Sex-specific differences in risk factors for sarcopenia amongst community-dwelling older adults

Abstract

With considerable variation including potential sex-specific differential rate of skeletal muscle loss, identifying modifiable factors for sarcopenia will be pivotal to guide targeted interventions. This study seeks to identify clinical and biological correlates of sarcopenia in community-dwelling older adults, with emphasis on the role of anabolic and catabolic stimuli, and special reference to gender specificity. In this crosssectional study involving 200 community-dwelling and functionally independent older adults aged ≥50 years, sarcopenia was defined using the Asian Working Group for Sarcopenia criteria. Comorbidities, cognitive and functional performance, physical activity and nutritional status were routinely assessed. Biochemical parameters included haematological indices, lipid panel, vitamin D level, anabolic hormones [insulin-like growth factor-1 (IGF-1), free testosterone (males only)] and catabolic markers [inflammatory markers (interleukin-6, Creactive protein) and myostatin]. Multiple logistic regression was performed to identify independent predictors for sarcopenia. Age was associated with sarcopenia in both genders. Malnutrition conferred significantly higher odds for sarcopenia in women (OR=5.71, 95 % CI 1.13-28.84.44, p=0.035) while higher but acceptable range serum triglyceride was protective in men (OR=0.05, 95 % CI 0.00-0.52, p=0.012). Higher serum myostatin independently associated with higher odds for sarcopenia in men (OR=1.11, 95 % CI 1.00-1.24, p=0.041). Serum IGF-1 was significantly lower amongst female sarcopenic subjects, with demonstrable trend for protective effect against sarcopenia in multiple regression models, such that each 1 ng/ml increase in IGF-1 was associated with 1 % decline in odds of sarcopenia in women (p=0.095). Our findings support differential pathophysiological mechanisms for sarcopenia that, if corroborated, may have clinical utility in guiding sex-specific targeted interventions for community-dwelling older adults.

Factors Associated with Poor Muscle Mass and Strength in A Community-Dwelling Elderly Population: A Cross-Sectional Study

“…shows that, in women, muscle mass is associated with decreased IGF-1 levels, and muscle strength with increased cortisol levels, suggesting an imbalance between anabolic and catabolic hormones. These results corroborate those reported by Tay et al in another cross-sectional study in community dwelling older adults, which showed lower IGF-1 levels in sarcopenic women in comparison to non-sarcopenic women [24]. However, this anabolic/catabolic imbalance seems to be less relevant in men, who may be protected by higher testosterone levels.…”

Prevalence of sarcopenia in community‐dwelling older people of Mexico City using the EGWSOP (European Working Group on Sarcopenia in Older People) diagnostic criteria

“…Statistically significant differences were maintained in all measurements relative to sarcopenia by gender. It has been suggested that the decrease in fat free mass among older men is related to the catabolic influence of myostatin as a negative regulator of muscle mass growth, whereas the reduction of type I insulin growth factor (IGF1) could contribute to the chronic anabolic deterioration relative to age in the muscle mass of women [30]. It is noteworthy that in our study there was a decrease in handgrip strength below the cut-off point, higher in women compared with men.…”

Effect of Decreased Skeletal Muscle Index and Hand Grip Strength on Functional Recovery in Subacute Ambulatory Stroke Patients

“…Although the prevalence of sarcopenia has some variations due to different definitions, tools of diagnosis, and patient populations, the European Working Group on Sarcopenia in Older People (EWGSOP) has reported a prevalence of up to 29% in elderly community-dwelling populations and a prevalence of 14%-33% in long-term care populations [8]. Among various factors causing sarcopenia, advanced age has been consistently suggested as a major risk factor for sarcopenia [9][10][11][12][13][14].…”