BACKGROUND Nonalcoholic fatty liver disease(NAFLD)includes a spectrum of conditions,progressing from mild steatosis to advanced fibrosis.Sarcopenia,characterized by decreased muscle strength and mass,shares common pat...BACKGROUND Nonalcoholic fatty liver disease(NAFLD)includes a spectrum of conditions,progressing from mild steatosis to advanced fibrosis.Sarcopenia,characterized by decreased muscle strength and mass,shares common pathophysiological traits with NAFLD.An association exists between sarcopenia and increased NAFLD prevalence.However,data on the prevalence of sarcopenia in NAFLD and its impact on the outcomes of NAFLD remain inconsistent.AIM To analyze the prevalence and outcomes of sarcopenia in patients with NAFLD.METHODS We conducted a comprehensive search for relevant studies in MEDLINE,Embase,and Scopus from their inception to June 2023.We included studies that focused on patients with NAFLD,reported the prevalence of sarcopenia as the primary outcome,and examined secondary outcomes,such as liver fibrosis and other adverse events.We also used the Newcastle-Ottawa scale for quality assessment.RESULTS Of the 29 studies included,the prevalence of sarcopenia in NAFLD varied widely(1.6%to 63.0%),with 20 studies reporting a prevalence of more than 10.0%.Substantial heterogeneity was noted in the measurement modalities for sarcopenia.Sarcopenia was associated with a higher risk of advanced fibrosis(odd ratio:1.97,95%confidence interval:1.44-2.70).Increased odds were consistently observed in fibrosis assessment through biopsy,NAFLD fibrosis score/body mass index,aspartate aminotransferase to alanine aminotransferase ratio,diabetes(BARD)score,and transient elastography,whereas the fibrosis-4 score showed no such association.Sarcopenia in NAFLD was associated with a higher risk of steatohepatitis,insulin resistance,cardiovascular risks,and mortality.CONCLUSION This systematic review highlights the critical need for standardized diagnostic criteria and measurement methods for sarcopenia in NAFLD patients.The variability in study designs and assessment methods for sarcopenia and liver fibrosis may account for the inconsistent findings.This review demonstrates the multidimensional impact of sarcopenia on NAFLD,indicating its importance beyond liver-related events to include cardiovascular risks,mortality,and metabolic complications.展开更多
为了快速、准确地建立4种不同滚子类型的弧面凸轮三维模型,采用UG Open Grip二次开发工具,根据不同弧面凸轮廓面方程生成一系列离散点,再由点生成线,由线生成面,由面生成体,逐步完成不同滚子类型弧面凸轮的三维建模。该方法为快速、准...为了快速、准确地建立4种不同滚子类型的弧面凸轮三维模型,采用UG Open Grip二次开发工具,根据不同弧面凸轮廓面方程生成一系列离散点,再由点生成线,由线生成面,由面生成体,逐步完成不同滚子类型弧面凸轮的三维建模。该方法为快速、准确地建立弧面凸轮三维模型提供了一种方法。展开更多
Objective This study aims to evaluate the association between lower grip strength and mortality hazard.Methods We selected 10,280 adults aged 45 to 96 years old from the China Health and Retirement Longitudinal Study ...Objective This study aims to evaluate the association between lower grip strength and mortality hazard.Methods We selected 10,280 adults aged 45 to 96 years old from the China Health and Retirement Longitudinal Study and used multivariate Cox proportional hazard models to assess the association of grip strength with mortality hazard.In addition,we explored the possibility of a nonlinear relationship using a 4-knot restricted spline regression.Results We found that elevated grip strength was associated with lower mortality up to a certain threshold.The baseline quartile values of grip strength were 30,37,and 44 kg for males and 25,30,and35 kg for females.After adjusting for confounders,with category 1 as the reference group,the adjusted HRs were 0.58(0.42-0.79)in males and 0.70(0.48-0.99)in females(category 4).We also found a linear association between grip strength values and all-cause death risk(males,P=0.274;females,P=0.883)using restricted spline regression.For males with a grip strength<37 kg and females with a grip strength<30 kg,grip strength and death were negatively associated.Conclusion Grip strength below a sex-specific threshold is inversely associated with mortality hazard among middle-aged and older Chinese adults with chronic diseases.展开更多
BACKGROUND Observational studies have suggested that depression is associated with sarcopenia.However,the causal relationship between depression and sarcopenia remains unclear.AIM To investigate the causal relationshi...BACKGROUND Observational studies have suggested that depression is associated with sarcopenia.However,the causal relationship between depression and sarcopenia remains unclear.AIM To investigate the causal relationship between depression and sarcopenia.METHODS We performed a Mendelian randomization(MR)analysis to identify the bidirectional relationship between depression and sarcopenia-related traits.Summarylevel data and independent variants used as instrumental variables came from large genome-wide association studies of depression(414055 cases and 892299 controls),of appendicular lean mass(ALM,450243 participants),and of hand grip strength(exposure:360000 participants;outcome:334925 participants).RESULTS We identified a negative association of depression with lower ALM[odds ratio(OR):0.932,95%confidence interval(95%CI):0.889-0.979,P=0.005].In the reverse MR analysis,we also observed an inverse association of hand grip strength with depression(OR:0.200,95%CI:0.108-0.370,P<0.001).Similar results were obtained in sensitivity analyses.CONCLUSION Depression was causally related to decreased muscle mass,and declined muscle strength might lead to a higher risk of depression.展开更多
Background: Although handgrip strength is a biomarker for morbidity/mor-tality, there is lack of evidence on the effects of resistance training on handgrip strength in healthy adults of all ages. Objective: The aim of...Background: Although handgrip strength is a biomarker for morbidity/mor-tality, there is lack of evidence on the effects of resistance training on handgrip strength in healthy adults of all ages. Objective: The aim of this systematic review was to assess the impact of resistance training on handgrip strength in healthy adults. Methods: Five databases/search engines were searched. Studies comparing different types of resistance exercise interventions versus a non-exercised control group on handgrip strength were included. The available data did not allow us to conduct the pre-planned meta-analyses;therefore, only descriptive statistics were performed to summarize the data. Results: Twenty studies (17 randomized and three non-randomized controlled trials) were included, most of which were conducted in older adults. Twelve studies reported no significant difference in the change in handgrip strength between the resistance training and control groups. Two studies showed increases in handgrip strength in the resistance training group compared with the control group. Other studies included results for multi-training groups or left/right hands and found increasing handgrip strength compared to controls, but only in one training group or one hand. Overall, the randomized and non-ran-domized clinical trials presented moderate risk of bias. Conclusions: Due to the lack of low risk-of-bias randomized controlled trials of young and middle-aged adults, different training protocols, and small sample sizes, the existing evidence appears insufficient to support resistance training for increasing handgrip strength in healthy adults. Future studies may seek to discern the optimal way to develop and employ resistance training to improve hand-grip strength.展开更多
文摘BACKGROUND Nonalcoholic fatty liver disease(NAFLD)includes a spectrum of conditions,progressing from mild steatosis to advanced fibrosis.Sarcopenia,characterized by decreased muscle strength and mass,shares common pathophysiological traits with NAFLD.An association exists between sarcopenia and increased NAFLD prevalence.However,data on the prevalence of sarcopenia in NAFLD and its impact on the outcomes of NAFLD remain inconsistent.AIM To analyze the prevalence and outcomes of sarcopenia in patients with NAFLD.METHODS We conducted a comprehensive search for relevant studies in MEDLINE,Embase,and Scopus from their inception to June 2023.We included studies that focused on patients with NAFLD,reported the prevalence of sarcopenia as the primary outcome,and examined secondary outcomes,such as liver fibrosis and other adverse events.We also used the Newcastle-Ottawa scale for quality assessment.RESULTS Of the 29 studies included,the prevalence of sarcopenia in NAFLD varied widely(1.6%to 63.0%),with 20 studies reporting a prevalence of more than 10.0%.Substantial heterogeneity was noted in the measurement modalities for sarcopenia.Sarcopenia was associated with a higher risk of advanced fibrosis(odd ratio:1.97,95%confidence interval:1.44-2.70).Increased odds were consistently observed in fibrosis assessment through biopsy,NAFLD fibrosis score/body mass index,aspartate aminotransferase to alanine aminotransferase ratio,diabetes(BARD)score,and transient elastography,whereas the fibrosis-4 score showed no such association.Sarcopenia in NAFLD was associated with a higher risk of steatohepatitis,insulin resistance,cardiovascular risks,and mortality.CONCLUSION This systematic review highlights the critical need for standardized diagnostic criteria and measurement methods for sarcopenia in NAFLD patients.The variability in study designs and assessment methods for sarcopenia and liver fibrosis may account for the inconsistent findings.This review demonstrates the multidimensional impact of sarcopenia on NAFLD,indicating its importance beyond liver-related events to include cardiovascular risks,mortality,and metabolic complications.
基金supported by the Ministry of Education of Humanities and Social Science Project[Grant No.Y202145935]。
文摘Objective This study aims to evaluate the association between lower grip strength and mortality hazard.Methods We selected 10,280 adults aged 45 to 96 years old from the China Health and Retirement Longitudinal Study and used multivariate Cox proportional hazard models to assess the association of grip strength with mortality hazard.In addition,we explored the possibility of a nonlinear relationship using a 4-knot restricted spline regression.Results We found that elevated grip strength was associated with lower mortality up to a certain threshold.The baseline quartile values of grip strength were 30,37,and 44 kg for males and 25,30,and35 kg for females.After adjusting for confounders,with category 1 as the reference group,the adjusted HRs were 0.58(0.42-0.79)in males and 0.70(0.48-0.99)in females(category 4).We also found a linear association between grip strength values and all-cause death risk(males,P=0.274;females,P=0.883)using restricted spline regression.For males with a grip strength<37 kg and females with a grip strength<30 kg,grip strength and death were negatively associated.Conclusion Grip strength below a sex-specific threshold is inversely associated with mortality hazard among middle-aged and older Chinese adults with chronic diseases.
基金Zhejiang Province Traditional Chinese Medicine Science and Technology Project,No.2023ZR075.
文摘BACKGROUND Observational studies have suggested that depression is associated with sarcopenia.However,the causal relationship between depression and sarcopenia remains unclear.AIM To investigate the causal relationship between depression and sarcopenia.METHODS We performed a Mendelian randomization(MR)analysis to identify the bidirectional relationship between depression and sarcopenia-related traits.Summarylevel data and independent variants used as instrumental variables came from large genome-wide association studies of depression(414055 cases and 892299 controls),of appendicular lean mass(ALM,450243 participants),and of hand grip strength(exposure:360000 participants;outcome:334925 participants).RESULTS We identified a negative association of depression with lower ALM[odds ratio(OR):0.932,95%confidence interval(95%CI):0.889-0.979,P=0.005].In the reverse MR analysis,we also observed an inverse association of hand grip strength with depression(OR:0.200,95%CI:0.108-0.370,P<0.001).Similar results were obtained in sensitivity analyses.CONCLUSION Depression was causally related to decreased muscle mass,and declined muscle strength might lead to a higher risk of depression.
文摘Background: Although handgrip strength is a biomarker for morbidity/mor-tality, there is lack of evidence on the effects of resistance training on handgrip strength in healthy adults of all ages. Objective: The aim of this systematic review was to assess the impact of resistance training on handgrip strength in healthy adults. Methods: Five databases/search engines were searched. Studies comparing different types of resistance exercise interventions versus a non-exercised control group on handgrip strength were included. The available data did not allow us to conduct the pre-planned meta-analyses;therefore, only descriptive statistics were performed to summarize the data. Results: Twenty studies (17 randomized and three non-randomized controlled trials) were included, most of which were conducted in older adults. Twelve studies reported no significant difference in the change in handgrip strength between the resistance training and control groups. Two studies showed increases in handgrip strength in the resistance training group compared with the control group. Other studies included results for multi-training groups or left/right hands and found increasing handgrip strength compared to controls, but only in one training group or one hand. Overall, the randomized and non-ran-domized clinical trials presented moderate risk of bias. Conclusions: Due to the lack of low risk-of-bias randomized controlled trials of young and middle-aged adults, different training protocols, and small sample sizes, the existing evidence appears insufficient to support resistance training for increasing handgrip strength in healthy adults. Future studies may seek to discern the optimal way to develop and employ resistance training to improve hand-grip strength.
