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This study aimed to determine whether risk factors for presarcopenia can be identified in a sample of early middle-aged men and women. Prospective study. Longitudinal data from the Dunedin Multidisciplinary Health and Development Study were used to investigate the relationship between presarcopenia at age 45 years and selected early markers at ages 26, 32, and 38 years. Longitudinal data from N=899 participants from the Dunedin Multidisciplinary Health and Development Study. Not applicable. Presarcopenia was defined as low relative appendicular lean mass index assessed by dual energy x-ray absorptiometry and low strength assessed by grip strength. Logistic regressions were used to describe the association between selected markers and presarcopenia at age 45 years. Multivariate logistic regression revealed that a higher body mass index (BMI) at ages 26, 32, and 38 years was associated with lower likelihood of presarcopenia at age 45 years in both men and women (odds ratio [OR] range, 0.46-0.64). Higher age-normative grip strength at age 38 years in both men and women (OR range, 0.88-0.92) was also associated with lower likelihood for presarcopenia. Lastly, lower self-perceived physical fitness level in men at age 38 years was associated with an increased likelihood of presarcopenia at age 45 years (OR, 9.35; 95% confidence interval, 3.28-26.70). BMI and strength were associated with lower likelihood of presarcopenia during middle age. A higher likelihood of presarcopenia was associated with sex-specific lower self-perceived physical fitness. These modifiable biomarkers may serve as targets for clinical screening and early intervention aimed at slowing or preventing progression to sarcopenia in old age. [ABSTRACT FROM AUTHOR]

Sarcopenic dysphagia is the term for swallowing difficulty associated with loss of mass, strength, and physical performance, which leads to increased pharyngeal residues. Unlike sarcopenia, presarcopenia is characterized by low muscle mass without decreased muscle strength or physical performance and can develop into dysphagia due to low skeletal muscle mass. This retrospective study investigated the impact of presarcopenic dysphagia (PSD) on 1-year mortality in patients with cancer and dysphagia who underwent a videofluoroscopic swallowing study (VFSS). An operational definition of PSD based on presarcopenia and pharyngeal residues was adopted. The psoas muscle mass index (cm2/height [m2]), calculated by the psoas muscle area at the third lumber vertebra via abdominal computed tomography (CT) and related to height, was used to assess presarcopenia with cutoff values of 4.62 for men and 2.66 for women. Pharyngeal residues were assessed using a VFSS to evaluate dysphagia. Patients' medical charts were analyzed to investigate 1-year mortality after a VFSS. Out of 111 consecutive patients with cancer, 53 (47.7%) were defined as having PSD. In a forward-stepwise Cox proportional regression analysis, PSD (HR 2.599; 95% CI 1.158–5.834; p = 0.021) was significantly associated with 1-year mortality after a VFSS, even after adjusting for the factors of operation, Functional Oral Intake Scale (FOIS) scores at discharge, and modified Barthel Index (BI) scores at discharge. PSD, defined as CT-based presarcopenia and pharyngeal residues observed during a VFSS, is associated with increased 1-year mortality in patients with cancer and dysphagia. [ABSTRACT FROM AUTHOR]

Background Sarcopenia is defined as a decline in skeletal muscle mass and whole-body physical function associated with aging. If only a decrease in skeletal muscle mass is observed, the term used is presarcopenia (PS). In this study, we retrospectively analyzed the clinical significance of PS in older patients with colorectal cancer aged ≥75 years. Results Of the 131 older patients with colorectal cancer, 33 were classified as PS group and 98 as non-PS group. Postoperative complications were more common in the PS group (P=0.051). In addition, Alb levels were lower in the PS group (Alb: P=0.069) and CRP-Alb ratio (CAR) was higher in the PS group (CAR: P = 0.069). The neutrophil-lymphocyte ratio (NLR) was higher in the PS group (NLR: P= 0.002). Conclusion PS in older patients with colorectal cancer was associated with an increased incidence of postoperative complications and longer hospital stay. Diagnosing PS before surgery may be useful as a screening tool for identifying patients at high risk of postoperative complications. Furthermore, PS was suggested to be associated with preoperative inflammation-related factors such as CAR and NLR. [ABSTRACT FROM AUTHOR]

Objective. Materials and methods: 82 patients with type 2 diabetes mellitus participated, which were divided into 2 groups: probable sarcopenia and comparison groups. Conducted: questionnaire surveys (Health Status Survey (SF-36)), Sarcopenia quality and life assessment (SarQoL)), strength, assistance with walking, getting up from a chair, climbing stairs and falling — Strength, Assisted walking, getting up from a chair, Climbing stairs and Falls (SARC-F)), assessment of walking speed and physical activity, carpal dynamometry, bioimpedancemetry, analysis of laboratory parameters. Results: the difference between the conducted questionnaires is statistically insignificant. According to bioimpedansometry, obesity of the 1st degree was recorded in the lesions. In the group with presarcopenia, the main decrease in body composition parameters decreases. In addition, in the main group, the rate of intake is reduced, and decompensation of carbohydrate and lipid metabolism occurs. Differences were considered significant at p < 0.05. Conclusion. Dynamometry and bioimpedance can be used for primary screening of sarcopenia in patients with type 2 diabetes. Maintaining the main indicators of glycemia, correction of dyslipidemia, compensation for obesity D and hypocalcemia of obesity in muscle mass and mass.

Background: Few studies on the risk of incident major adverse cardiac and cerebrovascular events (MACCEs) in sarcopenia have been reported. The objective was to assess the association between presarcopenia and sarcopenia and a higher risk of MACCEs. Methods: This study on the UK Biobank prospective cohort, used data collected between 2006 and 2021. Community‐dwelling Caucasian participants aged 37 to 73 years were included if values for Handgrip Strength (HGS) and Skeletal Muscle Index (SMI) were available and if no history of MACCEs was reported. Exposure was assessed using the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) criteria. Muscle strength was measured using HGS, and muscle mass using the SMI. Presarcopenia was defined through the two definitions available in the literature, as low HGS with normal SMI and as normal HGS with low SMI, whereas sarcopenia was defined as low HGS with low SMI. The main outcome was to determine whether presarcopenia and/or sarcopenia were predictors of MACCEs (composite events). Results: A total of 406,411 included participants (women: 55.7%) were included. At baseline, there were 18,257 (4.7%) presarcopenics—subgroup n°1 (low HGS only), 7940 (2.1%) presarcopenics—subgroup n°2 (low SMI only), and 1124 (0.3%) sarcopenics. Over a median follow‐up of 12.1 years (IQR: [11.4; 12.8]), 28,300 participants (7.0%) were diagnosed with at least one event. Compared to NonSarc, presarcopenic (subgroups n°1 and n°2) and sarcopenic status were significantly associated with a higher risk of MACCEs (respectively fully adjusted HRs: HR = 1.25 [95% CI: 1.19; 1.31], HR = 1.33 [95% CI: 1.23; 1.45] and HR = 1.62 [95% CI: 1.34; 1.95]). Conclusions: In a community‐dwelling population, the risk of MACCEs was higher in both presarcopenic and sarcopenic participants. See related editorial by Mirzai and Tang in this issue. [ABSTRACT FROM AUTHOR]

Dehydroepiandrosterone sulfate (DHEAS) is thought to be associated with life expectancy and anti-aging. Although skeletal muscle disorders are often found in diabetic people, the clinical significance of DHEAS in skeletal muscle remains unclear. Therefore, we aimed to determine whether DHEAS is associated with the development of skeletal muscle disorders in individuals with type 2 diabetes (T2D). A cross-sectional study was conducted in 361 individuals with T2D. Serum DHEAS levels, skeletal muscle mass index (SMI), handgrip strength (HS), and gait speed (GS) were measured in the participants. Pre-sarcopenia, sarcopenia, and dynapenia were defined according to the definitions of the AWGS 2019 criteria. DHEAS level was positively associated with HS but not with SMI or GS after adjustment of confounding factors. Multiple logistic regression analyses in total subjects showed that DHEAS level had an inverse association with the prevalence of dynapenia but not with the prevalence of pre-sarcopenia or sarcopenia. Furthermore, a significant association between DHEAS level and dynapenia was found in males but not in females. ROC curve analysis indicated that cutoff values of serum DHEAS for risk of dynapenia in males was 92.0 μg/dL. Therefore, in male individuals with T2D who have low serum levels of DHEAS, adequate exercise might be needed to prevent dynapenia. [ABSTRACT FROM AUTHOR]

• Skeletal muscle mass was a stronger predictor of short-term prognosis in acute stroke. • Low skeletal muscle mass was present in 46% males and 56% females. • Muscle mass was a more important factor than lower limb paralysis or stroke severity. Changes in skeletal muscle mass affect physical performance in chronic stroke survivors. The skeletal muscle mass index is thus an important assessment factor in stroke; however, its value in the acute phase is unclear. This study investigated the association between skeletal muscle mass and acute stroke outcome. This was a single-center cohort study design. A total of 189 consecutively hospitalized patients with acute stroke were included in the study. Not applicable. The main outcome of the study was a good modified Rankin Scale (mRS) score at hospital discharge. We divided the participants into good (mRS score 0–2) and poor (mRS score 3–6) function groups. Logistic regression was performed to identify the factors associated with functional prognosis. Atrial fibrillation (odds ratio [OR], 14.95; 95% confidence interval [CI], 2.45–91.39; P = 0.003), pre-mRS (OR, 2.22; 95% CI, 1.05–4.68; P = 0.036), National Institutes of Health Stroke Scale (OR, 1.32; 95% CI, 01.12–1.56; P = 0.001), skeletal muscle mass index (OR, 0.31; 95% CI, 0.11–0.87; P = 0.027), and Lower Extremity Fugl–Meyer Assessment (OR, 0.68; 95% CI, 0.56–0.82; P = 0.000) were all independently associated with the functional prognosis of the patients included in the study. This study confirmed that skeletal muscle mass is a strong prognostic factor in acute stroke. Thus, prestroke skeletal muscle mass, along with stroke severity and lower limb paralysis, needs to be assessed to more accurately determine the prognosis of patients with stroke. [ABSTRACT FROM AUTHOR]

Context: Low skeletal muscle mass often accompanies abdominal obesity in the aging process. Objective: We aimed to investigate the effect of reduced skeletal muscle mass and its interaction with abdominal obesity on incident type 2 diabetes. Methods: This retrospective longitudinal study included 36 304 diabetes-free Koreans who underwent 2 or more health checkups annually or biannually. Appendicular skeletal muscle mass was measured by bioelectrical impedance analysis and was presented as a skeletal muscle mass index (SMI) adjusted for body weight. Presarcopenia was defined as an SMI less than 1 SD of the sex-specific mean for a healthy young reference group. Abdominal obesity was defined using waist circumference greater than or equal to 90 cm for men and greater than or equal to 85 cm for women. Participants were classified into 4 groups of normal, presarcopenia alone, abdominal obesity alone, and presarcopenic obesity according to initial body composition. Results: The cumulative incidence of diabetes was 9.1% during the 7-year follow-up. Compared with the highest tertile, the lowest sex-specific SMI tertile was significantly associated with a greater risk of incident type 2 diabetes (adjusted hazard ratio [HR]=1.31; 95% CI, 1.18-1.45) in a fully adjusted model. Presarcopenic obesity significantly increased incident diabetes risk (adjusted HR=1.57; 95% CI, 1.42-1.73) compared with normal body composition, presarcopenia alone, or abdominal obesity alone. Conclusion: Low skeletal muscle mass and its coexistence with abdominal obesity additively increased the risk of incident type 2 diabetes independent of the glycometabolic parameters. [ABSTRACT FROM AUTHOR]

ABSTRACT Aims/Introduction To investigate the association of subtle alterations in thyroid function with presarcopenia among patients with type 2 diabetes mellitus. Materials and Methods A total of 1,865 adult patients with type 2 diabetes mellitus were enrolled in this cross‐sectional study, excluding patients with overt thyroid dysfunction. Skeletal muscle mass measured by dual energy X‐ray absorptiometry was used to assess presarcopenia. Logistic regression models were used to estimate the effects of thyroid hormones on presarcopenia, and subgroup analyses were carried out in different strata of age, sex and body mass index, respectively. Results Compared with the euthyroid group (Euthy), the subclinical hyperthyroidism group had an increased odds of presarcopenia (multivariate‐adjusted odds ratio 1.99, 95% confidence interval 1.09–3.63), but the subclinical hypothyroidism group did not (P > 0.05). In the subclinical hyperthyroidism group, age and body mass index 0.05). Additionally, in Euthy subgroup analyses stratified by middle‐age, sex and body mass index, a similar association was noted (all P for trend 0.05). Conclusions Subclinical hyperthyroidism was an independent risk factor for presarcopenia in patients with type 2 diabetes mellitus, but subclinical hypothyroidism was not. In the Euthy group with type 2 diabetes mellitus, a high free thyroxine : free triiodothyronine ratio was a good index of presarcopenia in addition to older age.

Dehydroepiandrosterone sulfate (DHEAS) is thought to be associated with life expectancy and anti-aging. Although skeletal muscle disorders are often found in diabetic people, the clinical significance of DHEAS in skeletal muscle remains unclear. Therefore, we aimed to determine whether DHEAS is associated with the development of skeletal muscle disorders in individuals with type 2 diabetes (T2D). A cross-sectional study was conducted in 361 individuals with T2D. Serum DHEAS levels, skeletal muscle mass index (SMI), handgrip strength (HS), and gait speed (GS) were measured in the participants. Pre-sarcopenia, sarcopenia, and dynapenia were defined according to the definitions of the AWGS 2019 criteria. DHEAS level was positively associated with HS but not with SMI or GS after adjustment of confounding factors. Multiple logistic regression analyses in total subjects showed that DHEAS level had an inverse association with the prevalence of dynapenia but not with the prevalence of pre-sarcopenia or sarcopenia. Furthermore, a significant association between DHEAS level and dynapenia was found in males but not in females. ROC curve analysis indicated that cutoff values of serum DHEAS for risk of dynapenia in males was 92.0 μg/dL. Therefore, in male individuals with T2D who have low serum levels of DHEAS, adequate exercise might be needed to prevent dynapenia.

Introduction: The European Working Group on Sarcopenia in Older People (EWGSOP) published a consensus on sarcopenia in 2010 and updated it in 2019 (EWGSOP2) which included the use of specific cut-off points. The aim was to assess how much prevalence of sarcopenia differed between EWGSOP2 and EWGSOP, as well as the use of specific cut-off points to assess differences in presarcopenia versus probable sarcopenia. Methods: Observational, transversal, and comparative study (n = 1,283 older adults; 57% women). Anthropometrics and handgrip strength were measured, and appendicular skeletal muscle mass equation was defined. Conceptual and methodological definitions of EWGSOP and EWGSOP2 consensus were applied to calculate prevalence of presarcopenia, probable sarcopenia, and sarcopenia. Results: Using cut-off points recommended for European population, prevalence of sarcopenia with EWGSOP2 was lower (−6.6%; p < 0.001) than EWGSOP. The prevalence of probable sarcopenia (EWGSOP2) was higher (+7.8%; p < 0.001) than EWGSOP presarcopenia. The agreement between EGWGSOP and EWGSOP2 was moderated (K = 0.45; IC = 0.40–0.51). Using specific-population cut-off points for muscle strength and appendicular muscle mass, the prevalence of probable sarcopenia with EWGSOP2 was higher (46.5%; p < 0.001) than EWGSOP (1.8%). The agreement between EGWGSOP and EWGSOP2 was moderated (K = 0.48; IC = 0.42–0.52). Conclusion: The new EWGSOP2 consensus underestimates the prevalence of sarcopenia, compared with EWGSOP using conventional cut-off points. The prevalence of presarcopenia with EWGSOP (low muscle mass) was lower than probable sarcopenia (low muscle strength) with the new EWGSOP2. In both cases, agreements between EWGSOP2 and EWGSOP were moderated. Discrepancies between the original and new consensus have implications on the primary health setting for identifying old and new cases for prevention and treatment. [ABSTRACT FROM AUTHOR]

Age-related decline in skeletal muscle mass and function are risk factors for reduced walking ability. This study aimed to understand the characteristic gait parameters of presarcopenia (low muscle mass only), dynapenia (low muscle function only), and sarcopenia (low muscle mass and function), which have differing skeletal muscle characteristics. Skeletal muscle mass, grip strength, and gait parameters (walking speed, cadence, step length, step width, gait angle, foot angle, stance time, swing time, and double stance time) were evaluated in 307 older Japanese women. Low muscle function was determined by grip strength and normal walking speed. Participants were assessed and divided into the normal (60.9%, n = 187), presarcopenia (25.7%, n = 79), dynapenia (5.2%, n = 16), and sarcopenia (8.1%, n = 25) groups. When compared to the normal group, the sarcopenia group had significantly slower walking speed and shorter step length (p < 0.05); the dynapenia group had significantly slower walking speed, smaller cadence, shorter step length, wider step width, and longer stance time (p < 0.05); and the presarcopenia group showed no differences. Skeletal muscle function may therefore be more strongly related to reduced walking function in older adults than body composition factors. The decrease in walking function was most pronounced in older women with dynapenia. [ABSTRACT FROM AUTHOR]

Aims/Introduction: To investigate the association of subtle alterations in thyroid function with presarcopenia among patients with type 2 diabetes mellitus. Materials and Methods: A total of 1,865 adult patients with type 2 diabetes mellitus were enrolled in this cross‐sectional study, excluding patients with overt thyroid dysfunction. Skeletal muscle mass measured by dual energy X‐ray absorptiometry was used to assess presarcopenia. Logistic regression models were used to estimate the effects of thyroid hormones on presarcopenia, and subgroup analyses were carried out in different strata of age, sex and body mass index, respectively. Results: Compared with the euthyroid group (Euthy), the subclinical hyperthyroidism group had an increased odds of presarcopenia (multivariate‐adjusted odds ratio 1.99, 95% confidence interval 1.09–3.63), but the subclinical hypothyroidism group did not (P > 0.05). In the subclinical hyperthyroidism group, age and body mass index <24 kg/m2 were independent risk factors for presarcopenia. In the overall Euthy group, an increased odds of presarcopenia was correlated with the elevated free thyroxine : free triiodothyronine ratio (all P for trend <0.05), whereas not with increment in free triiodothyronine level (P for trend >0.05). Additionally, in Euthy subgroup analyses stratified by middle‐age, sex and body mass index, a similar association was noted (all P for trend <0.05), but not in the older‐aged patients (P for trend >0.05). Conclusions: Subclinical hyperthyroidism was an independent risk factor for presarcopenia in patients with type 2 diabetes mellitus, but subclinical hypothyroidism was not. In the Euthy group with type 2 diabetes mellitus, a high free thyroxine : free triiodothyronine ratio was a good index of presarcopenia in addition to older age. [ABSTRACT FROM AUTHOR]

Objective: The risk of both osteoporosis and sarcopenia is high in inflammatory diseases, but there have been few reports of psoriatic arthritis (PsA). This study aimed to evaluate the rate of sarcopenia and osteoporosis, and the association of sarcopenia with osteoporosis in patients with PsA at our institution., Methods: The data in this study were extracted from 320 patients with PsA meeting CASPAR criteria diagnosed between January 2010 and December 2021. The 156 patients who had undergone body composition measurements with dual-energy X-ray absorptiometry were included., Results: Overall, the rate of sarcopenia and presarcopenia were 5.1% and 16.7%. Body mass index (BMI) was significantly lower in the presarcopenia and sarcopenia group. Furthermore, the presarcopenia and sarcopenia group had a significantly lower T-score in all regions. Multivariate analysis of the determinants of T-score for each site showed that SMI was significantly involved for the lumbar spine and the femoral neck, and BMI and rheumatoid factor positivity for the total hip., Conclusions: In patients with PsA, the rate of sarcopenia was 5.1%. Osteoporosis rates for males and females were 5.7% and 7.5%, respectively. SMI, T-score, and BMI are significantly correlated with each other and should be considered in clinical practice., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Yuichi Ono, Naohisa Miyakoshi, Yuji Kasukawa, Manabu Akagawa, Ryota Kimura, Itsuki Nagahata, Yusuke Yuasa, Chiaki Sato, Yoichi Shimada Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Akita, JapanCorrespondence: Yuichi OnoDepartment of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1, Hondo, Akita-shi, Akita 010-8543, JapanTel +81-18-884-6148Fax +81-18-836-2617Email yuichi.ono24@gmail.comPurpose: Sarcopenia and osteoporosis are both serious health problems in postmenopausal women. The Asia Working Group for Sarcopenia recommends using the skeletal muscle index (SMI), which is height-adjusted appendicular skeletal muscle mass (ASMM). However, loss of height has been shown to be a common clinical finding in patients with osteoporosis. This study examined the prevalence of presarcopenia using height and arm span, which is a predictor of height, and investigated the diagnostic accuracy for presarcopenia.Methods: A total of 55 post-menopausal osteoporotic patients aged 62– 95 years underwent bioelectrical impedance analysis (BIA) for ASMM measurement and dual-energy X-ray absorptiometry (DXA) scan for bone mineral density (BMD). Anthropometric measurements, including height, weight, and arm span were taken, and body mass index (BMI), SMI, and arm span-adjusted SMI (Arm span SMI) were calculated. Presarcopenia was defined as SMI or Arm span SMI < 5.7 kg/m2 in this study.Results: The prevalence of presarcopenia was 27.3% and 38.2% evaluated by SMI and Arm span SMI, respectively. The prevalence of presarcopenia was higher when evaluated by Arm span SMI than by SMI. In the presarcopenia group diagnosed only by Arm span SMI (n=11), the arm span-height difference was significantly higher (p< 0.001) and the percentage of young adult mean (YAM) femoral neck-BMD was significantly lower (p=0.013) compared to the normal group diagnosed by both SMI and Arm span-SMI (n=29).Conclusion: These results indicated that Arm span SMI might be useful for the diagnosis of sarcopenia in patients with severe osteoporosis and kyphosis.Keywords: arm span, body height, osteoporosis, presarcopenia, skeletal muscle mass

Yuan Cao, 1 Ming Zhong, 1 Yuke Zhang, 2 Zijie Zheng, 1 Yapeng Liu, 1 Xiaoning Ni, 1 Lu Han, 1, 3 Ming Song, 1 Wei Zhang, 1 Zhihao Wang 1, 4 1The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, and The Department of Cardiology, Qilu Hospital of Shandong University, Jinan, Shandong, People’s Republic of China; 2The First Affiliated Hospital of Shandong First Medical University, Shandong Provincial Qianfoshan Hospital, Department of Critical Care Medicine, Jinan, Shandong, People’s Republic of China; 3Department of General Medicine, Qilu Hospital of Shandong University, Jinan, Shandong, People’s Republic of China; 4Department of Geriatric Medicine, Qilu Hospital of Shandong University, and The Key Laboratory of Cardiovascular Proteomics of Shandong Province, Jinan, Shandong, People’s Republic of ChinaCorrespondence: Wei ZhangThe Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, and The Department of Cardiology, Qilu Hospital of Shandong University, No. 107, Wen Hua Xi Road, Jinan 250012, People’s Republic of ChinaTel +86 185 6008 6586Fax +86 531 8616 9356Email zhangweisdu7@163.com Zhihao WangThe Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, The Department of Geriatric Medicine, Qilu Hospital of Shandong University, and The Key Laboratory of Cardiovascular Proteomics of Shandong Province, No. 107, Wen Hua Xi Road, Jinan 250012, People’s Republic of ChinaTel +86 185 6008 2268Fax +86 531 8616 9356Email zhihao369@163.comPurpose: To investigate the impacts of skeletal muscle mass on carotid atherosclerosis in Chinese adults with metabolic syndrome (MetS).Methods: One hundred and ninety-five subjects with MetS had the waist-to-height ratio (WHTR)≥ 0.5 for all. One hundred and eighty-four subjects without MetS were divided into 2 groups: Non-Mets obese group (WHTR ≥ 0.5, n = 118) and Non-MetS control group (WHTR < 0.5, n = 66). All the groups had no difference in age. Appendicular skeletal muscle mass was acquired and skeletal muscle mass index (SMI) was calculated. Carotid intima-media thickness (IMT) was assessed by ultrasonography. Each group was stratified according to the presence or absence of presarcopenia.Results: While most parameters showed an increasing trend with WHTR and MetS in both genders, SMI and HDL-C showed a decreasing trend. The prevalence of carotid atherosclerosis showed the same increasing trend. Multivariate logistic regression analyses showed SBP and presarcopenia were both independent risk factors for carotid atherosclerosis in MetS (OR 1.026, P < 0.001; OR 2.788, P = 0.001, respectively). There was no significant difference in IMT among the three groups with preserved muscle mass whether the participants suffered from obesity or MetS, while there was a significant difference between the two groups with presarcopenia (in male P = 0.020, in female P = 0.009, respectively). The area under the ROC curve (AUC) was 0.641 (P< 0.001) for presarcopenia.Conclusion: Obesity was a risk factor for sarcopenia independent of age, especially in subjects with metabolic syndrome. In individuals with MetS, our findings suggest that presarcopenia may be an independent risk factor for atherosclerosis and appendicular skeletal muscle mass had potential protective effects for carotid atherosclerosis regardless of gender.Keywords: skeletal muscle mass, presarcopenia, metabolic syndrome, carotid atherosclerosis

Background: Presarcopenia is a common complication of chronic liver disease. However, the relationship between serum zinc concentration and presarcopenia in patients with chronic liver disease remains unclear. Herein, we examined whether serum zinc concentration could predict presarcopenia in patients with chronic liver disease., Methods: Between October 2015 and December 2019, 278 patients with chronic liver disease (median age, 68 years; women/men, 133/145; hepatitis B virus/hepatitis C virus/negative hepatitis B surface antigen and negative anti-hepatitis C virus antibody, 55/124/99) who underwent abdominal computed tomography (CT) and simultaneous measurement of serum zinc concentration were included. Zinc deficiency and subclinical zinc deficiency were classified using serum zinc concentration cutoff values of <60 and <80 μg/dL [based on the Japanese Society of Clinical Nutrition (JSCN) guidelines], respectively. Additionally, presarcopenia was evaluated based on the skeletal muscle mass as per the Japan Society of Hepatology (JSH)'s sarcopenia criteria., Results: Univariate analysis revealed that the following factors were significantly associated with the presence of presarcopenia in patients with chronic liver disease: age (P<0.001), male sex (P<0.001), body mass index (BMI) (P<0.001), serum zinc concentration (P=0.005), fibrosis-4 index (P<0.001), and serum albumin concentration (P=0.03). Additionally, the median L3 skeletal muscle indices were as follows: men, non-presarcopenia group/presarcopenia group, 47.56/37.91 cm 2 /m 2 (P<0.001); women, non-presarcopenia group/presarcopenia group, 41.64/32.88 cm 2 /m 2 (P<0.001). Multivariate analysis using logistic regression analysis revealed that male sex [odds ratio (OR), 0.194; 95% confidence interval (CI): 0.089-0.419; P<0.001], BMI (OR, 0.666; 95% CI: 0.582-0.761; P<0.001), and serum zinc concentration <60 μg/dL (OR, 5.930; 95% CI: 1.480-23.80; P=0.01) were factors associated with presarcopenia. The OR for serum zinc concentration between 60 and 80 μg/dL was 1.910 (95% CI: 0.824-4.420; P=0.13)., Conclusions: Low serum zinc levels may be an independent predictor of presarcopenia in patients with chronic liver disease., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://tgh.amegroups.com/article/view/10.21037/tgh-23-77/coif). The authors have no conflicts of interest to declare., (2024 Translational Gastroenterology and Hepatology. All rights reserved.)

Objective: To evaluate the presence of sarcopenia in patients with rheumatoid arthritis (RA). Method: This cross‐sectional study included 100 patients with RA and 100 gender‐matched healthy individuals. Sarcopenia was assessed by performing tests evaluating muscle strength, muscle mass, and physical performance, using the criteria determined by The European Working Group on Sarcopenia. Sarcopenia is defined as a decrease in muscle strength and muscle mass. On the other hand, presarcopenia is defined as a decrease in muscle strength with a normal muscle mass. Results: The participants comprised of 70 females and 30 males. The frequency of presarcopenia was 35% in the RA group and 9% in the control group (P <.001). Results of handgrip and gait speed tests were lower in the RA group than in the healthy control group (P =.002 and P <.001, respectively). Presarcopenia was seen at higher rates among female and older patients, and patients with longer disease duration. Disease activity scores were higher in patients with presarcopenia than in patients without sarcopenia (P <.05). In multivariate regression analysis for presarcopenia; a statistically significant association was found between handgrip test results and age, gender, and disease activity (P <.001, R2 =.62). Conclusions: Longer disease duration and higher disease activity may provoke the development of sarcopenia due to chronic inflammation in patients with RA. Physicians should be aware of the development of sarcopenia during the course of disease and take into account the preservative and preventive methods against sarcopenia by encouraging them about exercise along with controlling disease activity. [ABSTRACT FROM AUTHOR]

Background: Studies have provided controversial and limited knowledge regarding the impact of sarcopenia on surgical outcomes in esophageal cancers due to retrospective study designs and single muscle-mass assessment. This prospective cohort study aimed to resolve these issues.Methods: Bioelectrical impedance analysis, handgrip strength measurement, and the 4-m walking test were conducted before surgery. Sarcopenia was diagnosed as low appendicular skeletal muscle mass index (<7.0 kg/m2 in men and <5.7 kg/m2 in women) plus low handgrip strength (<26 kg in men and <18 kg in women) and/or low gait speed (<0.8 m/s). Presarcopenia was diagnosed as either: (1) solely low muscle mass index; or (2) solely low handgrip strength and/or gait speed. Endpoints included perioperative biochemical indicators, postoperative complications, and the recovery of postoperative quality of life (QOL).Results: In total, 212 patients were enrolled, including 55 (25.9%) and 60 (28.3%) patients diagnosed with sarcopenia and presarcopenia, respectively. The presarcopenic and normal patients showed a similar risk of postoperative complications and were combined. Despite similar baseline levels, sarcopenic patients (vs. non-sarcopenic) showed decreased prealbumin on postoperative day (POD) 1, decreased albumin on PODs 1, 3, and 5, and delayed recovery of lymphocyte counts (all P < 0.05). The levels of C-reactive protein in sarcopenic patients was lower than in non-sarcopenic patients on POD 1 (P = 0.010) but higher on POD 5 (P = 0.001). Multivariate analyses demonstrated the independent predictive value of sarcopenia for overall complications (P < 0.001), major complications (Clavien-Dindo grade ≥ III, P = 0.001), and delayed hospital discharge (>12 days, P < 0.001). Sarcopenia was demonstrated as a risk factor for deteriorated global QOL (P = 0.001), physical (P = 0.001) and role functions (P = 0.006), and severe fatigue (P = 0.004) at four weeks after surgery.Conclusions: Sarcopenia was associated with poor metabolic stress and immune responses surrounding esophagectomy and was a potential target for reducing complications and promoting recovery of QOL. [ABSTRACT FROM AUTHOR]

Aging of society has increased the incidence of physical disability. The goal of this study was to examine the physical ability of elderly people classified as having sarcopenia, presarcopenia, or dynapenia (a low muscle function without low muscle mass) in a community in Japan. The subjects were volunteers aged >60 years who were participants in a health checkup in Yakumo, Hokkaido and were in good general health. Demographic data were collected and physical performance tests were performed to measure grip strength, walking speed, back muscle strength, maximum stride length, and 3-m timed-up-and-go (3m TUG) time. A measurement of skeletal muscle mass was used as a basis for calculating the appendicular skeletal muscle index (aSMI). The rates of sarcopenia, presarcopenia, and dynapenia were 10%, 22%, and 8% in males (n=101, age 69.7±5.4 years), and 19%, 23%, and 13% in females (n=112, 68.5±5.9 years). Body mass index in subjects with dynapenia was significantly higher compared to that in subjects with sarcopenia and presarcopenia (p<0.01). Back muscle strength, maximum stride length and 3m TUG were similar in dynapenia and sarcopenia, but differed significantly with those in presarcopenia in both males and females without the influence of age (p<0.05). Further studies are needed to evaluate the benefits of dynapenia intervention programs and to explore the underlying pathophysiology of dynapenia. [ABSTRACT FROM AUTHOR]

• Older adults were divided to two group based on their skeletal muscle mass. • Individuals with low physical functions, i.e., sarcopenia, were excluded. • Normally, motor units fire with hierarchy depending on recruitment thresholds. • In low skeletal muscle mass group, the hierarchical firing pattern was absence. Muscular dysfunctions involving a decline in muscle strength are often induced by loss of muscle mass in older adults. Understanding neural activation in older adults in addition to muscular characteristics may be important to prevent such age-related dysfunctions. This study aimed to investigate the difference in motor unit firing patterns between community-dwelling older individuals with normal and low skeletal muscle mass. Sixty-six older adults (62–90 years) performed muscle strength and function tests. On conducting high-density surface electromyography of the vastus lateralis, individual motor unit firing properties were assessed. Individual motor units were divided into three different recruitment threshold groups and their firing rates were compared. The skeletal muscle quantity and quality were assessed using bioimpedance methods and ultrasound images. They were divided into two groups according to sarcopenia criteria: a normal group (n = 39) and presarcopenia group with low skeletal muscle mass but normal physical functions (n = 21). Skeletal muscle mass and muscle thickness were greater and echo intensity was lower in the normal group than presarcopenia group. Motor units in normal older adults fired at different rates with a hierarchy depending on their recruitment threshold, observed as a normal phenomenon. However, motor units in the presarcopenia group fired without showing the hierarchical pattern. The results suggest that older adults with low skeletal muscle mass exhibited an abnormal neural input pattern, in addition to declines in muscle quantity and quality. [ABSTRACT FROM AUTHOR]

Objective: The present study was designed to examine the prevalence of sarcopenia in patients who have Diabetic Neuropathy (DN); and to determine the relation between DN and sarcopenia.Material and Methods: A total of 602 diabetic patients (mean age 60.2 ± 10.6 years; 40.5% male) were included in the study, which was designed as a cross-sectional study. The body composition was measured with the bioimpedance analysis method, and the muscle strength was measured by evaluating the hand grip strength. Those who showed only reduced handgrip strength were categorized in the s-presarcopenia group, whereas patients with only muscle volume loss were categorized in the v-presarcopenia group, those who had them together were defined as sarcopenia; and sarcopenia that was accompanied by obesity was defined as sarcopenic obesity. DN consisted of Diabetic Sensorimotor Polyneuropathy (DSPN) and Diabetic Autonomic Neuropathies (DAN) as two large groups. DAN consisted of its sub-groups of Cardiovascular Autonomic Neuropathy (CV-AN), Gastrointestinal Autonomic Neuropathy (GI-AN), Genitourinary Autonomic Neuropathy (GU-AN), Sudomotor Autonomic Neuropathy (SM-AN), which were identified with their own methods. Logistic regression analyzes were carried out to determine the relations of DN and its subgroups with sarcopenia and its components.Results: The DN prevalence was determined to be 85% in the entire patient population; and it was 80.2% in those who had normal muscle mass and strength, 84.4% in s-presarcopenic patients, 82.1% in v-presarcopenic patients, and 94.1% in sarcopenic patients. On the other hand, DN prevalence was 89.2% in non-obese sarcopenics; however, it was determined as 95,9% in sarcopenic obese patients. Similarly, the DN prevalence of non-sarcopenic patients was determined to be 76.7% in non-obese patients; and 88.5% in those who were obese. The sarcopenia incidence in patients who had DN was higher at a significant level than in those without DN (24.7%-8.9%). In the multivariate logistic regression analyzes, DN was determined to be associated with sarcopenia, independently from age and gender, even from accompanying concomitant diseases, BMI, Ha1c and GFR levels (OR: 2.38, 95% CI: 1.02-5.54).Conclusions: The present study revealed the relation of sarcopenia with DN, especially with GI-AN and GU-AN. [ABSTRACT FROM AUTHOR]

Objectives: Sarcopenia is an aging-induced decrease in muscle mass that increases frailty and fall in elderly people. Presarcopenia corresponds to the preliminary stage of sarcopenia. The purpose of this prospective study is to examine predictors of presarcopenia in health screening. Methods: The subjects were 124 community residents aged ≥60 years (55 males, 69 females, average age 70.2 years) who attended local government health checkups in 2010 and 2015, as part of the Yakumo study, and did not have presarcopenia in 2010. Body mass index (BMI), waist and hip circumferences, grip strength, bone mineral density (BMD), 10-m gait time, back muscle strength, and stride length were measured. Presarcopenia was defined using the appendicular skeletal muscle index (arm and leg skeletal muscle mass/height²). Results: The prevalences of presarcopenia in 2015 in males and females were 21.8% (12/55) and 30.4% (21/69), respectively. BMI, grip strength, BMD, back muscle strength, and osteoporosis deteriorated significantly more in the pre-sarcopenia group (n=33) compared with controls (n=91; no presarcopenia in 2015). In multivariate analysis, osteoporosis (OR 3.12, 95% CI 1.07-9.09; p<.05) was significantly associated with presarcopenia after 5 years. Conclusions: Establishment of risk factors for future pre-sarcopenia may allow development of evidence-based prevention strategies for this condition. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the anthropometric, body composition, and somatotype characteristics of Japanese young women and to focus on normal-weight obesity syndrome and sarcopenia diagnosis criteria. A total of 124 Japanese university freshmen women were measured at body mass index (BMI), percent body fat and skeletal muscle index (SMI), usual gait test, and handgrip strength. The subjects were divided into obesity (≥30% body fat; BMI: ≥25.0 kg/m2), normal-weight obesity (≥30% body fat; BMI: 18.5–24.9 kg/m2), sarcopenia (handgrip, <18 kg; gait speed: ≤0.8 m/s; SMI: <5.7 kg/m2), or presarcopenia (SMI: <5.7 kg/m2). There were no subjects below the sarcopenia diagnosis criteria in usual gait speed, but not for handgrip (0.8%) and SMI (36.3%). The prevalence of presarcopenia group (36.3%) is higher than in the normal-weight obesity (16.9%) and obesity (4.8%) groups. Anthropometry and sarcopenia diagnosis assessments were significantly higher in normal-weight obesity and standard groups compared with presarcopenia group. The number of young women was higher in the presarcopenia group than in the normal-weight obesity group, suggesting that the improvement of intrinsic skeletal muscle mass rather than fat mass is important for Japanese young women. [ABSTRACT FROM AUTHOR]

Objectives: This cross-sectional pilot study aims to investigate presarcopenia in female patients with rheumatoid arthritis (RA) and to evaluate its relationship to the disability assessment. Patients and methods: Forty female patients with RA (mean age 48.3±8.3; range 31 to 66 years) and 40 healthy controls (mean age 46.2±6.9; range 31 to 58 years) matched for age, sex, and body mass index were included. Pain, morning stiffness duration, disease activity score, erythrocyte sedimentation rate, C-reactive protein, and Health Assessment Questionnaire (HAQ) were evaluated. Body compositions were assessed with whole body dual energy X-ray absorptiometry. The appendicular skeletal muscle mass and skeletal muscle mass index (SMI) of RA patients were compared to the controls and possible correlations between SMI, disease characteristics, and HAQ score were investigated. Results: The body mass index values and percentages of obese, overweight, and healthy weight subjects were similar in the patient and control groups. However, appendicular skeletal muscle mass and SMI calculations were significantly lower, and the percentage of presarcopenia was significantly higher in patients with RA (20%) than controls (7%) (p<0.05). Although there was no significant correlation between SMI and other parameters, a significant negative correlation was determined between SMI and HAQ score in patients with RA (p<0.05). Conclusion: We demonstrated lower SMI values and higher presarcopenia ratios in patients with RA than healthy controls. Independent from other disease characteristics, the Inverse correlation between SMI and HAQ scores may contribute to understanding of the impact of the process on patient disability. [ABSTRACT FROM AUTHOR]

Objectives: This cross-sectional pilot study aims to investigate presarcopenia in female patients with rheumatoid arthritis (RA) and to evaluate its relationship to the disability assessment. Patients and methods: Forty female patients with RA (mean age 48.3±8.3; range 31 to 66 years) and 40 healthy controls (mean age 46.2±6.9; range 31 to 58 years) matched for age, sex, and body mass index were included. Pain, morning stiffness duration, disease activity score, erythrocyte sedimentation rate, C-reactive protein, and Health Assessment Questionnaire (HAQ) were evaluated. Body compositions were assessed with whole body dual energy X-ray absorptiometry. The appendicular skeletal muscle mass and skeletal muscle mass index (SMI) of RA patients were compared to the controls and possible correlations between SMI, disease characteristics, and HAQ score were investigated. Results: The body mass index values and percentages of obese, overweight, and healthy weight subjects were similar in the patient and control groups. However, appendicular skeletal muscle mass and SMI calculations were significantly lower, and the percentage of presarcopenia was significantly higher in patients with RA (20%) than controls (7%) (p<0.05). Although there was no significant correlation between SMI and other parameters, a significant negative correlation was determined between SMI and HAQ score in patients with RA (p<0.05). Conclusion: We demonstrated lower SMI values and higher presarcopenia ratios in patients with RA than healthy controls. Independent from other disease characteristics, the inverse correlation between SMI and HAQ scores may contribute to understanding of the impact of the process on patient disability. [ABSTRACT FROM AUTHOR]

Context: Low skeletal muscle mass often accompanies abdominal obesity in the aging process., Objective: We aimed to investigate the effect of reduced skeletal muscle mass and its interaction with abdominal obesity on incident type 2 diabetes., Methods: This retrospective longitudinal study included 36 304 diabetes-free Koreans who underwent 2 or more health checkups annually or biannually. Appendicular skeletal muscle mass was measured by bioelectrical impedance analysis and was presented as a skeletal muscle mass index (SMI) adjusted for body weight. Presarcopenia was defined as an SMI less than 1 SD of the sex-specific mean for a healthy young reference group. Abdominal obesity was defined using waist circumference greater than or equal to 90 cm for men and greater than or equal to 85 cm for women. Participants were classified into 4 groups of normal, presarcopenia alone, abdominal obesity alone, and presarcopenic obesity according to initial body composition., Results: The cumulative incidence of diabetes was 9.1% during the 7-year follow-up. Compared with the highest tertile, the lowest sex-specific SMI tertile was significantly associated with a greater risk of incident type 2 diabetes (adjusted hazard ratio [HR] = 1.31; 95% CI, 1.18-1.45) in a fully adjusted model. Presarcopenic obesity significantly increased incident diabetes risk (adjusted HR = 1.57; 95% CI, 1.42-1.73) compared with normal body composition, presarcopenia alone, or abdominal obesity alone., Conclusion: Low skeletal muscle mass and its coexistence with abdominal obesity additively increased the risk of incident type 2 diabetes independent of the glycometabolic parameters., (© The Author(s) 2022. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Summary: Data gathered from a nationally representative cohort demonstrated that subject with low skeletal muscle mass had consistently low femoral neck composite strength indices for compression, bending, and impact, especially in older women, supporting the highly integrated nature of skeletal muscle and bone. Introduction: Skeletal muscle and bone interact mechanically and functionally. The present study was performed to investigate the association between muscle mass and femoral neck composite strength indices using a nationally representative cohort. Methods: This is a population-based, cross-sectional study from Korea National Health and Nutrition Examination Surveys, including 1,275 Koreans (674 women and 601 men) aged 50 years or older. Femoral neck axis length and width were measured by hip DXA scans and were combined with BMD, body weight, and height to create composite indices of femoral neck strength relative to load in three different failure modes: compression, bending, and impact. Presarcopenia was defined as an appendicular skeletal muscle mass (ASM) divided by body weight that was less than 1 SD below the sex-specific mean for young adults. Results: After adjusting for confounders, women with presarcopenia had consistently lower indices for compression strength (CSI), bending strength (BSI), and impact strength (ISI) than women without this condition. Men with presarcopenia had a lower ISI value than men without presarcopenia. Multiple regression analyses revealed that lower relative skeletal muscle mass (ASM/weight) associated significantly with lower values for all three femoral neck composite indices in women and with lower CSI and ISI in men. Conclusions: These findings provide the first clinical evidence for the notion that age-related low muscle mass may increase the risk of osteoporotic hip fractures by decreasing femoral neck strength relative to load, especially in older women, and support the highly integrated nature of skeletal muscle and bone. [ABSTRACT FROM AUTHOR]

Background: Systemic inflammation and low skeletal muscle volume (presarcopenia) have received increasing attention in many malignancies. However, their association and the combined effect on postoperative survival in esophageal cancer (EC) patients have been poorly studied., Methods: Eighty-nine patients with EC who underwent surgery between 2006 and 2014 were included in this study. Neutrophil-to-lymphocyte ratio (NLR) ≥3.0 was categorized as having systemic inflammation. Presarcopenia was defined as a Skeletal muscle index (SMI) less than 52.4 cm 2 /m 2 for men and less than 38.5 cm 2 /m 2 for women., Results: Multivariate analysis revealed that presarcopenia was an independent prognostic preoperative factor for overall survival (OS) (p = 0.004). Multivariate analysis for OS stratified by systemic inflammation revealed that presarcopenia with systemic inflammation (Hazard ratio(HR),20.70; 95% confidence interval (CI),1.34-318.90) was associated with nearly a seven-fold higher risk of death than those without systemic inflammation (HR, 2.94; 95%CI, 1.04-8.34)., Conclusions: Systemic inflammation enhanced the effect of presarcopenia on the prognosis of EC patients. The combined assessment of those factors may have potential prognostic value for EC., Competing Interests: Declaration of competing interest The authors declare that there is no conflict of interest., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Objectives : Sarcopenia is an aging-induced decrease in muscle mass that increases frailty and fall in elderly people. Presarcopenia corresponds to the preliminary stage of sarcopenia. The purpose of this prospective study is to examine predictors of presarcopenia in health screening. Methods: The subjects were 124 community residents aged ≥60 years (55 males, 69 females, average age 70.2 years) who attended local government health checkups in 2010 and 2015, as part of the Yakumo study, and did not have presarcopenia in 2010. Body mass index (BMI), waist and hip circumferences, grip strength, bone mineral density (BMD), 10-m gait time, back muscle strength, and stride length were measured. Presarcopenia was defined using the appendicular skeletal muscle index (arm and leg skeletal muscle mass/height 2 ). Results: The prevalences of presarcopenia in 2015 in males and females were 21.8% (12/55) and 30.4% (21/69), respectively. BMI, grip strength, BMD, back muscle strength, and osteoporosis deteriorated significantly more in the pre-sarcopenia group ( n  = 33) compared with controls ( n  = 91; no presarcopenia in 2015). In multivariate analysis, osteoporosis (OR 3.12, 95% CI 1.07-9.09; p  < .05) was significantly associated with presarcopenia after 5 years. Conclusions: Establishment of risk factors for future pre-sarcopenia may allow development of evidence-based prevention strategies for this condition.

Objective: Low muscle mass has been associated with increased morbi-mortality and should be identified for optimizing preventive and therapeutic strategies. This study evaluates the prevalence of bioelectrical impedance analysis (BIA)-derived low muscle mass in older persons using definitions found through a systematic literature search and determines the link between body mass index (BMI) and low muscle mass., Methods: We performed a systematic search of trials involving ≥100 persons that derived low muscle mass from BIA and reported cut-offs for low muscle mass normalized for body height or weight. These cut-offs were applied to all adults ≥65 y who underwent a BIA measurement at Geneva University Hospital between 1990 and 2011 (N = 3181). The association between BMI and low muscle mass was evaluated through multivariate logistic regressions., Results: We identified 15 cut-offs based on the fat-free mass index (FFMI), skeletal muscle index (SMI), or skeletal muscle percentage (SMP). Depending on the definition, the prevalence of low muscle mass was 17% to 68% in women and 17% to 85% in men. The risk of low muscle mass increased with a BMI <18.5 kg/m 2 when using cut-offs based on FFMI (odds ratio [OR] ♀ 14.28-24.04/♂ 25.42-50.64) or SMI (OR ♀ 3.56-4.56/♂ 7.07-8.87) and decreased with a BMI ≥25 kg/m 2 (FFMI: OR ♀ 0.03-0.04/♂ 0.01-0.04; SMI: OR ♀ 0.18-0.25/♂ 0.14-0.18). The opposite association appeared between BMI and cut-offs based on SMP., Conclusion: The prevalence of low muscle mass varies widely depending on the definition, especially in persons with BMI <18.5 or ≥25 kg/m 2 ., (Copyright © 2016 Elsevier Inc. All rights reserved.)