Disparities in the consequences of sarcopenia: implications for African American Veterans

Harris‐Love, Michael O.; Adams, Bernadette; Hernandez, Haniel J.; DiPietro, Loretta; Blackman, Marc R.

doi:10.3389/fphys.2014.00250

Cited by 16 publications

(13 citation statements)

References 43 publications

(86 reference statements)

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“…Compared to NHW cases, Black PC cases of both genders were diagnosed younger and had poorer mean survival (Table ), in line with national and state data . Also consistent with published data, at baseline, Blacks had slightly higher total skeletal muscle volumes than NHW. Among males, but not females, Blacks had higher psoas muscle volumes than NHW.…”

Section: Resultssupporting

confidence: 90%

“…We previously demonstrated that a measure of myopenia, the psoas muscle index (PMI), is a powerful predictor of survival in PC patients undergoing surgery; low PMI correlated strongly with low preoperative serum albumin levels and poor survival. Given that the prevalence and consequences of muscle wasting are higher in Blacks than NHW and low serum albumin levels and high platelet counts are surrogate markers of cachexia, we have suggested that biologic correlates of PC‐induced cachexia may be more common among Black PC patients and possibly account for some degree of disparities in outcomes.…”

Section: Introductionmentioning

confidence: 99%

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Racial and ethnic disparities in a state‐wide registry of patients with pancreatic cancer and an exploratory investigation of cancer cachexia as a contributor to observed inequities

et al. 2019

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Pancreatic cancer (PC) is characterized by racial/ethnic disparities and the debilitating muscle‐wasting condition, cancer cachexia. Florida ranks second in the number of PC deaths and has a large and understudied minority population. We examined the primary hypothesis that PC incidence and mortality rates may be highest among Black Floridians and the secondary hypothesis that biological correlates of cancer cachexia may underlie disparities. PC incidence and mortality rates were estimated by race/ethnicity, gender, and county using publicly available state‐wide cancer registry data that included approximately 2700 Black, 25 200 Non‐Hispanic White (NHW), and 3300 Hispanic/Latino (H/L) Floridians diagnosed between 2004 and 2014. Blacks within Florida experienced a significantly (P < 0.05) higher incidence (12.5/100 000) and mortality (10.97/100 000) compared to NHW (incidence = 11.2/100 000; mortality = 10.3/100 000) and H/L (incidence = 9.6/100 000; mortality = 8.7/100 000), especially in rural counties. To investigate radiologic and blood‐based correlates of cachexia, we leveraged data from a subset of patients evaluated at two geographically distinct Florida Cancer Centers. In Blacks compared to NHW matched on stage, markers of PC‐induced cachexia were more frequent and included greater decreases in core musculature compared to corresponding healthy control patients (25.0% vs 10.1% lower), greater decreases in psoas musculature over time (10.5% vs 4.8% loss), lower baseline serum albumin levels (3.8 vs 4.0 gm/dL), and higher platelet counts (332.8 vs 268.7 k/UL). Together, these findings suggest for the first time that PC and cachexia may affect Blacks disproportionately. Given its nearly universal contribution to illness and PC‐related deaths, the early diagnosis and treatment of cachexia may represent an avenue to improve health equity, quality of life, and survival.

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Section: Resultssupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Racial and ethnic disparities in a state‐wide registry of patients with pancreatic cancer and an exploratory investigation of cancer cachexia as a contributor to observed inequities

et al. 2019

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“…In this study, we have used a conceptual aLM/ht 2 prediction model based on BMI, age, and a direct measure of muscle morphometry via diagnostic ultrasound. The general use of BMI remains problematic (Romero-Corral et al, 2008 ; Harris-Love et al, 2014a ) concerning the misclassification of very fit individuals as “overweight,” its potential overestimate of obesity rates in African Americans, and the wide range of BF% levels attributed to people with a BMI range between 20 and 30. However, the value of retaining BMI within the proposed aLM/ht 2 prediction model is its significant association with LBM in many patient populations, and its representation of body size which serves to provide a scaling factor for the aggregate muscle thickness values obtained via sonography.…”

Section: Discussionmentioning

confidence: 99%

“…However, due to space requirements for DXA, initial equipment costs, body size constraints, and general barriers related to specialized LBM assessment software and examiner training, DXA assessment of aLM is not an ideal measure for large scale sarcopenia clinical trials, bedside assessment, or community health screening efforts. Individual attributes such as age and sex are meaningful determinants of LBM, and alternative anthropometric methods have been used to estimate LBM (Harris-Love et al, 2014a ). In addition, BMI has been shown to explain a significant proportion of the variance in LBM values (Iannuzzi-Sucich et al, 2002 ).…”

Section: Introductionmentioning

confidence: 99%

Diagnostic ultrasound estimates of muscle mass and muscle quality discriminate between women with and without sarcopenia

et al. 2015

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Introduction: Age-related changes in muscle mass and muscle tissue composition contribute to diminished strength in older adults. The objectives of this study are to examine if an assessment method using mobile diagnostic ultrasound augments well-known determinants of lean body mass (LBM) to aid sarcopenia staging, and if a sonographic measure of muscle quality is associated with muscle performance.Methods: Twenty community-dwelling female subjects participated in the study (age = 43.4 ± 20.9 years; BMI: 23.8, interquartile range: 8.5). Dual energy X-ray absorptiometry (DXA) and diagnostic ultrasound morphometry were used to estimate LBM. Muscle tissue quality was estimated via the echogenicity using grayscale histogram analysis. Peak force was measured with grip dynamometry and scaled for body size. Bivariate and multiple regression analyses were used to determine the association of the predictor variables with appendicular lean mass (aLM/ht2), and examine the relationship between scaled peak force values and muscle echogenicity. The sarcopenia LBM cut point value of 6.75 kg/m2 determined participant assignment into the Normal LBM and Low LBM subgroups.Results: The selected LBM predictor variables were body mass index (BMI), ultrasound morphometry, and age. Although BMI exhibited a significant positive relationship with aLM/ht2 (adj. R2 = 0.61, p < 0.001), the strength of association improved with the addition of ultrasound morphometry and age as predictor variables (adj. R2 = 0.85, p < 0.001). Scaled peak force was associated with age and echogenicity (adj. R2 = 0.53, p < 0.001), but not LBM. The Low LBM subgroup of women (n = 10) had higher scaled peak force, lower BMI, and lower echogenicity values in comparison to the Normal LBM subgroup (n = 10; p < 0.05).Conclusions: Diagnostic ultrasound morphometry values are associated with LBM, and improve the BMI predictive model for aLM/ht2 in women. In addition, ultrasound proxy measures of muscle quality are more strongly associated with strength than muscle mass within the study sample.

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“…Because a convenience sample of participants who met specific entry criteria was used, the higher rates of frailty in the three ethnic groups studied than in European Americans should be further studied in other populations. Future research should also examine factors that may explain these differences, such as genetics, lower income and education level, dietary behavior and nutrition, physical activity level, prevalence of chronic diseases, and receipt of medical care . The ethnic differences also suggest the need for further research into the underlying causes of and development of culturally sensitive interventions to prevent and treat frailty.…”

Section: Discussionmentioning

confidence: 99%

Frailty in Four Ethnic Groups in South Florida

Naharci

Engström

Tappen

et al. 2016

J American Geriatrics Society

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Disparities in the consequences of sarcopenia: implications for African American Veterans

Cited by 16 publications

References 43 publications

Racial and ethnic disparities in a state‐wide registry of patients with pancreatic cancer and an exploratory investigation of cancer cachexia as a contributor to observed inequities

Racial and ethnic disparities in a state‐wide registry of patients with pancreatic cancer and an exploratory investigation of cancer cachexia as a contributor to observed inequities

Diagnostic ultrasound estimates of muscle mass and muscle quality discriminate between women with and without sarcopenia

Frailty in Four Ethnic Groups in South Florida

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