18 healthy older adults (age 69.0 ± 5.7 years). The physical characteristics, calf circumference, body composition, calf muscle thickness, and physical activity questionnaire that included items on exercise-related activity thermogenesis (EAT) and nonexercise activity thermogenesis (NEAT) were assessed. The association between calf circumference and these additional measures was examined. Results: Positive and significant correlations were found between the calf circumference and body weight, body mass index (BMI), skeletal muscle mass, skeletal muscle mass index, calf muscle thickness, total questionnaire score, and NEAT score (r = 0.66 - 0.87). However, no significant correlations were observed between the calf circumference and EAT scores. Conclusion: Calf circumference in older women may reflect NEAT activity. Improving NEAT activity is an important health-promoting factor in older women.

Associations of Sarcopenia, Handgrip Strength and Calf Circumference with Cognitive Impairment among Chinese Older Adults

Objective To evaluate the associations of sarcopenia,handgrip strength and calf circumference with cognitive impairment among Chinese older adults.Methods Totally 2,525 older adults were recruited from the Healthy Aging and Biomarkers Cohort Study.Cognitive impairment was assessed by the Chinese Mini-Mental State Examination.Handgrip strength was calculated from the means of the right and left hand values.Calf circumference was measured at the site of maximum circumference of the non-dominant leg.The formula developed by Ishii was used to define sarcopenia.Multiple logistic regression was performed to evaluate the associations of sarcopenia,handgrip strength,and calf circumference with cognitive impairment.Results The prevalence of cognitive impairment was 34.36%.The adjusted odds ratio(OR)for cognitive impairment in individuals with sarcopenia was 2.55[95% confidence interval(95%CI):1.86-3.50].Compared with individuals in the first quartile(Q1)of calf circumference,the adjusted ORs in the second,third,and fourth quartiles(Q_(2),Q_(3),and Q_(4))were 0.75(95% CI:0.58-0.96),0.59(95% CI:0.44-0.79),and 0.62(95% CI:0.45-0.8),respectively.Compared with individuals in Q1 of handgrip strength,the adjusted ORs for Q_(2),Q_(3),and Q_(4) were 0.49(95%CI:0.38-0.62),0.31(95% CI:0.23-0.41),and 0.30(95%CI:0.21-0.44),respectively.Conclusion Sarcopenia,identified by low handgrip strength and low calf circumference,was positively associated with cognitive impairment.

Detection of thinned corticospinal tract and corticoreticular pathway in a patient with a calf circumference discrepancy

In clinical practice, it is challenging to elucidate the location of the lesion in a patient＇s nervous system that is causing the neurologic symptoms, because lesions are often microscopic and cannot be revealed by conventional evaluation methods.

Malnutrition Increases the Risk of Mortality in Hospitalized Lung Cancer Patients

Background The Global Leadership Initiative on Malnutrition(GLIM)recently developed a new set of diagnostic criteria for identifying patients with malnutrition.Because the GLIM criteria were only introduced a little over 3 years ago,additional validation and reliability testing are needed in a variety of populations.Methods We performed an observational,multicenter cohort study.From July 2013 to October 2018,lung cancer patients were recruited from the Daping Hospital of Army Medical University and the First Hospital of Jilin University as part of the INSCOC project.Previously-established cut-off values for the calf circumference(CC,male<30 cm,female<29.5 cm)were applied as the reduced muscal mass of phenotypic criteria to establish the GLIM diagnosis.Multivariate Cox regression analyses were performed to analyze the association between the GLIM criteria and survival.Results A total of 1219 patients with lung cancer were studied as subjects.Their age was 58.81±9.92 years old,and 820 were male and 399 were female.According to the GLIM diagnostic criteria using the CC as a muscle mass measurement,303 patients(24.9%)were categorized as malnourished,142 patients(23.1%)in the adult group(18≤age<60)and 161 patients(26.7%)in the older group(age≥60 years).The patients with malnutrition had a higher incidence of anemia than the nourished patients(P=0.012).The QLQ-C30 score and KPS score indicating that the malnourished patients had a consistently worse quality of life compared to the nourished group(all P<0.001).The median survival of the malnutrition group was 42(95%CI:34-50)months,which was much shorter than the 62(95%CI:57-66)months in the nourished group(P<0.001).In the adult group,the median survival decreased from 65(95%CI:55-72)months in nourished group to 34(95%CI:25-48)months in the patients with malnutrition(P<0.001).In the older group,it decreased from 61(95%CI:55-67)months to 48(95%CI:39-59)months(P=0.001).A Cox regression analysis showed that GLIM-diagnosed malnutrition was associated with an increased risk of death among adult group(HR=1.670,95%CI:1.29-2.16),older group(HR=1.332,95%CI:1.05-1.69)and overall(HR=1.453,95%CI:1.22-1.72).Conclusion All of these results demonstrate that GLIM-diagnosed malnutrition is associated with a poorer survival for all lung cancer patients,independent of age.