Background:Sarcopenia, the age-related decline in skeletal muscle volume and function, is associated with negative clinical and socioeconomic outcomes in elderly people. Clinical biomarkers to diagnose sarcopenia that can be quantified in a reliable, and cost- effective manner, are needed. We investigated whether the creatinine (Cr) /cystatin C (CysC) ratio is correlated with muscle volume and physical function in Japanese community-dwelling elderly subjects. Methods: The present study included 213 men aged 73.2±6.2 years and 464 women aged 72.4±5.5 years from a rural area in the Hyogo prefecture of Japan. To evaluate whether the Cr/CysC ratio is correlated with sarcopenia criteria in elderly individuals with preserved kidney function, we excluded subjects with estimate glomerular filtration rate (eGFR) <45. Results:The prevalence of sarcopenia diagnosed according to the AWGS criteria was 2.8% in men and 3.4% in women. The Cr/CysC ratio correlated with skeletal mass index (r = 0.49, p <0.0001), skeletal muscle mass (r = 0.53, p <0.0001), grip power (r = 0.59, p <0.0001), knee extension muscle strength (r = 0.49, p <0.0001), normal gait speed (r = 0.18, p <0.0001), and maximal gait speed (r = 0.32, p <0.0001). A negative correlation between the Cr/CysC ratio and, body fat mass (r = -0.20, p <0.0001) and percentage of body fat mass (r = -0.39, p <0.0001) was observed. In a multiple regression analysis, Cr/CysC was also found to be significantly positively correlated with each component of the sarcopenia criteria. Conclusions:Even in elderly individuals with preserved kidney function, the Cr/CysC ratio was positively correlated with muscle volume and physical function and negatively correlated with body fat mass. Therefore, the Cr/CysC ratio might be a useful biomarker to predict sarcopenia.
This study investigated the relationship between tongue pressure during swallowing and dysphagia in patients with Parkinson's disease (PD). A total of 24 patients with PD (12 men and 12 women, mean age 70.4 years) were studied. Their mean Hoehn and Yahr scale was 3.0 ± 1.3 (range 1-5). All participants underwent tongue pressure measurement and videofluorography during swallowing. Tongue pressure when swallowing 5 mL of barium on videofluorography was measured using a sensor sheet with five sensors. Based on the findings of videofluorography, the patients were divided into two groups: dysphagic PD group (n = 9) and non-dysphagic PD group (n = 15). The maximal magnitude (kPa), duration (s), time to peak pressure (s), and pressure gradient (kPa/s) of tongue pressure were analyzed for each part. For duration, time to peak pressure, and pressure gradient, similar values were calculated from the total waveform. There was no significant difference in maximal tongue pressure between the groups. The dysphagic PD group had prolonged duration of tongue pressure and time to peak pressure and a reduced pressure gradient compared with the non-dysphagic PD group. These results indicate that there is a clear difference in the temporal aspects of tongue pressure between the non-dysphagic and dysphagic PD patients. These differences provide the characteristics of tongue movement during swallowing in PD patients with dysphagia, which may be useful for the diagnosis and treatment of dysphagia.
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